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Pernicious Anaemia Society
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Help interpreting MMA test results please

Hello there,

I recently had an MMA urine test done via Medichecks and the results came back 'normal'. I no that that word is sometimes a bit hazy so just wanted to know what you kind folks thought about the following results:

Methylmalonic acid Urine: 0.42 mg/L

Creatinine: 0.17 g/l

Methylmalonic acid/creatinine: 2.5 mg/g crea < 3.7

Thanks for your help!

4 Replies

You don't provide ranges for most of the results.

The MMA test is actually quite good as a marker with very little risk of someone who has problems being in the range used.

So, very unlikely that your cells aren't getting enough B12


Neither of the tests, MMA or creatinine, require ranges. They use a sensible testing technique that give absolute values, unlike the biologupy-based tests for B12, etc.

The important range is the MMA/creatinine ratio which should be less that 3.76 mg/g. Your result is quite a way below that upper limit, so it looks like you don't have a B12 deficiency.

They use the ratio when testing a one-off sample rather than a 24 hr sample. As we all know urine can vary in concentration. The creatinine level compensates for any such variation.



Article on MMA


In Sally Pacholok's and JJ. Stuart's book "Could it Be B12" they mention in Chapter 1, patients with severe B12 deficiency with low b12 and normal MMA.

My personal experience was that I was highly symptomatic for B12 deficiency, majority of tests were normal range and I responded significantly when I got B12, some of my neuro symptoms disappeared so my personal view is that none of the tests for B12 deficiency are infallible.


Thanks for your comments guys. I'll discuss this all with my doctor when I go in to talk about my latest thyroid results which are also all 'normal' but not good.


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