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What Does My Methylmalonic Acid Test Report Indicate?

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Posted on Tue, 29 Mar 2016
Question: My doctor ordered a Methylmalonic Acid test because I have been having symptoms of neuropathy and shortness of breath. The test came back low (67) which I think would mean high vitamin B12. My B12 test was normal. I don't take any viatmin b12. Just calcium plus Vitamin D and some other medications for COPD and GERD. What does that methylmaconic score mean?
doctor
Answered by Dr. Dariush Saghafi (17 minutes later)
Brief Answer:
Low or normal MMA simply means NO B12 deficiency.

Detailed Answer:
Good evening and thank you for your question.

In actuality there is little interpretation or even NEED to interpret a low or low normal MMA.

When we are trying to assess for B12 deficiency we are concerned about LOW vitamin B12 which is a true low reading. This is why we get the MMA in addition to homocysteine levels. If I had ordered the testing on you I would've ordered a Homocysteine as well. A HIGH MMA or homocysteine suggests that B12 is truly low even if readings are NORMAL. or LOW NORMAL.

I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload images if you like but just keep in mind what I've said about that process and call TECHNICAL SUPPORT if necessary.

Otherwise, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback. In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my response.

Write to me any time at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered.

Many thanks for using this service to ask your questions. Be well.

This consult request has taken a total of 11 minutes of time to read, research, and respond.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dariush Saghafi (3 minutes later)
So the conclusion is that my neuropathy is not being caused by a Vit B12 deficiency.
doctor
Answered by Dr. Dariush Saghafi (8 hours later)
Brief Answer:
Your conclusion is correct

Detailed Answer:
Thank you for the return comment and YES, you are correct. With a low level of MMA and normal levels or even LOW NORMAL levels of Vit. B12, the correct conclusion of interpreting those 2 tests together is that the body stores of Vit. of B12 are probably NORMAL and therefore B12 deficiency is ruled out and hence not a likely cause of any neuropathic condition.

But again, having said that...I also mentioned to you that in general when I do corroborative B12 assays I tend to choose BOTH Homocysteine and MMA. In that way, all I'm looking for is that ONE of those tests becomes elevated to help me diagnosis a B12 deficiency. My threshold for B12 deficiency, however, is up to about 350 while there have been authors concluding that the cutoff number should be raised to 400. I've not found that to be true in my patient population over nearly 5 years of testing since those newer guidelines have come out so I stick with the more traditional XXXXXXX Guidelines.

You could ask your doctor to order a homocysteine (can be done in both blood as well as urine).....if in urine, the specimen has to be obtained fresh and processed by the lab in 30 min. or less so it's best to go get that test done (if ordered) directly to the lab. Others can be drawn in the doctor's office and held for up to 24 hrs. before processed.

I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload images if you like but just keep in mind what I've said about that process and call TECHNICAL SUPPORT if necessary.

Otherwise, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback. In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my response.

Write to me any time at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered.

Many thanks for using this service to ask your questions. Be well.

This consult request has taken a total of 20 minutes of time to read, research, and respond.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2473 Questions

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What Does My Methylmalonic Acid Test Report Indicate?

Brief Answer: Low or normal MMA simply means NO B12 deficiency. Detailed Answer: Good evening and thank you for your question. In actuality there is little interpretation or even NEED to interpret a low or low normal MMA. When we are trying to assess for B12 deficiency we are concerned about LOW vitamin B12 which is a true low reading. This is why we get the MMA in addition to homocysteine levels. If I had ordered the testing on you I would've ordered a Homocysteine as well. A HIGH MMA or homocysteine suggests that B12 is truly low even if readings are NORMAL. or LOW NORMAL. I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload images if you like but just keep in mind what I've said about that process and call TECHNICAL SUPPORT if necessary. Otherwise, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback. In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my response. Write to me any time at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered. Many thanks for using this service to ask your questions. Be well. This consult request has taken a total of 11 minutes of time to read, research, and respond.