Just got my MMA result back from Medichecks: it's 103 ug/l (range <32 ug/l).
I dropped a letter off at my GP practice this afternoon enclosing the results and asked for B12 deficiency treatment.
I have Hashimoto's thyroiditis and trying to improve my fatigue and brain fog. The GP has done other blood tests but refused anything further with low B12. I know, its not a surprise...
So, should I expect any help from GP/ NHS? Or should I carry on sorting my health issues with advice from here? Frankly, I prefer sorting it myself but thats more necessity than choice!
How should I treat this? I've no issues injecting myself (used to be sheep farmer). Lolz
Thank you peeps
Written by
RexandBoone
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Give the G.P. a chance to address the information you sent him/her. If you haven't heard within a few days then I would consider treating yourself. It is always advisable that the first injection be administered in a medical environment. One thing when first starting on B12 your potassium levels tend to drop .... advise you to eat banana and high potassium food for a few weeks.
Good that you got this done prior to B12 injections. Shows a very high level.Methylmalonic acid (MMA) will show as high in serum if there is a lack of vitamin B12 there to make a link with it - so it will continue to build, waiting for the B12 that isn't there (or else is, but unable to form a useful connection: functional B12 deficiency at cell/tissue level). Having a Hashimoto's diagnosis makes pernicious anaemia (PA) the most likely answer.
Awful to say great that your MMA is so high....but it should prompt the following action/s from your GP:
Renal problems: blood test should have been done simultaneously to rule out this as another cause for rising MMA. If not, please ask for this, so that treatment can be started as soon as possible -for either cause.
B12 loading injections started - to bring up B12 levels and so bring down MMA levels. This should start happening very quickly, and you would want MMA to be back within normal range before a maintenance frequency for B12 injections is started.
Later -should the need arise to look for an alternative cause- a small intestine bacterial overgrowth (SIBO) test can be requested, if not by your GP then certainly by a haematologist/ gastroenterologist. This is a fasting series of breath tests over a few hours which will show a pattern plotted on a graph, which will then determine if you have SIBO or not. This does not rule out B12 deficiency - the bacteria are quite keen on robbing their host of B12 along with other vitamins - but although difficult to eradicate, can be cured by antibiotics -which of course can affect B12 levels ....so not the easy option one might hope for.
You may find that your folate and ferritin are a little erratic, you might want your vitamin D level checked (I had osteoporosis of the spine), and I guess you are already sorting out your thyroid condition anyway, but that would be the other thing.
All of the above, including MMA tests, are available through the NHS.
Thank you for all the info. Extremely helpful. On the back of my letter to the GP, I was contacted by the health centre to make a phone appointment with the GP. Oh boy.
There is a helpline number that PAS members can ring.
Links to forum threads where I left detailed replies with lots of B12 deficiency info eg causes and symptoms, UK B12 documents, B12 books, B12 websites and B12 articles and a few hints on dealing with unhelpful GPs.
Some links may have details that could be upsetting.
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seeing neurologist, advice on b12 injections welcomed…
Has anyone had insomnia from B12 injections?
About German online Pharmacies. — If they follow pharmaceutical rules rules,they are not allowed to supply U.K. with B12 ampoules! 
