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Methylmalonic acid

Methyl Malonate (MMA)

Methyl malonate (MMA) is a substance in the body that helps break down certain fats and proteins. It is part of a process called the Krebs cycle, which is important for the body to be able to produce energy. An analysis of MMA is often used to investigate whether there is a deficiency of vitamin B12. The MMA concentration in the blood increases when there is not enough B12.

What is Methyl Malonate MMA?

Methyl malonate also known as MMA is a metabolite that has an impact on the body's metabolism. MMA works in the breakdown of specific fatty acids and amino acids. To produce this energy, the body uses a process called the Krebs cycle, which can be more simply explained as an assembly line in a factory where energy is produced. Methyl malonate is a part that needs to be processed on this assembly line. Because Vitamin B12 is necessary to convert MMA into another important part, called "succinyl-CoA" which is essential for the energy-producing process to work efficiently. In the case of a lack of vitamin B12, the process is disturbed, which can cause a lack of energy in the body.

Since MMA levels are dependent on the availability of vitamin B12, a blood test for MMA can be performed to identify mild forms of B12 deficiency. When there is a deficiency of this B12, the body cannot efficiently convert MMA, resulting in a gradual increase of MMA in the blood. Therefore, analysis of MMA is a relevant diagnostic method that can possibly confirm vitamin B12 deficiency in people whose B12 levels are in the borderline range or when symptoms are ambiguous.

Why is MMA analyzed?

Analysis of MMA is recommended when B12 deficiency is suspected where B12 levels are low but within reference and when symptoms of B12 deficiency occur at the same time. Common symptoms include fatigue, weakness, nerve damage and cognitive impairment, these can be mild and even overlap with other medical conditions. An elevated MMA value therefore provides support for the diagnosis of B12 deficiency, which can facilitate decisions for treatment in order to prevent potentially irreversible damage. This makes MMA analysis a valuable tool in both clinical diagnostics and monitoring the effectiveness of treatment.

What does a high value of MMA mean?

A high value of methylmalonate (MMA) in the blood can be an indication that there is a lack of vitamin B12 in the body.

What does a low value of MMA mean?

A low value of methylmalonate (MMA) in the blood or urine is usually a sign that the body has sufficient amounts of vitamin B12 to efficiently convert MMA into succinyl-CoA, part of the body's energy production system. Low MMA levels are normally considered a sign of good health and that the metabolic processes involving vitamin B12 are working properly.

Reference interval MMA and interpretation of test results

When interpreting test results of MMA, it is important to understand that elevated levels often indicate a lack of vitamin B12, so-called "cobalamin deficiency". If an elevated MMA value is caused by B12 deficiency, it usually tends to normalize quickly after treatment with B12 injections. However, if the person suffers from impaired kidney function, the MMA value may not completely return to normal, but it should at least show a clear decrease relatively quickly.

Reference values MMA

Tests containing the marker Methyl Malonate (MMA)

Other health tests

Other health tests

Methylmalonic Acid Test

Methyl malonate

  • Measures the MMA concentration in the blood.
  • Analysis of methyl malonate.
  • When investigating Vitamin B12 deficiency.

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