Other names: Methylmalonic Acid or MMA
Methylmalonic acid (MMA) is a substance produced in very small amounts and is necessary for human metabolism and energy production. In one step of metabolism, vitamin B12 promotes the conversion of methylmalonyl CoA (a form of MMA) to succinyl Coenzyme A. If there is not enough B12 available, then the MMA concentration begins to rise, resulting in an increase of MMA in the blood and urine. The measurement of elevated amounts of methylmalonic acid in the blood or urine serves as a sensitive and early indicator of vitamin B12 deficiency.
This marker is considered superior to measuring serum B12 levels directly. A 2012 publication by Miller showed that 20% of those tested had a genetic defect in the protein that transports B12 to cells. These patients may have a functional B12 deficiency, even if serum levels of B12 are normal.
Elevated levels of methylmalonate may occur when there are nutritional enzyme inhibitions of the breakdown pathways, inherited low-activity enzymes are present, if there are high levels of precursors (branch-chain amino acids, methionine, threonine), or if there are higher levels of its downstream products (methylsuccinate). Digestive disorders may prevent the absorption of vitamin B-12 and raise levels. Methylmalonate can also be converted into CAC intermediary succinyl-CoA via enzymes dependent upon vitamin B2 and B12. High levels of methylmalonate can inhibit mitochondrial functions and may induce oxidative damage in nerves. High levels of urinary methylmalonate correlate with serum vitamin B12 levels in diabetics and may be an early indicator of diabetic polyneuropathy. If both urinary methylmalonate and serum or urine homocysteine (not measured) are elevated, enzyme blocks (nutritional, acquired, or inherited) are likely in B12 metabolism and the methylation pathway.
→ Support the conversion of methylmalonate into succinyl-CoA with vitamin B2 and adenosylcobalamin (B12). Dietary cobalt (cobalamin) is available is higher amounts in animal products.
→ Antioxidants can help decrease oxidative stress associated with nerve damage and diabetic polyneuropathy.
Own it for life
Our exclusive data entry service is a convenient way to get your results into your private dashboard. Simply attach an image or a file of your lab test results, and one of our qualified data entry team members will add the results for you. We support all sorts of files, whether PDFs, JPGs, or Excel. This service is excellent whether you have a lot of reports to upload or are too busy to do the data entry yourself.
We strive to make the data entry process easy for you. Whether by offering dozens of templates to choose from that pre-populate the most popular laboratory panels or by giving you instant feedback on the entered values. Our data entry forms are an easy, fast, and convenient way to enter the reports yourself. There is no limit on how many lab reports you can upload.
billed every month
Data entry included
$6.60/month billed annually
Data entry included
own it for life
Are You a Health Professional?
Get started with our professional plan
Welcome to Healthmatters Pro.
Save time on interpreting lab results with the largest database of biomarkers online. In-depth research on any test at your fingertips, all stored and tracked in one place. Learn more
Pro Monthly Plus
for health professionals
$75 per month