Vitamin B12 - Active 58 pmol/L, MMA 54.0 ug/L

[bflare]

I have now received my results from Medichecks for Pernicious Anemia as below. I have underlined the results which are said to be out of range.

Red Blood Cells

Haemoglobin X 175 g/L (Range: 130 - 170)

Haematocrit X 0.506 L/L (Range: 0.38 - 0.5)

Red Cell Count 5.32 x10^12/L (Range: 4.4 - 5.8)

MCV 95.1 fL (Range: 81 - 98)

MCH 32.9 pg (Range: 27 - 33)

MCHC 346 g/L (Range: 300 - 350)

RDW 13.6 % (Range: 11.5 - 14.4)

White Blood Cells

White Cell Count 9.1 x10^9/L (Range: 3 - 10)

Neutrophils 6.7 x10^9/L (Range: 2 - 7.5)

Lymphocytes 1.60 x10^9/L (Range: 1.2 - 3.65)

Monocytes 0.7 x10^9/L (Range: 0.2 - 1)

Eosinophils 0.10 x10^9/L (Range: 0 - 0.4)

Basophils 0.1 x10^9/L (Range: 0 - 0.1)

Clotting Status

Platelet Count 240 x10^9/L (Range: 150 - 400)

MPV 10.50 fL (Range: 7 - 13)

Iron Status

Ferritin 86 ug/L

Vitamins

Folate - Serum 10.43 ug/L (Range: 3.89 - 26.8)

Vitamin B12 - Active 58 pmol/L (Range: 37.5 - 150)

Methylmalonic acid - Serum X 54.0 ug/L (Range: < 32)

Autoimmunity

Intrinsic Factor Antibodies <0.50 AU/mL

...............................................

I am awaiting the results of a Parietal cell antibody test.

Do these tests reveal anything further especially the B12 active and MMA?

[Asselchen]

MCV/MCH are both relatively high - might point to b12 deficiency, but not a proof.

Active b12 is is in a grey area - might be b12 deficient.

MMA is high - that is proof of b12 deficiency.

[Nackapan]

Mma result looks high .Not sure why it hasn't got a above range comment 🤔

Active B12 in range .

Perhaps FlipperD or someone else can comment and familiar with measurement used.

I read that as below 32 in range ? On your results.

IFA I thought would state positive or negative .

Interestingly pAs info would recommend this test for a PA diagnosis

Dr kleine's recent talk posted on here uses Parietial cell antibody test .

Neither seem robust or definitive unless a clear positive .

I thought 20% of those positive could be a negative for PA ( parietal cell )as this test shows other autoimmune conditions.

IFA we know picks up about 40- 50% of those with PA .

A positive is a firm diagnosis that it wouid appear more likely to get if caught early.

So I would query get explained your MMA result.

Also go by your symptoms.

I will be interested to see other replies on this .

[Orchard33]

Your ferritin is low, especially if you have indications of B12D. This means low iron stores which will give you anaemia-like symptoms.

[Nackapan in reply to Orchard33]

I was told to aim for above 50 ug/L ferritin

[Orchard33 in reply to Nackapan]

Opinions seem to vary, but around the 100 mark for PA people seems to be one consensus.

[Cherylclaire Forum Support]

MMA is above range. This can indicate renal problems (so need to be ruled out by blood test) or SIBO (small intestine bacterial overgrowth) - which can rob you of B12 and other vitamins, and can be ruled out by a fasting breath-test series ....... or it can indicate B12 deficiency.

This is why it is used as a secondary test if a B12 test result is borderline, but deficiency is suspected (on NICE advice).

My MMA tests showed constant levels of 350- 400 nmol/L (range 0-280 nmol/L) after B12 injections started, then dropped into range for my 6th and final MMA test, but it took 3 years to get there. My GP found raised MMA unusual and had only seen 2 cases in her career - but the Adult Inherited Metabolic Diseases consultants, who did my last test, were more familiar with it and had seen MMA many times higher than mine, which explains why mine was considered "raised" not high. I have no idea what my MMA was like before being given B12 injections.

Since my B12 injection frequency was increased, after the first test, to twice a week, I can only assume that it was this action that finally normalised my MMA. Nothing else as cause was found - renal problems being eliminated previously and SIBO later on. All else that may have explained even some of my symptoms was ruled out along the way (bowel cancer, Coeliac disease etc). No additional medication involved as nothing else found to treat.

I hope this helps.