MMA test

[Zengirl65]

My MMA has been .7 the last two times it was tested should be under .3 but since taking the B12 my blood test for the B12 it’s self has gone from 364 to 1100 has anyone brought down there MMA number after reviving B12 or will that always stay higher when having PA? This is all new to me

[EllieMayNot]

Are you having B12 injections or taking it orally? If you are having a difficult time getting the B12 into your cells, then MMA might be increasing due to taking the B12 orally rather than by injection. If you are injecting, I am hoping someone else on this forum has more knowledge and can educate us all as to why your MMA may be testing higher after injections.

[Zengirl65 in reply to EllieMayNot]

Hi I am doing sublingual because I had a bad reaction to the injections my MMA is staying the same from the last test 3 months ago it has gone down by two points prior to the last two tests that were done quite a while back I was just wondering if it should go a lot lower and how long it takes I’ve been doing the sub lingual for about three months and it’s definitely improved the B 12 levels just has not changed the MMA

[EllieMayNot in reply to Zengirl65]

Unfortunately, blood levels do not indicate cellular levels. I had been supplementing orally with no effect on my symptoms, MMA or Hcy levels at all although my blood level looked great. Only by injecting have I had any improvements.

Sleepybunny has a lot of posts and replies with numerous links on B12 education.

Here is short list of references on this forum:

healthunlocked.com/pasoc/po...

Some individuals have different experiences injecting different forms of B12. It is definitely not a one form suits all type of thing. If you have only tried one form of B12 injection, you may want to look into others.

Hope you find the right treatment to suit your needs.

[fbirder]

The sublinguals are definitely getting the B12 into your blood.

There are other reasons why MMA might be slightly elevated, although you would probably know if you were pregnant. Have you had a kidney function test recently?

It may be a functional B12 problem, where there is plenty in the blood, but it's not entering the cells. A homocysteine test will tell you if that is a possibility. If hCys is normal then there's definitely B12 getting into the cells.

But, as we often hear, treat the symptoms, not the numbers. Are your sublinguals helping with symptoms?

[natcap1 in reply to fbirder]

Hi, do you know anything about low homocysteine? I have just had this tested and it is just off the bottom of the scale. A very cursory google about this says that this is also not good, particularly for the nerves (and I am having a problem in this regard which I assumed was B12 but could possibly be an absorption problem). Just wondered if you knew anything about this. Or can one have too much folate/B12 (not in a toxic sense but more of a functional one).

[fbirder in reply to natcap1]

Although there is possibly a link between low levels of hCys (hypohomocysteinaemia - HH) and Idiopathic Peripheral Neuropathy - ncbi.nlm.nih.gov/pubmed/222... (Although this abstract is confusing as they say " Of patients with HH, 5.9% had IPN" then they say "Overall, 41% of patients with HH had IPN"). The correlation may be because whatever causes their IPN also lowers hCys, or it could be that the people with IPN are taking lots of B12 and/or folate which is known to lower hCys.

I can find not a single other study that backs up their findings.

I would take it with a very large pinch of salt.

[natcap1 in reply to fbirder]

Ok thats interesting. I assume that if I have lots of B12 in my blood that hCys will be low. So kind of a pointless test once injecting regularly?

[palmier]

How strong are your sublinguals? Keep in mind that only about 1 % is absorbed, so they're not as strong as they seem. Perhaps you need a higher dose initially, for the first month or so.

Maths: To compare injections and tablets you need to compare how much is retained from an injection with how much is absorbed from a tablet. Of a 1000 mcg hydroxycobalamin injection, an estimated 30 %, or 300 mcg, is retained. From a 1000 mcg tablet, 1 %, or10 mcg, is absorbed. So one such injection corresponds to 30 such tablets - though I don't think it's a good idea to take 30 tablets at once! A typical loading period of six injections should then correspond to a total of 180 tablets.

If you only take one 1000 mcg tablet a day it might take a very long to build up the levels and normalise the MMA. One tablet a day is probably more of a maintenance dose once the levels have been restored. I've seen recommendations of 4 tablets a day the first month somewhere, though it'd be a bit slower than six injections in two weeks, and not quite as much in total.

It's not for me to tell you how much you should take, but perhaps you could ask your doctor about taking a higher dose until your MMA has normalised.

[fbirder in reply to palmier]

The reason that only 1% is absorbed is because the Intrinsic Factor absorption is limited to about 10 mcg at a time. That is why all of the tests of the absorption of oral B12, or sublingual B12, show that about 1% of a 1000 mcg dose is absorbed.

That means that about 0% of a sublingual dose is absorbed sublingually. The 100% that isn't absorbed is swallowed and 1% of that is absorbed from the gut.

If any of it was absorbed sublingually then you would expect 1% of the 1000 mcg dose to be absorbed sublingually and 99% of it to be swallowed. Then 1% of the swallowed dose (9.9 mcg) would be absorbed. For a total of about 2% absorption.

But that's not what you see, Therefor B12 isn't absorbed sublingually. Which is no surprise because the B12 molecule is too large and too hydrophilic.

[palmier in reply to fbirder]

Actually, I think 1 % can be absorbed by passive diffusion across the mucous membrane and that people can absorb some b12 from pills. About 100 years ago pernicious anemia was treated by letting people eat large amounts of raw or lightly cooked liver every day. It wasn't nice, but the only way to get enough b12 from food before they figured out how to inject it.

I think it is the b12 produced by bacteria in the large intestine that can't be absorbed. This makes sense, because bacteria in that part of the digestive system can produce toxins that mustn't cross the wall of the large intestine or people would get sick.