Pernicious Anaemia Society
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Understanding MMA results

I asked for an MMA blood test/b9 to be run since the doctors won't do much else than "standard blood tests" and I am just wanting opinions and a better understanding of the results! Thanks!

My result for MMA was '159 mmol/L' and the standard range is '< =400 mmol/L'

And Folic acid was '18.6 ng/mL' standard range is '> =4.0 ng/mL'

Thanks so much guys! Is there any way to get more tests run or ... what else can be done, my doctors do not take me seriously and do not give me any options and my symptoms, especially the (lack of) cognitive function, are getting worse... I am tempted to just ask for B12 injections however I am anemic and won't know if those will help if PA is a factor...

Thanks so much!

2 Replies

Your MMA is not significantly raised. That's a very good sign that you have enough B12 where it's supposed to be and that it's doing the job it's supposed to do while it's there.

Your folate levels are fine.

Are you being treated for your iron deficiency anaemia? That can cause fatigue, dizziness and weakness - all of which can affect the way the brain works.

You say you were diagnosed as B12 deficient in 2014, when your B12 levels were only just in range. But they are now well over 500 ng/L.

You could try asking for the jabs, but I doubt a doctor would agree being as both your serum B12 and your MMA are normal. Perhaps you could come to some agreement whereby he'll give you a trial of 9 injections over three weeks. If they make you feel better, then he'll do one every two months after. If they don't then you'll accept that it's not B12. It couldn't hurt and you may both benefit.

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The lower your b12 the higher your MMA and Homosistyne will be. You need more that Folic acid to metabolize b12. Iron, vitamin c and multiple others must be at good levels as well. Have you had your actual b12 levels checked? Please do not start b12 supplementation before you have this drawn. True PA is autoimmune so there are tests for that as well intrinsic factor, antiparietal cell antibodies are some words you can throw around, but these tests can sometimes be unreliable. It doesn't matter if it's autoimmune or low b12, symptoms need to be treated.

Good luck and feel better!!

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