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Pernicious Anaemia Society
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Is MMA ever wrong?

Hi there. I have a good number of symptoms that I believe line up with Pernicious Anemia. Before going to the Dr recently, I would have bet a good bit of money. I got word back that my MMA test came in at .14. What I understand to be a very normal level.

Is this test ever wrong?

I had read somewhere that sublingual B12 will throw this off. Is that right? I had been taking sublingual Methyl B12, loads of it, for days before getting tested. If this throws it off, is there another test I can request?

Thanks so much for your help!

8 Replies

yes, the sublingual is likely to affect the results.



This next link mentions that taking any B12 supplements before testing for B12 deficiency can affect results and make it difficult to get a diagnosis.





1 like

Of corse

You take extra B12 because you want a result.

MMA goding down is the best result.

You probobly already know you have a risk for B12 dificency.

But this result show you have enough


Best prof



Your pill works

MMA is a prof,


What I'm hearing is... The only way an MMA test can get thrown off is if your body is actually absorbing B12. So, basically it can't get thrown off because it's accurately showing that you are absorbing and utilizing B12. I was hoping there was a middle ground where the test was thrown off by sublingual B12, but you could still be overall deficient and be suffering symptoms of deficiency, because the day this test was drawn, I can conclusively tell you that my symptoms were active.



Another link that may be of use.

Flowchart from BSH Cobalamin and Folate Guidelines


Flowchart suggests that if secondary tests eg MMA, Active b12 and Homocysteine are normal range but there is a clinical response to B12 treatment then a continuation of treatment should be considered.

Something similar is suggested in link about MMA in my post above.

Think there may be something in Sally Pacholok's book "Could it Be B12; An Epidemic of Misdiagnoses" about patients with normal range secondary tests.



I'm convinced that B12 is involved in some other process than the MMA and hCys reactions. I need jabs twice a week to function properly, even though my MMA and hCys are both low every time I've been tested.

If I were to win 50 million quid I'd set up a lab to do some metabolomics research to try and figure out what, if any, difference there is between people like me, those who survive on two-monthly jabs, and people who don't need any extra B12.


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