A Methylmalonic Acid Test 
For B12 Deficiency is Useful, but

The Methylmalonic Acid Test, also called an MMA Test, is really the ONLY accurate test for Vitamin B12 Deficiency that there is- and it's certainly the ONLY one to which you should trust your health!

What is Methylmalonic Acid?

Also called Methylmalonate, is a waste product that builds up in the blood and is excreted in the urine when Vitamin B12 is not available to transform into the energy metabolite Succinic Acid. Because it begins to build up within ten days after a Vitamin B12 deficiency begins, it is not only the most accurate marker, but it is the EARLIEST detectable marker of Vitamin B12 deficiency.

And because Methylmalonic Acid is found in both blood and urine in amounts relative to the degree of deficiency, both urine and blood tests are good tests for Vitamin B12 deficiency, however, they still have their limitations, and they still can't tell you if you will BENEFIT from taking vitamin B12, and in particular Methylcobalamin B12



All Vitamin B12 Tests 
Are Not Created Equal

Essentially there are 3 Vitamin B12 Tests that really matter:

While MCV tests and Vitamin B12 Levels are more common, they are actually less accurate! But doctors have a 'standard of care' that they abide by. And that standard includes getting an inaccurate Vitamin B12 Level only if there is a condition present called Macrocytic Anemia, that shows up on the MCV blood test. But macrocytic anemia often doesn't show up for nearly TWO YEARS after vitamin b12 deficiency begins!

Then, they will ONLY get an MMA Test IF the Vitamin B12 Test is abnormal. Unfortunately, the Vitamin B12 Test is rarely abnormal except in cases of SEVERE deficiency. In more subtle cases, or in someone who only RECENTLY became vitamin B12 deficient, it will be normal! And in cases of about 33% of the population with the MTHFR Gene mutation, the Vitamin B12 Level can even be HIGH in the presence of a serious vitamin B12 deficiency. How confusing is that when you can be deficient in Vitamin B12 with a low, normal, or high Vitamin B12 level! 

Why is the Methylmalonic
Acid Test Better?

Rather than have ME tell you why the MMA Test ais a much better choice to test Vitamin B12 levels, I'll let the research speak for itself.


Quotes from research studies.

  1. "If serum MMA... levels are elevated, a therapeutic trial of vitamin replacement therapy may be undertaken."(1)
  2. "MMA, being more specific, is preferable for assessment of cobalamin status."(2)
  3. "we found that a urine MMA Test... was a simple, rapid, convenient, specific and sensitive method for the diagnosis of cobalamin deficiency."(3)
  4. "MMA levels are a good indication of cobalamin distribution and function... With rapid, reliable quantitation..., urinary MMA can now be a useful clinical test."(4)
  5. "Many elderly people with "normal" serum vitamin concentrations are metabolically deficient in cobalamin..."(5)

Not to mention the fact that a Vitamin B12 Level must be done on blood. As an Alternative to Blood Test the convenient Methylmalonic Acid Test can be done right in your own home- painlessly using a single urine sample, and there is no need to talk to your doctor to get it. It's an especially great test for use on children and the elderly, since it's completely painless and you can order it and perform the test right in your own home.



MMA Still Has it's Limitations

The Methylmalonic Acid Test STILL has it's limitations, though. While it is a great test for determining if you have Vitamin B12 deficiency, it still cannot tell you whether you will BENEFIT from taking Vitamin B12. You see, Vitamin B12 does more than just resolve Vitamin B12 deficiency. In particular, a form of Vitamin B12 called Methylcobalamin B12 has a myriad of beneficial effects on the body, including detoxification and protecting neurologic function. Vitamin B12 Deficiency Treatment in extremely high doses, completely separate from any deficiency, has improved or reversed health conditions as diverse as fatigue, all the way to Mental Changes from Vitamin B12 Deficiency

So, if you INSIST on being tested for Vitamin B12 deficiency, then the MMA test is going to be the best test that you can do, however, it's still not going to tell you if you are going to benefit from taking Vitamin B12. Keep reading to find out why Methylcobalamin B12 can benefit almost everyone in a variety of ways. 

Next ---> 

Take the Right KIND of B12 

Vitamin B12 Resources

  • Beyond B12, Methylcobalamin Supplements- Vitamin B12 SHOULD be taken in the form of Methylcobalamin. Don't take anything less! This formulation has Folic Acid, Biotin and Vitamin B6 as well.
  • Accurate In-Home Vitamin B12 Testing- If you insist on being tested for Vitamin B12 Deficiency, this test is not only the most sensitive vitamin B12 test available, but it it done Right in Your Home using a single urine sample! 
  • 23andMe Genetic Test- Genetic testing for the MTHFR Gene is becoming more and more important, as it's being recognized as a significant cause of vitamin B12 deficiency, and many chronic illnesses. Get your test and be informed. 



Already Answered Questions about Vitamin B12

Click below to see already answered questions about Vitamin B12?

Does methylmalonic acid level decrease so quickly? 
I had a blood work in January and was diagnosed with anemia, with slightly low RBC and slightly high MCV. My PCP recommended me to take B12 and iron without …

B12levels after 6 loading doses 
My initial B12 blood test was 136 pg. I have had 6injections and it has risen to 606 is this a metabolically useful level. My GP has stopped any repeat …

Research Used for this page

(1)Laboratory Diagnosis of Vitamin B12 and Folate Deficiency

(2)Evaluation of Indicators of Cobalamin Deficiency Defined as Cobalamin-induced Reduction in Increased Serum Methylmalonate

(3)Quantitation of urinary methylmalonate by gas chromatography mass spectrometry and its clinical applications

(4) Cobalamin (vitamin B12) deficiency detection by urinary methylmalonic acid quantitation

(5)Prevalence of cobalamin deficiency in the Framingham elderly population

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