• Welcome to Phoenix Rising!

    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

    To become a member, simply click the Register button at the top right.

MMA & B12

Messages
10
I have had MMA and B12 checked a few times. I have been getting B12 shots and then after a time they check after I had a low B12 shots were started. I am confused as to the correlation of MMA to B12. Both the MMA and B12 are low and doing the shots are making both go up but really slowly. I do have neurological symptoms so I do suspect a b12 deficiency is real but don't understand the low MMA then. Especially as when B12 goes up MMA goes up too.
 
Messages
10
My MMA went up when my b12 went up. I was getting weekly shots for a month and it barely went up too. Less than a 100. I switched to monthy shots at B12 went down. Dr has not gotten back to me about it but I suspect. I will have to next time try biweekly shots or they will want me to go back to weekly. Not looking forward to it as I have to go in clinic a 45 min drive and I can't drive so I need to find rides.
 

helen1

Senior Member
Messages
1,033
Location
Canada
What kind of B12 are you getting in the shots?

MMA shows your status of adenosylB12, so if you're getting shots of methylB12, it won't improve (decrease) your MMA levels.

I'm wondering if taking methylB12 (assuming that's what you're getting) which increases your cellular processes could decrease your adenosylB12 by doing so.

If you're getting cyanoB12, that can block methylB12 and adenosylB12 from getting into cells, so your MMA would get worse i.e. increase.
 
Messages
10
I am getting the cyno b12 shots. My b12 is going up but so is the MMA level. My MMA levels are out of range low. I am confused how I would have so many symptoms of b12 deficiency if MMA is low and that means no issue with b12 even if levels are low. It makes no sense to me.
 

Sushi

Moderation Resource Albuquerque
Messages
19,935
Location
Albuquerque
If you're getting cyanoB12, that can block methylB12 and adenosylB12 from getting into cells, so your MMA would get worse i.e. increase.
The problem may be that you are taking cyano. You may not be able to convert it to active forms (it needs something like 15 steps), but it could raise the "normal" B12 test levels as they measure total B12--even the forms that you cannot use.
I am getting the cyno b12 shots. My b12 is going up but so is the MMA level.
Rich Van K used to say that ideally MMA should be zero.
 

Sushi

Moderation Resource Albuquerque
Messages
19,935
Location
Albuquerque
Hi @Mandabear05,
If you use tagging (I tagged you above) or quoting, the people you are answering will get a message. This works well.

Why would MMA be zero ideally?
This is what Dr. Rich Van Konynenburg said. I don't have the references handy. It would basically indicate that you have good levels of adeno B12 which would probably indicate that you also had good levels of methyl B12.

I've inserted a bit that he wrote about measuring B12. It is interesting. I'm sorry, I don't have a link for it as I saved his posts from many different forums.

On the blood serum B12 measurement, it's true that it isn't very useful unless
it's low. If it's low, it indicates B12 deficiency. If it's normal or high,
though, it doesn't mean the the B12 situation is O.K. The reason is that there
are two carriers of B12 in the blood, transcobalamin and haptocorrin. Most of
the B12 in the blood is bound to haptocorrin, and this B12 is not accessible to
the cells of the body, except liver cells. Only the B12 bound to transcobalamin
can be given to the other types of cells in the body.

The other issue is that even though the overall B12 status may be O.K., it
doesn't mean that the B12 is being used properly in a functional sense. It has
to be taken into the cells, stripped first of its ligand (cyano, hydroxo, aquo,
methyl or adenosyl) and then converted to one of the coenzyme forms (methyl or
adenosyl). If there is a problem in this processing, the B12 will not be able
to be used properly. The best indicator of this is methylmalonate, as you
mentioned. If it's high, there is a problem in the production of
adenosylcobalamin, and that usually means that there will also be a problem in
production of methylcobalamin.
 
Messages
10
I am just confused because then low mma would mean my b12 low doesn't mean I have a deficiency but I have a deficiency because I have symptoms.
 

helen1

Senior Member
Messages
1,033
Location
Canada
@Mandabear05
There are 4 types of cobalamins or B12s. You are taking the least helpful one, because as Sushi said, it requires several steps before it's absorbable into cells. The problem is that many people don't have the required enzymes to make those conversions happen. Your cyanoB12 is then worse than useless.

Worse because it can block the active forms of B12's access to receptors. So whatever B12 you get from food sources can't get into your cells where you need them. You then end up with a B12 deficiency caused by the cyano form of B12 and your body's lack of specific enzymes.

MMA tells you your level of adenosylB12 only, the form of B12 that's used in the krebs cycle to generate ATP (energy). MMA tells you nothing about your cyano, hydroxy or methyl B12 levels.

Also, MMA levels are known to be quite variable and unstable so the changes may not mean much. Were the changes in your MMA moderate or huge?
 
Last edited:
Messages
10
They were very small changes in the MMA. This whole b12 thing is so confusing. I don't think I can absorb b12 from food from my understanding. I don't know if it is true or not but I have an illeostomy. I was told with that you can't absorb the b12 properly from food or other sources properly so I have not taken any from other sources either.
 

helen1

Senior Member
Messages
1,033
Location
Canada
I dont think you should be concerned at all about your MMA since they were small changes. And definitely switch your B12 shots to methylB12.
Let us know how it goes.
@Mandabear05