MMA testing

[Moggie]

Hi all,

I am seriously thinking about have the B12+ test done privately at St.Thomas Hosp, which consists of:-

Total B12, Active B12 and methylmalonic acid (MMA), but also folate (B9) and homocysteine.

My question is would taking 5,000iu oral B12 supplements render this test meaningless and therefore a was of my money.

Thanks

Moggie x

[Moggie]

Sorry that should have read "waste of my money"

Moggie x

[clivealive Forum Support in reply to Moggie]

A wiser person than I has commented previously:

Times for testing

"Taking supplements that contain B12 will affect any tests ordered by your doctor to assess your B12 status. You should not take any supplement with B12 before having your B12 assessed (including MMA/homocysteine/Active B12). For testing intrinsic factor antibodies: keep one week between an injection and the test".

For Folate I believe it's best tested before eating breakfast as many cereals are now fortified with folic acid,

I am not a medically trained person but I've had Pernicious Anemia (a form of B12 deficiency) for more than 46 years.

I wish you well.

[Moggie in reply to clivealive]

Thanks for the reply.

I am not find the paragraph you sent me conclusive as it just gives a time limit for the IF test of one week. The paragraph just states you should not take supplements before taking the MMA test, which is the test I am asking about, but what I want to know if how long before the test should I stop supplementing, or in fact should I stop at all, or if taking 5,000iu daily for the last three years will mean the MMA test will be compromised considering the amount of B12 I most probably have in my blood?????

I appreciate your help with this tricky question as I cannot even find a definite answer on my old friend goggle.lol.

Moggie x

[fbirder in reply to Moggie]

If your body is absorbing the B12 from the tablets, and if that B12 is getting into the cells in sufficient amounts, then it will affect your MMA levels.

How long you’d have to wait for the effects of the pills to wane depends on how much you’ve absorbed and whether your body can recycle B12 by enterohepatic recirculation (which it won’t if you have PA). Most people reckon three months as a minimum. If you’ve been absorbing most of those 5000 mcg (not iu) a day then your levels will be astronomical, so it may take a lot longer for them to drop.

The question is: Why do you want to do these tests?

[Moggie in reply to fbirder]

Hi fbirder,

Because I have a history of PA in my family, from my mum downwards, I have almost every symptom, I have Hashimotos (autoimmune thyroid illness) which gives me a 40% greater chance of having PA. I have been a vegetarian for 35 years and a vegan for 3.

The amount of falls I have had recently is ridiculous, with one ending up with me in hosp. My balance is totally shot to pieces, I am tired all day, my memory is nonexistent and if I don't sort this mess out I will end up having to give up work. I want to do these tests to rule PA either in or out as my GP, who did the IF a few weeks ago, refuses to do any more, and we all know that the IF test is not reliable (although she is referring me to a "falls clinic"!!!!). I watched my mum suffer with these symptoms and dealt with the amount of falls she was having until I got her diagnosed and sorted out with weekly injection and I recognise the same symptoms in me, which is why I started taking oral supplements. These stopped the symptoms for a few years but recently they do not seem to be working. My mum also had thyroid illness, she also had low vitd, as have I, and I have also been diagnosed with hypoferritinemia (normal iron levels with low ferritin levels). All the above points to my gut being in a mess and seeing as I am gluten, dairy, sugar, all processed food, legume and meat free my gut should be very healthy. My last lot of bloods showed my thyroid levels had gone up (not good), my ferritin levels have dropped, as have my vitd levels, but the amount of medication I take for these has not changed so something is wrong and like most medical problems the fight to get the right diagnoses is proving difficult. Maybe I have a folate problem but until I can get the right testing I cannot rule anything out.

I just want to rule out PA as a cause for all the above so I can work out where to go next because I know I cannot function as I am now.

Thanks for the reply.

Moggie x

[Gambit62 Administrator in reply to Moggie]

Unfortunately there isn't a good test for PA - which is a specific cause of B12 deficiency and just one of a number of absorption problem - albeit the most common - that will lead to a B12 deficiency.

The tests at St Thomas's are tests for B12 deficiency and they are likely to be skewed by high dose supplementation - at least 3 months without B12 supplementation - may be nearer 6 that is needed to get a base-line on active B12.

To be honest it is probably easier to rule other possibilities out than it is to demonstrate B12 deficiency.

[Moggie in reply to Gambit62]

Thanks for that, I had a long chat with a lovely lady at the test centre and she said , as I am taking high dosses of B12 it would show deficiency but would not show cause as B12 can get into your cells via other ways (sorry she did say the name but it was too long and complicated).

I am having a normal B12 blood test done next week at the GP's and if that does not come back sky high then my GP will have to look again at B12 issues. I know, due to other low vitamins, that I have absorption issues but finding the cause will be near on impossible.

Thanks for your help in this, it's much appreciated.

Moggie x

[Dadvatar]

Yes definitely!

We learnt the hard way with my daughter. She has an un supplemented test result of 127 and after 1 week of 4mg per day sub lingual methyl cobalamin it went up to 255.

NHS did not want to know after that.

Even though the result was higher her symptoms were no different if not slightly worse.

Probably better spending your money elsewhere.

[Moggie in reply to Dadvatar]

Thanks for the reply,

Am having a normal B12 test done next week at the GP's and will wait and see what that throws up because if the reading isn't sky high then something is definitely wrong. Will then have the other tests done, even though it wont prove PA, because it will still pick up a deficiency in the cells.

Thanks for the reply, it's much appreciated.

Moggie x