Checking MMA

Would checking my MMA be a good guide, besides improvement of symptoms, as to whether my body was getting enough B12? My MMA was quite elevated at 0.88, when my B12 deficiency was diagnosed. I have been receiving weekly shots for 2 and a half months. Wouldn't that be a more reasonable way to tell if shots are effective and if my frequency of shots is adequate?

[fbirder]

Really, the only way to tell if your injections are frequent enough is the improvement of symptoms.

If your symptoms aren’t improving then either the B12 isn’t getting into the cells, or the symptoms aren’t caused by a lack of B12. Testing for MMA will give you a good idea of whether or not it is the former.

[Nackapan in reply to fbirder]

So if your MMA is in range the b12 should be getting to cell level.

Can this test be done any time ??

What if the mma test is above range?

More b12 and or further investigations?

[fbirder in reply to Nackapan]

If B12 is not getting into the cells then MMA will be raised. If MMA is normal then B12 is getting into the cells.

If MMA is raised it does not necessarily mean that B12 is not getting into the cells. There are other possible causes. Like pregnancy, kidney disease, certain genetic mutations. If B12 is not getting onto the cells then hCys will also be raised.

[Nackapan in reply to fbirder]

Thank you for clarifying that

[Hidden in reply to fbirder]

Yes, thank you, fbirder, you answered my question nicely.

[Retteacher]

Not really. The sensitivity of the MMA test in patients has not been properly determined. It goes back to a normal value very easily while symptoms still persist. For example, patients who have had bariatric surgery develop a B12 deficiency with low serum B12 and increased MMA. As little as 10 micrograms of cobalamin puts the MMA back to normal. Needless to say that level of supplementation does not treat the symptoms. In other words, it is not a suitable test for assessing the adequacy of injections - stick to whether or not the symptoms are improving/decreasing. Incidentally some researchers have speculated that the central nervous system is compartmentalized from the rest of the body in terms of absorbing the large cobalamin molecules. The cobalamin may be getting into most cells but not as easily into the CNS cells. Only speculation but interesting.

[Hidden in reply to Retteacher]

Thank you Retteacher, that is very interesting indeed.