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Methylmalonic Acid Test (uMMA) (A B12 Status Marker)
Do you know your number?
Your Vitamin B12 test results are reported in specific units. The units are mmol MMA/mol creatinine (cr). Optimal vitamin B12 status is indicated when the result is below 2.0 mmol MMA/mol cr. A result above 3.8 mmol/mol cr means B12 status is very low and should be confirmed with further testing.
What the Vitamin B12 Test Measures:
The Vitamin B12 test measures a substance called methylmalonic acid (MMA) in the urine, which is a specific indicator of low B12 status. The more MMA you have, the more likely you are to be low in this critical nutrient.
Optimal Vitamin B12 Levels Have Been Linked to:
Healthy cells
Heart
Nerves
Pregnancy
Brain
Why Test Your B12 Level?
Vitamin B12 is rich in many animal products, so vegans and vegetarians are at risk of having low B12 in their body unless they take a supplement. But most people are not vegetarians and eat enough B12 food sources to meet their needs. However, not everyone is able to absorb it.

Many different conditions, from autoimmune diseases to gut complications, can interrupt B12 absorption. Common medications like proton-pump inhibitors and metformin can also make B12 absorption more difficult. So, often dietary intake is NOT the reason someone has a functional B12 deficiency, which makes testing even more important.

It has been estimated that vitamin B12 deficiency is present in about 20% of the elderly population. Nearly 40% of 3000 subjects in the Framingham Offspring study, were found to be B12 deficient.

Why do we Test B12 in the Urine?
A substantial amount of B12 is stored in the liver and recycled by the body, potentially masking B12 deficiency for up to 10 years! Because of this, B12 levels in the blood don’t always respond quickly to a decrease in B12 absorption. MMA levels in blood and urine respond to functional B12 deficiency at the cellular level early on, so a nutritional solution can help avoid the worst symptoms related to B12 deficiency, such as brain fog and nerve damage.

Measuring MMA levels in the urine (and correcting for creatinine levels) helps reduce the chance that kidney issues are falsely increasing levels, which is not the case for blood MMA levels. This makes it easier to detect when it is even slightly elevated and a more sensitive test. It also doesn’t degrade for several weeks, so your sample will reach the lab in good time to be tested accurately.

Who is at Risk of a Vitamin B12 Deficiency?

Vegans and vegetarians are especially vulnerable to B12 deficiency because it is mainly found naturally in animal foods.

Pregnant women need more B12 to support their baby’s development.

Forty percent of people who take metformin for diabetes have B12 deficiency. This aggravates the neuropathy that is common in diabetes and can lead to serious problems.

People taking antacids or proton pump inhibitors (PPIs) for heartburn can also have B12 deficiency.

People who have had bariatric or other intestinal surgeries are more likely to have issues absorbing B12

Autoimmune diseases can also destroy the parietal cells in the stomach that make intrinsic factor (IF) causing a disease called “pernicious anemia”.

Elderly people can have a digestive system that doesn’t breakdown food as well, which can also contribute to a B12 deficiency.

Why B12 Testing Matters

Symptoms of B12 deficiency include lack of energy, weight loss, irritability, weak muscles and decreased appetite – view study

If left untreated, the symptoms of vitamin B12 deficiency tend to worsen and irreversible problems involving the nerves and brain may develop – view study

People at risk of B12 deficiency are those who have autoimmune disease, follow a vegetarian diet or take medications like Metformin – view study

Up to 40% of US adults could have a B12 deficiency – view study

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These statements have not been evaluated by the Food and Drug Administration. This test is not intended to diagnose, treat, cure, prevent or mitigate any disease. This site does not offer medical advice, and nothing contained herein is intended to establish a doctor/patient relationship. OmegaQuant, LLC is regulated under the Clinical Laboratory improvement Amendments of 1988 (CLIA) and is qualified to perform high complexity clinical testing. The performance characteristics of this test were determined by OmegaQuant, LLC. It has not been cleared or approved by the U.S. Food and Drug Administration.