Methylmalonic acid and the significance of the MMA test in vitamin B12 deficiency
This blog informs about the role of methylmalonic acid in the diagnosis of B12 deficiency, its normal values, and when the test is useful, including the differences between blood and urine tests.
The MMA test measures methylmalonic acid in blood or urine and is essential for detecting long-term vitamin B12 deficiency, especially when standard tests such as Holo-TC show no abnormalities.
Vitamin B12 is essential for proper functioning of the body, especially for the formation of red blood cells and maintenance of the nervous system. Vitamin B12 deficiency can lead to serious health problems, including anemia and neurological damage. One of the important markers to diagnose a B12 deficiency, especially when the deficiency has been going on for some time, is measuring methylmalonic acid (MMA) in the blood or urine.
What is Methylmalonic acid?
Methylmalonic acid is a substance produced in the body as a byproduct of the metabolism of fatty acids and proteins. Vitamin B12 plays a crucial role in the conversion of methylmalonic acid to succinyl-CoA, a molecule that is further used in energy production. When B12 is deficient, methylmalonic acid accumulates in the body, which can be measured in both blood and urine.
What is the Normal Value of Methylmalonic Acid?
The normal value of methylmalonic acid in the blood is usually between 70 and 270 nmol/L, depending on the laboratory. When MMA levels exceed these reference values, it may indicate a vitamin B12 deficiency. An elevated MMA level can be an early indication of B12 deficiency, even if other tests, such as the Holo-TC (Holotranscobalamin) test, are within normal limits.
When is the MMA Test Meaningful?
The MMA test is especially useful in cases where a long-term vitamin B12 deficiency is suspected, but standard tests, such as Holo-TC, show no obvious abnormalities. This may be the case, for example, in people who have had symptoms consistent with B12 deficiency for a long time, such as fatigue, memory problems, or tingling in the limbs, but whose Holo-TC values are still normal.
In cases of long-term B12 deficiency, the body may have already compensated for low B12 levels, making the Holo-TC test less sensitive. In such cases, elevated levels of methylmalonic acid in the blood or urine may be a better indication of deficiency.
Difference between MMA from Blood and Urine
There are two ways to measure methylmalonic acid: by blood test or by urine test.
- MMA in Blood: This test is commonly used and gives a direct measurement of methylmalonic acid in the blood. Its advantage is that it gives an accurate representation of the MMA concentration in the body at the time of the test.
- MMA in Urine: The urine test measures the amount of methylmalonic acid excreted by the kidneys. This test can be convenient because it is easier to collect than a blood sample, especially for people who are afraid of needles. However, values in the urine can vary depending on hydration status and kidney function, which can make the test less consistent.
Conclusion
An elevated MMA level can be an early indicator of vitamin B12 deficiency, especially when other tests such as Holo-TC show no abnormalities. The MMA test is particularly valuable in detecting long-term B12 deficiencies that might otherwise go undetected. Whether you choose a blood or urine test, measuring methylmalonic acid offers a more in-depth understanding of your B12 status and can be crucial for timely diagnosis and treatment.
At Bloedwaardentest.nl, you can easily order an MMA test to have your methylmalonic acid levels checked to better assess your vitamin B12 status.
