Homocysteine and MMA testing? Feeling a bit lost!

[Gilly27]

Hi all, bit confused about how to proceed here. 6 months ago I had my full blood works done and my B12 came back deficient: 135 (187-883). They put me on 5 loading doses and a top up every 3 months (I'm currently due my 2nd top up). The problem is I still have a lot of debilitating fatigue, memory issues and general mood problems (I am also on antidepressants and have been for many years).

People have told me that my serum B12 levels are likely to remain high after injection so there's not much point in retesting, but there is a possibility it's not being used properly on a cellular level and the way to check this is to test homocysteine and MMA? Have I understood it correctly?

I asked my GP for the two tests and she said they can only request a Holocysteine test, not MMA (unless my B12 serum comes back low...which it won't?!). How do I proceed if I want to find out if I now have a 'functional deficiency' or just to persuade the GP to give me more frequent injections?

If I test my B12 and it comes back normal or high (which it most likely will after injections) I really worry they'll stop the injections altogether. She even said my initial result may have been an 'incidental result' and B12 might not be an issue, despite being the only thing that fits my symptoms.

(Incidentally, my iron was also quite low, though not deficient and I have just finished a 4month course of supplementation. Helped a little I think but wreaked absolute HAVOC on my tummy....).

[KimberinUS]

Iron and b12 were both originally low and you still feel crap after supplimenting both. If you white blood cell level is above 7.5 thousands/ul which is of coursr still in tange, please get checked for h pylori.

H pylori reduces stomach acid and causes malabsorbtion of b12 and iron and can cause stomach symptoms ranging from basically nothing to serious pain if it has caused an ulcer.

My b12 in Oct 2014, was originally 169 pg/ml with wbc at 9.5. I took b12 and folate tablets for 16 months before going back to the doctor in Feb 2016. By then I was forcing myself to exercise 3-4X weekly and i hurt everywhere!!! And i was only fast walking on a treadmill for an hour each time for prior 3 months. My results were b12 246 and wbc 7.7 but like i said, i felt worse!!! Only thing i can think of was i had laughing gas at dentist between tests which deactivates b12 and with the exercise my body was trying to heal itself but failing miserably.

I wasnt tested for h pylori until Aug 2017, after essentially demanding it, because i had no stomach pain. I was positive.

If you dont feel better it doesnt mean the b12/iron/folate won't work. It could just mean you have an underlying root issue that hasnt been addressed.