MMA rises when vitamin B12 is functionally deficient because B12 is required to metabolize MMA. The test detects B12 deficiency at the tissue level and can be elevated even when serum B12 is in the low-normal range, making it more sensitive than serum B12 alone.
This test is used when B12 deficiency is suspected but blood levels are equivocal, to evaluate patients with neuropathy or cognitive symptoms despite normal-appearing B12, and to confirm true deficiency in older adults or those with malabsorption. MMA can also rise in kidney disease, which must be considered when interpreting results. Sample type is serum.
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