Do you need to be clear for 4 months for MMA test?

[Ian232]

Hi, please can anyone tell me, is there any reason why I should not have the following blood tests?

Serum Active B12 (holo TC)

Serum Methylmalonic Acid (MMA)

Serum Total Homocysteine

I have not taken any B12 supplements since June 19, but had breakfast cereal fortified with b12 until about 3 weeks back.. I am just questioning if I have "Functional B12 deficiency", & I am getting a little desperate with symptoms to wait for another 2 months +!

Thank you.

[jade_s]

The "conventional wisdom" says to wait 4 months, but I'm not exactly sure where that comes from.

Ian - I don't think anyone here can say for sure. B12 metabolism is so individual - it's possible everything will come back low now, if you are a very poor absorber, or it's possible you could stay off tablets for 2 years and everything would still come back 'normal'.

I can't tell you what to do, but here's what I did because symptoms were unbearable and both arms had gone numb. Despite having been on sublingual B12 for years, I went ahead with private testing. As expected, everything came back 'normal', including IF ab. I started injecting anyway, because I figured that if it was a B12 issue, then my reponse to the injections would be sufficiently informative. And it was, so I continued. I have tested IF ab 4 times over the last 7 years, and it has always come back negative.

I'm annoyed that I have never had a low B12 test (normal mma, homocysteine 0.5 above range, aactive b12 normal), but I couldn't wait the 4 months, I was so ill. But really the only part that annoys me is that it's not on my medical record. I may regret that in the future.

[Nackapan in reply to jade_s]

Even though I've the first ever B12 serum test result on my medical notes it's still very much ignored at times.Well replete nod every fine !!

It was 106pg/mL ( 200-914)

This was only done 2 weeks after i collapsed after a failed Epley

manoeuvre.

Even then I clearly remember one G.p i saw and trusted up to that point saying it not particularly low .!!

What's thr point in the test if not believed or acted upon.

Even clearly under lab range.

He said

Probably a 'red herring '

Dietary.??

Loading doses of b12 didn't start immediately but after i just rung and booked them in . The same time as booking another consult.

There seems to be a 'blind spot '

Lack of training on this an understatement.

So k shouldn't worry too much about it not being on your medical notes.

You could always write a letter to your surgery.

Before and after b12 treatment.

Nothing else found.

Clinical response to B12

It should be scanned onto your notes .

Dates ect .

You were wise to act quickly

[jade_s in reply to Nackapan]

That's also a very good point Nackapan, thank you. And one of my relatives - even with a positive IFab test result, wasn't "allowed" injections more than once a month. 🤷

[Ian232 in reply to jade_s]

Hi Jade, & thank you so much.

I have been trying to contact my Doctor, but here in the UK everyone appears to be struggling to get seen.

I think I will try and pay privately & get the Serum Methylmalonic Acid (MMA) Serum Total Homocysteine tested to give me some results to go on. I have had a quick search, but it looks like I will have to get buy these at separate companies, & get the blood tests done at 2 different locations too.

I already have an active B12 Medichecks home test kit, which is the easy part.

It is so anxiety inducing being unwell, & it does not help not being able to get help as quick as we once did.

Thank you so much again!

[am111]

fortified breakfast should not affect results as the B12 amount is small and is also cyanocobalamin that increase serum B12 values only gradually as per tests, but any kind of high-dose supplements will. I think 2.5 months is a lot of time for things to stabilise after oral supplements especially, so you may get reliable results. I think the most unreliable are serum B12 results, others show how the cells are using B12, so should be more reliable. This is my understanding, but may be wrong.