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Here’s What Methylmalonic Acid Levels Tell You About Your Health

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It’s no secret that chemical substances in your body suggest health conditions you should address immediately. With that, you may want to further your understanding of methylmalonic acid, especially if you’re at risk of vitamin b deficiency. 

MMA is a substance used as a functional marker to detect low vitamin b12 or cobalamin. By extension, your primary care provider also takes an interest in your MMA levels to diagnose conditions related to vitamin b deficiency, such as anemia, Celiac disease, Crohn’s disease, and HIV infection. Likewise, it could also indicate kidney problems.

Going beyond the normal methylmalonic acid range can spell bad news for your health. Fortunately, you can have it under control with proper diagnosis and practical lifestyle alterations. 

Read on and find out how to do them.

What Is Methylmalonic Acid? 

Methylmalonic acid is produced as protein gets digested in your gastrointestinal tract. It is created in small amounts during the process. 

While little is known about the active role of MMA in metabolism other than it’s a by-product of protein digestion, it has sealed its function as an effective marker for vitamin b deficiency and renal function

According to research, low cobalamin or vitamin b12 blocks the enzyme that controls MMA production. Therefore, this mechanism became essential in detecting the condition through blood and urine tests. 

The methylmalonic acid blood test goes hand-in-hand with a homocysteine blood test wherein it uses homocysteine, an amino acid broken down by vitamins b12, b6, and folates, to create other substances. High homocysteine levels suggest the vitamins’ deficiency as the protein was not processed as it should have been. 

What Is a Good Methylmalonic Acid Level? 

MMA blood tests and urine tests use reference values to detect several health conditions. In the case of an MMA blood test or urine test, as with other lab tests, you should expect results within the established normal limits to verify non-issue with the substance. 

That being said, the normal range for serum methylmalonic acid does not exceed 0.40 μmol/mmol

What Does Elevated Methylmalonic Acid Indicate? 

If your test says high MMA level, it could suggest health conditions that trigger the overproduction of the substance. Here are some of the illnesses generally associated with elevated MMA.  

Vitamin B Deficiency 

Since methylmalonic acid increases with low vitamin B12, it remains an effective marker to detect the deficiency. 

When there are sufficient levels of this vitamin, the methylmalonyl CoA, a type of MMA, gets converted into other functional enzymes that aid in metabolism. On the other hand, low vitamin B due to insufficient dietary supply or functional defects leave the substance at high levels. 

As the relationship between cobalamin and MMA remains consistent, MMA tests are used to help diagnose related conditions such as the following:

  1. Anemia

Vitamin B12 is essential for the production of healthy red blood cells. Hence, if the vitamin is low, it could lead to megaloblastic anemia or pernicious anemia wherein the RBCs fail to develop normally. 

  1. Inflammatory Bowel Disease (IBD)

Your digestive tract sustains direct impact from cobalamin deficiency. Hence, an MMA test for B12 becomes necessary to diagnose gastrointestinal conditions like ulcerative colitis, Celiac disease, Crohn’s disease, and other related illnesses. 

Diarrhea is pretty common among people who suffer from vitamin B12 deficiency. Although the symptom does not directly represent the condition on its own, its frequency can be associated with the inadequate oxygen supplied in the digestive tract tissues. So naturally, the lack of functional RBC can be at fault for this consequence. 

Human Immunodeficiency Virus (HIV) Infection

Individuals diagnosed with HIV infection are prone to severe vitamin b12 deficiency. In addition, experts believe that the progression of the insufficiency contributes to the development of neurological issues among patients. 

Likewise, low cobalamin also influences immune functions increasing susceptibility to diseases and infections. Again, this can be associated with low RBC production affecting oxygen supply. 

  1. Kidney Disease

Research showed that people with chronic kidney disease (CKD) have low vitamin B12 in their system. As a result, high MMA could also support CKD diagnosis or other renal conditions that reduce kidney functions. 

Methylmalonic Acidemia (Newborn)

An MMA blood test is performed as part of the newborn screening to detect methylmalonic acidemia. This autosomal recessive genetic disorder prevents an infant from digesting certain fats and proteins. 

Methylmalonic acidemia may be a rare inherited metabolic disorder, but it can be life-threatening if left undiagnosed and untreated, leading to a newborn’s death. 

When To Get a Methylmalonic Acid Blood Test? 

You have to secure a MMA blood or urine test if you experience symptoms of vitamin B12 deficiency, which include: nausea, diarrhea, numbing or tingling in hands and feet, fatigue, sudden weight loss, increased heart rate, loss of appetite, weakness, and irritability.  

Likewise, if you have been diagnosed with the conditions mentioned above, it’s best to secure a lab test for low vitamin B12. Addressing the deficiency can prevent further complications. 

Furthermore, if you’re pregnant with a family history of methylmalonic acidemia, consider getting your newborn tested for the condition as a safety precaution. Consult your doctor and disclose the genetic disorder during your prenatal visit. 

How Can MMA Levels Be Reduced? 

To lower your MMA levels, the solution is quite simple depending on what causes vitamin b12 deficiency in your system. 

If it’s due to insufficient intake, your doctor may prescribe a specific dosage of cobalamin supplements. On the other hand, if the problem is physiological, suggesting that your digestive system cannot absorb vitamin B12, the issue will have to be adequately addressed first. 

Meanwhile, you can also consider increasing your dietary intake of vitamin B12 if you include more of the following in your meals: lean mean, fish, shellfish, liver, eggs, fortified cereal, milk and dairy products, tofu, and nutritional yeast.

What Does Low MMA Mean? 

There’s nothing to worry about if you got a low MMA level, as it doesn’t indicate any medical concerns. So far, no health conditions have been thoroughly researched associated with reduced MMA in the body. 

Bottom Line

If you have symptoms of vitamin B12 deficiency, it’s imperative to have them checked immediately. The complications brought about by the condition could be dire if you don’t seek treatment. With that, it’s best to pursue proper diagnosis through blood and urine tests that detect cobalamin deficiency markers like methylmalonic acid. 

Medically Approved By Dr. Edward Salko, MD

Dr. Edward Salko is the board-certified physician who reviews lab tests provided by PERSONALABS™. He earned his Bachelor of Science in chemistry and pre-med from the University of Florida in Gainesville and his Doctor of Osteopathy Medicine in 1980 from Kansas City University School of Medicine.

Dr. Salko’s career has specialized in family and emergency medicine. His passion is to provide clients with the tools they need in the most convenient way possible to allow them to take charge of their own healthcare. He has held a variety of positions in Kansas, Florida and Washington. Currently, in addition to his duties as Medical Director for Personalabs, he is a practicing emergency physician in Kennewick, Washington.

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