Results MMA & Homocysteine


At last results are in and I would welcome your opinions, please. I feel these are not sufficiently, if at all, indicative of B12 issue and suggest my GP will not want to initiate any treatment, to be honest.

Results -

Oct 2016

Serum Vit B12 – 165 ng/L [197.0 - 771.0]

Serum folate level - >20 (4.6 – 18.7) ng/ml

March 2017

Serum Vit B12 level 215 ng/L [197.0 - 771.0]

Serum folate level 18.7 ug/L (<3 ug/L suggestive of folate deficiency)

HOMOCYSTEINE 14.6 umol/L [0.0 - 16.0]

MMA (METHYL MALONIC ACID) 0.16 umol/l (0-0.28)

Plasma MMA values of less than 0.29umol/L are

considered not indicative of B12 deficiency

I am also hypothyroid, prescribed Levothyroxine for many years and, therefore, wonder if my symptoms may be more Thyroid related, but involving a B12 issue, appreciating these are all interlinked.

Rather than duplicate posting and repeating myself, here is the link to the HU ThyroidUK post, if interested

Many thanks for any thoughts

Last edited by

6 Replies

  • Your raised Homocysteine level suggests B12 deficiency - in my non medical opinion. I have read that a level of single figures is preferred and that around 6 is considered optimal.

    Often raised in us Hypo folk as we are also low in other vitals - including B12 and VitD. My Hcy levels reduced once the thyroid was well treated. I am T3 only .....

  • "Plasma MMA values of less than 0.29umol/L are

    considered not indicative of B12 deficiency"

    Although hCys is a little high (but still in range) there are many possible causes for raised serum levels.

  • I agree with Marz, your Homocysteine is too high. irrespective of anything else - it is too high. It is a marker for vit B12 deficiency. B12 when active, converts Homocysteine back into Methionine. If you have a high homocysteine level 10 or over, this functional pathway is not working efficiently. Take a look at this article. You need to be proactive and bring your homocysteine down also check out the Food for the Brain website - I will post the link below

  • Food for the Brain link too - quoting studies - to help you with your GP. But basically you will have to manage this yourself as GP's / consultants don't have or have very little nutritional training. Lots of info on this site

  • Your homocysteine is within the normal range.

    All normal ranges are based on looking at the values for large numbers of people and all of them suffer from the fact that they are generalised pictures and there will always be problems applying the general to particular individuals.

    I don't know what the standard deviations are for the homocysteine test - which would give a measure as to how likely it is that someone falling into the normal range is actually B12 deficient is very small - unlike the situation with the serum B12 test - hence its use as a test for clarifying in the case of ambiguous results.

    That doesn't mean that it isn't impossible that - just that it is very unlikely that you are B12 deficient based on the homocysteine result above.

    Marz and LynneG please note.

  • Thanks, @Marz, @LynneG, @Eoaz and Gambit62

    I appreciate your thoughts. It's a shame these results don't really clarify my B12 status and, being within range, my GP will not be keen to instigate treatment.

    I think what I will likely do is to get some B12 sub-lingual or lozenge to try for a time. It would be interesting to see if my symptoms, particularly of fatigue, improved or not. I can't see there any harm in trying this.

    Can anyone recommend a sublingual product that is known to be reliable and effective, easily available in UK, please?

    Many thanks


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