Urine versus Serum MMA test?

[Sneedle]

Hello everyone,

Could anyone tell me if there is a reason either way to choose on of these tests over the other?

I'm thinking of getting my daughter to do one after her 6 loading doses of B12. As a baseline for if she does or doesn't respond much, and for going forward from here. I'm guessing the level should be low if she is responding?

Is it something I could use eg. if still high, to persuade a GP to do more frequent injections?

The GP I spoke to about my own health enquired for me about MMA testing and was told it's not available on NHS where we live.

Should homocysteine be done too?

This is a bit of a new stage and my brain fog is dreadful, so I appreciate anything which will help me decide!

Thanks.

[jade_s]

I've not looked into this so a quick search gives the following

medlineplus.gov/lab-tests/m...

labtestsonline.org.uk/tests...

and every other website I found mentions "serum or urine" so it may not matter much?

Yes Homocysteine is also useful, but MMA is more specific to B12D.

However her levels may be fine even if she needs more frequent injections. You may get lucky, like Cherylclaire, and find that MMA remains raised anyway.

Good luck

[Sneedle in reply to jade_s]

Ooooh you're quick!

Thank you😀

[Gambit62 Administrator]

urine was recommended in the past because it was easier to look at other metabolites at the same time to check that raised MMA isn't due to kidney issues.

[ktwing]

Hi  Sneedle , I remembered that in the Sally Pacholok book, urinary MMA is recommended and couldn't remember why so I looked it up and it says:

"According to Dr. Eric Norman of Norman Clinical Lab, Inc., MMA is 40 times more concentrated in the urine than in the blood, and the urinary MMA (uMMA) is the preferred test over the serum MMA."

Pacholok, Sally M.; Stuart, Jeffrey J.. Could It Be B12?: An Epidemic of Misdiagnoses (p. 11). Linden Publishing. Kindle Edition.

Apparently it can be useful, and there is also this warning note:

"Moreover, the serum MMA also has limitations and can cause false positives and false negatives. The specificity of these tests is debated.13, 14, 15 We have seen symptomatic patients denied treatment because their serum B12 was in the “gray zone” and their urinary MMA, serum MMA, and/or homocysteine (see next section) was normal, only for these patients to return many months later in worse shape and with tests showing deficiency."

Pacholok, Sally M.; Stuart, Jeffrey J.. Could It Be B12?: An Epidemic of Misdiagnoses (p. 12). Linden Publishing. Kindle Edition.

I'm not sure if that helps - testing is such a minefield! Urine is potentially easier to collect at least...

[Sneedle in reply to ktwing]

Thank you ktwing for putting all that into text for me!It does help...yes a minefield.

When you read the last part it seems for some people the only indication is symptoms, until they are so ill it shows up on a b12 level.

Yes if I do buy a test, I think urine will be the way to go.