Pathology
Increased methylmalonic acid levels may indicate a vitamin B12 deficiency. However, it is sensitive (those with the disease almost always test positive) but not specific (those that test positive do not always have the disease). MMA is elevated in 90-98% of patients with B12 deficiency. It is not as specific as 20-25% of patients over the age of 70 have elevated levels of MMA, but 25-33% of them do not have B12 deficiency. For this reason, MMA test is not routinely recommended in the elderly.
An excess is associated with methylmalonic acidemia.
MMA concentrations in blood are measured by Gas chromatographic Mass spectrometry and the expected values of MMA in healthy people are between 73-271 nmol/L.
Read more about this topic: Methylmalonic Acid
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—Bronislaw Geremek (b. 1932)