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Pernicious Anaemia Society
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Test Results

Hi All,

So I got my Total Homocysteine test results back today and my MMA Urine test results.

Both Normal apparently. Can anyone confirm that they are within normal range or if there are any anomalies. I kind of expected them to be normal really, due to my 8 weeks of injections, but still at least I've had them done.

Pathology Investigations

TOTAL HOMOCYSTEINE 6 umol/L [0.0 - 18.0]



MMA/CREATININE RATIO 0.8 * [0.2 - 2.4]



4 Replies

Hi Dan10. Yes, total homocysteine and MMA/Creatinine Ratio both within normal limits. (Optimum levels of homocysteine are below 10-12).

Did you have reference ranges for the other two? Look okay but difficult to be entirely sure without the actual reference ranges (don't get asked about urine results too often and don't have time right now to go look it up 😉).


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Hi Foggyme,

Thanks for the reply. I don't have reference ranges for the other two, I just copied and pasted directly from my patient page.

Everything appears to be showing as normal, but I guess it's going to after 2+ months of IM injections, eh?

Kinda stuck in a vicious circle.

Looks like I'm just gonna have to trial and error on my own with a variety of vitamins etc. and hope for the best. No-one I've seen, NHS, or private.. G.P. or Neurologist seem keen to investigate further, or entertain other possibilities, since my Brain/Spine/bloods and urine have all come back normal.

Wish me luck.

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Hi Dan10. Yes, sending luck your way...but better than luck...are you sure that you're having enough B12...perhaps more frequent B12 injections may help. Prime indicator that you need more frequent injections is if your symptoms return prior to your next jab, and then get better once you’ve had it. The idea is to time frequency of injections so that you have them before symptoms return.

Also - if you have neurological symptoms, the treatment (following loading doses) is B12 injections every other day until no further improvement.

Couple of tips...

Vitamins - many here take a multi vitamin and mineral tablet daily. Some take 400mcg folic acid daily (though not everybody needs it). 5mg doses of folic acid are only for those with proven deficiency, and then only for a short time.

Take care with iron - best to take under medical supervision since GP can test levels to monitor and manage appropriate dosage (too much can be worse than too little - can cause iron overload).

Take care with vitamin B6 - over supplementation can cause peripheral neuropathy and potentially irreversible neurological damage. Some supplements contain 300%+ RDA - too much for most people. And even 100% RDA may be too much, if not needed.

Don't take B complex and a multi-vitamin/mineral tablet (multivitamin contains B vitamins so therefore taking both results in double dosing B vitamins.

Potassium - never take potassium tablets unless under medical supervision. Potassium finely balanced and too much can be as bad as too little (causes cardiac arrest). Best to get potassium from increasing potassium rich foods (if you think you need it).

Vitamin D - if you need to take this, some suggest taking vitamin K2 as well - but take care with vitamin K - shoudn't be taken if suffering from any blood disorder or taking warfarin (blood 'thinners'). Couple of other contraindications but can't recall so best to look up (drugs.com or Mayo clinic) if you're thinking of taking it.

Finally, good news that MMA and homocysteine are normal...high levels following B12 injections can be an indicator of functional B12 deficiency...so you can be reasonably certain that you don't have that 😉😀.

Sorry for slow reply...and perhaps stilted response...playing catch-up 'cause not always able to log-in as often as I'd like (at the moment).

So, again....good luck. Let us know how you get on...and post again if you need more support or advice.


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Hi Foggyme,

Thankyou for such an in-depth reply.

This is all really helpful information.

I am currently taking multi-vit every morning. I have a Vit B complex too, but haven't taken that for a few weeks now. I also have folic acid (which I bought/took briefly), but I heeded warnings I saw in this group re: FA, so aired on the side of caution and ceased that too.

I have a calcium Vit D3 tab that I take 2-3 times a week. But I haven't gone anywhere near Iron or potassium, as like you say, I try to get as much as I can from my diet.

My most recent additions have been K2 mk7 and magnesium (Again on advice that I got from here) and here's the funny thing. I took them on alternate days (Mainly because I try to feel my way through my taking of supplements so as I can monitor reactions/progress more accurately and easily, rather than bombarding my body with them) and after 4-5 days, I had my first ALMOST symptom free day. The pains in my joints were lessened, the pins and needles have been a little less prevalent, and my feeling sensation doesn't feel quite so alien. There may be some level of coincidence involved, but progress is progress. This was a few days ago and things definitely do seem on the up, I hope. I am certainly less convinced that this is P.A. now. I think my issues are more neuropathy based. My lifestyle has been a very sociable one for years, and I'm aware that alcohol can take it's toll on, well, lets be brutally honest, on everything. AND I was a smoker for 20 years, so I'm sure my body is far from peak shape. But I have calmed down a hell of a lot since these symptoms began. It's been a very scary wake up call, and I have barely touched a drop of alcohol since, and haven't touched a cig. I just hope I can rescue myself from the edge, if indeed this is the cause. If so, I guess I'm one of the lucky ones... although I do feel very much like the fool to have got myself into such a situation on a self inflicted basis.

Thanks again for your help and advice. Everybody on here is beyond helpful, and the information you have given me is invaluable. I've found over the past few months that the best course of action is, annoying as it may be, trial and error. Different strokes for different folks and all that. What's good for the Goose, isn't always good for the Gander it would seem. So, as you advised, I'm trying to gauge my own responses/progress/symptoms to my b12 shots and their regularity, and supplementing on a trial and error basis with any complementing additions, and just seeing how I feel, as it would appear that, as encouraging as test results are (and it is nice to receive 'normal' test results) your body, and the feeling of your own well-being is still THE best gauge of your current state available!!

Oh, lastly I am also on Gabapentin, which the Neurologist has prescribed for me, so I think I'm on the right track, I just hope my improvement continues.

Keep up the great work Foggyme, I've seen many of your replies to people's posts about their fears, concerns and problems on here. From where I was at 4 or 5 months ago, feeling so scared about my situation and getting very little help from my GP (Which I think is what brings most people to this site), yours and a few others advice on here, is more helpful than I think any of you are really aware. Having someone listen to your concerns and give you honest and relevant experienced advice, and mainly just having somewhere to turn, where it feels like people completely understand what you are going through, does nigh on as much to alleviate the symptoms as that first b12 shot.

Thanks again.


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