Home Test5 Amino Levulinic Acid 24 Hours Urine Test

5-Amino Levulinic Acid (5-ALA), 24-Hour Urine Test: Booking, Price, and Results

About 5-Amino Levulinic Acid (5-ALA), 24-Hour Urine Test: Booking, Price, and Results

Field	Value
Also Known As	Delta-aminolevulinic acid (δ-ALA), dALA, Delta-ALA, ALA Urine Test
Sample Type	24-hour urine collection
Fasting Required	No fasting required; avoid alcohol for 24 hours before and during collection
Report Time	4 Days
Recommended For	Adults of both genders; children if clinically indicated
Price	Starting at ₹4,500

What is a 5-Amino Levulinic Acid (5-ALA), 24-Hour Urine Test?

The 5-Amino Levulinic acid (5-ALA), 24-Hour Urine Test measures the amount of a compound called delta-aminolevulinic acid in urine collected over a full 24-hour period. This compound is the first substance formed in the body's pathway for producing haeme, the essential building block of haemoglobin in red blood cells.

Doctors order this test when they suspect porphyria (a group of disorders affecting haeme production), heavy metal poisoning, or certain inherited metabolic conditions. It is also known as the Delta-ALA test or ALA Urine Test. The sample required is a 24-hour urine collection, not a blood draw.

What Does a 5-Amino Levulinic Acid (5-ALA), 24-Hour Urine Test Measure?

This test measures the concentration of 5-aminolevulinic acid excreted in urine over 24 hours. Because ALA levels can shift throughout the day, a full-day collection gives a more accurate picture than a single spot sample.

The table below summarises what the test evaluates:

Component	What it Tells Us
5-ALA (delta-aminolevulinic acid)	The amount of this haeme-pathway compound excreted in urine over 24-Hour
Total daily excretion	Whether haeme biosynthesis is functioning normally or is disrupted

Why is a 5-Amino Levulinic Acid (5-ALA), 24-Hour Urine Test Done?

A doctor may request the 5-ALA test when a patient presents with symptoms that suggest a disorder of haeme production or exposure to certain toxins. The following sections outline the common reasons this test is ordered.

Common Symptoms That May Require This Test

Several symptoms may prompt a doctor to request the 5-ALA 24-Hour Urine Test. These include:

Severe abdominal pain with no clear cause
Pain in the back, arms, or legs
Nausea and vomiting
Rapid or irregular heartbeat
Muscle weakness or paralysis
Seizures or mental changes, such as anxiety and hallucinations
Fever alongside the above neurological or abdominal complaints

Conditions This Test Can Help Detect

The 5-Amino Levulinic acid test can help identify several conditions. These include:

Acute hepatic porphyrias, including acute intermittent porphyria (AIP), hereditary coproporphyria (HCP), and variegate porphyria (VP)
ALA dehydratase deficiency (ADP) porphyria, where ALA is elevated but porphobilinogen is not
Lead or mercury poisoning
Hereditary tyrosinaemia (a metabolic disorder affecting how the body breaks down the amino acid tyrosine)
Chronic alcoholism

5-Amino Levulinic Acid (5-ALA), 24-Hour Urine Test for Chronic Disease Monitoring

For patients already diagnosed with an acute porphyria, this test plays a useful role in ongoing monitoring. ALA levels may remain elevated for months or even years after an acute attack, and periodic testing helps track how active the disease is.

Doctors may also use repeat testing to assess how well a patient is responding to treatment and to identify early signs of a relapse.

How to Prepare and What to Expect

Preparing for the 5-ALA 24-Hour Urine Test is straightforward, but the 24-hour collection process does require some planning at home.

Do You Need to Fast?

No fasting is required for this test. However, you must avoid alcohol for the full 24 hours before and during the collection period, as alcohol can affect ALA levels in urine.

If your doctor has ordered additional tests at the same time, check whether those require fasting.

Practical Tips Before Your Test

Following these steps will help ensure your sample is valid and your results are accurate:

Avoid alcohol for at least 24 hours before beginning the collection
Avoid tyramine-rich foods such as aged cheese, red wine, and smoked meats for 24 hours before the test
Inform your doctor about all medications you are taking, particularly barbiturates, oral contraceptives, penicillin, and griseofulvin, as these can influence results
Plan your collection on a day when you will be at home to avoid transporting urine samples
Keep the collection container refrigerated throughout the 24 hours and protect it from light
Bring a detailed clinical history, including your symptoms, previous test results, and relevant family history, as this is required for the test

Step-by-Step Procedure

Here is how the 24-hour urine collection works:

On the morning you begin, empty your bladder completely and discard the first urine in the toilet. Note the exact time — this is your start time.
From this point onwards, collect every urine sample passed over the next 24 hours in the sterile container provided.
Keep the container refrigerated and away from light throughout the collection period.
The following morning, at the same time you started, urinate one final time and add this sample to the container.
A small 5 ml aliquot from the total collected urine will be taken and sent to the laboratory for analysis using column chromatography.
Hand over the sample to the Lupin Diagnostics collection team or drop it at your nearest centre as soon as the collection is complete.

Factors That Can Affect Accuracy

Several factors can interfere with the reliability of your results:

Incomplete urine collection during the 24 hours
Exposure of the sample to light
Failure to refrigerate the sample during collection
Alcohol consumption within 24 hours of the test
Certain medications, including barbiturates, oral contraceptives, griseofulvin, and penicillin

Understanding Your 5-Amino Levulinic Acid (5-ALA), 24-Hour Urine Test Results

Your results will show the amount of 5-ALA excreted in your urine over 24 hours. The table below provides general reference ranges used across laboratories.

Parameter	Reference Range	Unit
5-ALA (24-hour urine)	0.5 to 5.1	mg/24-Hour
5-ALA (24-hour urine)	0 to 60	µmol/day
5-ALA (adults, 24-hour)	1.0 to 7.0	mg/24-Hour

These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.

Elevated ALA levels may point to acute porphyria attacks, lead or mercury poisoning, tyrosinaemia, or chronic alcoholism. Low or normal levels generally suggest that haeme biosynthesis is proceeding without disruption.

Results During Special Conditions

Certain conditions can alter how results are interpreted:

Pregnancy may cause mildly elevated ALA levels due to normal physiological changes, even without any underlying disease.

During the latent (symptom-free) phase of acute intermittent porphyria, hereditary coproporphyria, and variegate porphyria, ALA levels may appear normal.

In hereditary tyrosinaemia, an abnormal metabolite called succinylacetone blocks ALA dehydratase activity, leading to elevated urinary ALA.

In children, urinary ALA does not rise until blood lead reaches 40 µg/dL; blood lead testing is a more sensitive indicator of lead poisoning in this age group.

How to Maintain Healthy Levels

These general wellness tips may help keep ALA levels within a normal range, particularly for individuals with a known porphyria diagnosis:

Avoid known porphyria triggers such as alcohol, prolonged fasting, infections, and certain medications
Maintain a steady carbohydrate intake and avoid crash dieting, as low carbohydrate intake can provoke acute attacks
Discuss any new prescription or over-the-counter medications with your doctor before starting them

Lupin Diagnostics 5-Amino Levulinic Acid (5-ALA), 24-Hour Urine Test Price and Home Collection

The 5-ALA test cost at Lupin Diagnostics starts at ₹4,500, and home collection is available in select cities. The table below lists approximate prices across major Indian cities for reference.

City	Approximate Price (₹)
BHOPAL	4500
CHENNAI	4500
HYDERABAD	4500
KOLKATA	4500
NAVI MUMBAI	4500
PUNE	4500

Prices are indicative and may vary by location. Please confirm the current price at the time of booking.

How to Book

Booking the 5-ALA test online with Lupin Diagnostics is simple:

Select the test on the Lupin Diagnostics website.
Choose your city and preferred time slot.
Opt for home sample collection by a certified phlebotomist, or visit your nearest Lupin Diagnostics centre.
Receive your report via email or WhatsApp within the stipulated turnaround time.

Home Collection

Lupin Diagnostics offers 5-ALA test home collection across multiple cities, so you can complete the 24-hour urine collection in the comfort of your own home. All samples are processed in NABL-accredited laboratories by experienced laboratory professionals. Your digital report will be delivered directly to you once ready.

Frequently Asked Questions

5-Aminolevulinic acid is the first compound formed in the body's pathway for producing haeme, the key component of haemoglobin. When this pathway is disrupted by disease or toxin exposure, ALA accumulates and spills into the urine. Measuring it helps doctors identify the underlying cause.

ALA levels naturally vary throughout the day, so a single urine sample may not reflect true excretion. Collecting urine over a full 24-hour period gives a more reliable and complete picture of how much ALA your body is excreting.

Keep the collection container refrigerated at all times during the 24 hours. Also, protect it from light exposure, as light can break down ALA and lead to inaccurate results.

Yes. Barbiturates, oral contraceptives, penicillin, and griseofulvin are among the medicines known to influence results. Always inform your doctor about any medications or supplements you are taking before the test.

No, it is not the preferred test for children. Urinary ALA does not rise until blood lead levels are already quite high, making it an insensitive marker in paediatric cases. A blood lead test is the recommended option for children.

Your doctor will compare your result against the reference range and consider your symptoms, medical history, and any other tests you have had. Do not attempt to interpret the result on your own. Always consult your doctor for a proper explanation.

Avoid alcohol completely for 24 hours before you start and throughout the collection period. Also, avoid tyramine-rich foods such as aged cheese, smoked meats, and red wine. Inform your doctor about all medicines you are currently taking.