Pernicious Anaemia Society
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MMA & B12 Results

I requested a MMA test & B12 test from the private sector. Results are ---

Vitamin B12 490ng/L (197 - 771)

Folate 11,8 ngmL >3.0

Methylmalonic Acid - Serum 0.19 ug/L <0.29

I receive three monthly injections from the NHS. The above test was taken approximately

seven weeks after the last injection..

Should the B12 be higher on injections? I would welcome your opinions.

5 Replies

I would have expected it to be higher - presuming that you probably start to feel grotty at least a month before your next injection is due - probably because that is the point at which most of the B12 has been removed from your system - so you probably do need more frequent injections. However, getting that through to a GP and even a haemo can be quite difficult.

1 like

Thank you for your reply Gambit62. I have experienced symptoms in the past few weeks. (injection due next week).

Could I supplement with sublingual during my last month, before three monthly injection? I have no idea which may be the best product Methycobalamin tablets?

I do not think I will be able to "get through" to my GP about the need for more frequent injections


absolutely nothing to stop you supplementing.

options as outlined by taka below - they don't work for everyone and different types of B12 can work better for some people than others.


I'm similar... B12 was just under 390ng/L range 8 weeks after my 6 loading doses. It was measured at 413ng/L at 8 weeks post injection in Aug 2016. As a result my GP agreed to 2 monthly injections (even though no neuro symptoms) from summer 2016 but was not willing to allow more frequently than that without input from a haematologist, even though I feel drained by ~6-7 weeks. Sadly the haemo replied a couple of weeks ago that there was no evidence for needing B12 more frequently than every 2 months. (Grrrrrr!) :-(

I keep having blood tests for non B12 reasons and my GP almost always throws in measuring B12 again. As a result I only infrequently supplemented B12 while I was initially struggling on 3 monthly injections and not since then as I didn't want to alter things by taking additional supplements and I was lobbying for more frequent injections. I've now started supplementing again since the haemo reply. So far my "B12 boost" spray (Methylcobalamin) gives me an annoying headache so I need to try something else - possibly hydroxocobalamin sublinguals?

There seem to be lots of options and strengths for supplementing - mouth sprays, nasal sprays, methycobalamin sublinguals and hydroxo sublinguals. There is always self injecting between GP injections too.


I am taking 1000ug Cyanocobalamin sublingual, (while waiting for the next injection); but it does not appear to be working for me. I am now considering 5000ug Methycobalamin, as my B12 blood test appeared to be rather low on injections. 490 (197-771).

Many thanks for your replies; and encouragement


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