Methylmalonic Acid, Serum

Optimal Result: 0 - 378 nmol/L.

What is Methylmalonic acid?

Methylmalonic acid is a compound that reacts with vitamin B-12 to produce coenzyme A (CoA).

What is Coenzyme A?

Coenzyme A is essential to normal cellular function. Coenzyme A is involved in hundreds of reactions and is required for the metabolism of fatty acids, carbohydrates, amino acids and ketone bodies. 

Why perform the methylmalonic acid test?

When vitamin B-12 deficiencies occur, methylmalonic acid levels increase. Measurement of methylmalonic acid through the methylmalonic acid test can provide your doctor with information about an existing vitamin deficiency, especially if the B-12 deficiency is mild or just beginning.

The methylmalonic acid test is more sensitive than the vitamin B-12 test. As a result, it’s better able to identify vitamin B-12 deficiencies at the lower end of the normal range. The methylmalonic acid test is often used along with the vitamin B-12 test or to clarify ambiguous vitamin B-12 test results.

The methylmalonic acid test may also be ordered if the results of other blood tests are abnormal. For instance, abnormal results from a homocysteine test may prompt your doctor to order the methylmalonic acid test.

What are Symptoms of B-12 deficiency:

  • cognitive impairment
  • gait or walking abnormalities
  • irritability
  • jaundice
  • peripheral neuropathy

What does it mean if your Methylmalonic Acid, Serum result is too low?

Lower than normal levels of MMA are not common and not considered a health problem. 

Methylmalonic acid (MMA) is a substance found in the body that is produced as a part of certain metabolic pathways, including the metabolism of some amino acids and fatty acids. It is converted to succinate by the enzyme methylmalonyl-CoA mutase, which requires vitamin B12 (cobalamin) as a cofactor.

A low level of MMA in the blood or urine is usually considered normal and is not typically a cause for concern.

What does it mean if your Methylmalonic Acid, Serum result is too high?

Although higher levels of methylmalonic acid may be an indication of vitamin B-12 deficiency, elevated levels may not warrant immediate treatment. Your doctor may want to monitor your methylmalonic acid levels to determine if your vitamin B-12 deficiency is progressing. Your doctor may also order additional tests to determine the cause of the deficiency. These tests include homocysteine and folate tests (there’s an indirect correlation between abnormal folate levels and abnormal B-12 levels).

 

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