Recent retest B12 over 1,000

[Zengirl65]

My dr diagnosed me with PA in February he recently retested my b12 and did another MMA test, my b12 serum went from 300 in February to over 1,000 this month and the MMA test is 0.7 it was only a point higher in February.... does the MMA test ever get better when having PA? Or will that always stay high even when getting B12 into your system.... is that good that my serum is over 1,000 now? Does that mean the B12 is working?

[fbirder]

Serum tests for B12 are pointless once you've started injections. All they show you is that you've got a lot of B12 going into your body. But you already know that - you can see a lot of B12 going in.

What units were the MMA test results in and what fluid was it measured in? Was it high back in February?

[Zengirl65 in reply to fbirder]

I’m not sure on how to read these tests they say <=0.3 umol/L is normal range and mine is 0.7

[fbirder in reply to Zengirl65]

That means that less than 0.3 is normal. Yours is greater than 0.3 and is, therefore, high.

There are other possible causes of high MMA. Ask your doctor.

[pvanderaa]

Are you taking folic acid to support the B12 doing its job processing off MMA and homocysteine?

[Gunj_redjem in reply to pvanderaa]

Is it necessary to take Folic acid with b12 as my folate is already high 24... even I’m not taking Folic acid

[deniseinmilden in reply to Gunj_redjem]

Everyone is different and if you are OK and your levels remain high then you (probably) don't need to take extra.

Pvanderaa was suggesting the folic acid because the MMA figure was only dropping slowly, suggesting that the B12 may not have been working optimally.

There may be something else limiting too so it would be worth considering a broad spectrum multivitamin and mineral supplement plus extra folate, potassium, magnesium and iron, maybe vitamin D ideally from dietary sources.

PS sorry this was so poorly written this morning - I've now (hopefully) corrected my typos!

[fbirder in reply to deniseinmilden]

Folic acid deficiency can affect hCys levels, but not MMA.

[Gambit62 Administrator]

Possible that you have functional B12 deficiency - get kidney function tested to rule out kidney problems as cause of raised MMA - if comes back negative then you need to keep B12 levels higher. This isn't uncommon in people who have had loading shots as raising serum B12 through loading shots can do something to affect the efficiency with which B12 transfers from blood to cells - so your cells don't have enough B12 at the moment. As its an effect on the efficiency of transfer more frequent injections should keep serum B12 levels high enough for enough B12 to get into the cells.

[Hanneke12 in reply to Gambit62]

Hi Gambit62 , would you perhaps have the scientific article explaining this? It could be useful for convincing my GP that I need more injections now...

[Gambit62 Administrator in reply to Hanneke12]

think this is probably the closest I can get

academic.oup.com/qjmed/arti...

is actually about using high B12 levels as a marker for conditions that will lead to raised B12 - eg liver and kidney problems - but it does show that functional B12 deficiency is a real thing. The mechanism isn't understood and I'm not aware of anything that formally says that keeping levels high in patients who have had loading shots and are showing signs of functional B12 deficiency.

this article covers patient who responded to keeping B12 levels high

pn.bmj.com/content/9/1/37 but I can only get as far as the abstract.

this article looks at incidence of holoT antibodies in patients being treated with injections whose serum B12 levels don't fall the way they would be expected to fall

bloodjournal.org/content/bl...

[Hanneke12 in reply to Gambit62]

Thank you so much!