Methylmalonic acid (MMA) blood test: Procedure, Purpose, Results, Normal range, Cost, Price, Online booking

What is Methyl Malonic Acid (MMA) Blood test?

An MMA blood test determines the level of methylmalonic acid in circulating in your bloodstream. It is mainly done to check for vitamin B12 deficiency.

Methylmalonic acid (MMA) is a biological compound that your body produces in minute quantities during the digestion of proteins.

The concentration of MMA is linked to the level of vitamin B12 in your blood. If you have a deficiency of vitamin B12, the amount of MMA in your blood will rise and vice versa. Hence, the levels of MMA in your blood serve as a marker for vitamin B12 deficiency.

Vitamin B12 is a water-soluble vitamin that is required by your body for the metabolism of proteins. It also plays an important role in the formation of red blood cells and maintenance of the central nervous system functions. Most of our daily recommended vitamin B12 can be obtained from food sources. Animal food sources such as meat, eggs, milk and shellfish contain more B12 than plant sources. Although fortified breakfast cereals may be a good source of vitamin B12 for vegetarians. A deficiency of B12 may occur due to a number of reasons, ranging from low intake in diet, less absorption in the body to autoimmune diseases.

Why is a Methyl Malonic Acid (MMA) Blood test performed?
How do you prepare for a Methyl Malonic Acid (MMA) Blood test?
How is a Methyl Malonic Acid (MMA) Blood test performed?
Methyl Malonic Acid (MMA) Blood test results and normal range

Why is a Methyl Malonic Acid (MMA) Blood test performed?

Your doctor will ask you to get this blood test done if he/she suspects that you have a vitamin B12 deficiency. You may not experience the symptoms of the deficiency immediately as they develop gradually. Most common symptoms of vitamin B12 deficiency include the following:

Numbness in feet and hands
Tingling sensation in extremities
Inflammation or swelling of the tongue
Weakness and unexplained tiredness
Anaemia
Difficulty thinking and reasoning
Memory loss

This test may also be suggested if the doctor suspects that you have methylmalonic acidaemia, a rare genetic condition in which the body is not able to metabolise certain proteins and fats. Symptoms of the disorder begin to appear very early, usually during infancy, and include lethargy, dehydration, vomiting, seizures and delayed development.

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How do you prepare for a Methyl Malonic Acid (MMA) Blood test?

No fasting or prior preparations are needed. Make sure to inform your doctor if you are taking any routine medications or health supplements.

How is a Methyl Malonic Acid (MMA) Blood test performed?

A trained healthcare provider will take a blood sample from a vein in your arm using the following procedure:

The healthcare provider will wrap an elastic band (a tourniquet) around your upper arm. It helps to slow down the blood flow and locate the appropriate vein from which the sample can be drawn.
Once a suitable vein is located, a technician will clean the skin above it using an antiseptic solution. This is done to minimise the risk of any infection.
He/she will then insert a needle into the vein. You may feel a pricking or piercing sensation when the needle is being inserted. A small tube attached to the needle helps in the collection of the required amount of blood.
After the required amount of blood is drawn, the tourniquet will be released, and the needle will be removed.

The entire test takes only up to a few minutes. If you tend to get anxious about needles, communicate this to your healthcare provider so that they can make you relax before the test is done.

The area where the needle is inserted may be bruised for a while after the test but it will heal eventually.

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Methyl Malonic Acid (MMA) Blood test results and normal range

Normal results:

The normal MMA range in blood is 53-376 nmol/L.

Normal results indicate that you may not have a vitamin B12 deficiency, and the symptoms could be attributed to some other health conditions.

Abnormal results:

If the test is done for an infant, abnormally high MMA levels might be indicative of methylmalonic acidemia.

An abnormally high level of MMA could also be due to the following:

Vitamin B12 deficiency
Kidney diseases
Pregnancy

In case of kidney diseases, MMA is not excreted properly in urine due to which it accumulates in the blood.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.

References

University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; Methylmalonic Acid (Blood)
Stabler SP. Clinical practice. Vitamin B12 deficiency. N Engl J Med. 2013;368(2):149–160. PMID: 23301732.
Langan RC, Zawistoski KJ. Update on vitamin B12 deficiency. Am Fam Physician. 2011;83(12):1425–1430. PMID: 21671542.
National Human Genome Research Institute [Internet]. Bethesda (MD): National Institute of Health. U.S.A.; About Methylmalonic Acidemia
Velente E, et. al. Diagnostic accuracy of Holotranscobalamin, Methyl Malonic acid, Serum cobalamin, And other indicators of tissue vitamin B12 status in the elderly. Clinical Chemistry. 2011 June;57(6).
Salwen MJ. Vitamins and trace elements. In: McPherson RA; Pincus MR, eds. Henry’s Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St Louis, MO Elsevier; chapter 26.
Mason JB. Vitamins, trace minerals and other micronutrients. In: Goldman L, Schafer AL, eds., Goldman- Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders: chap 218.
Harvard Health Publishing. Harvard Medical School [internet]: Harvard University; Vitamin B12 deficiency can be sneaky, harmful
Genetic and Rare Diseases Information Center [Internet]. National Center for Advancing Translational Sciences. National Institute of Health. U.S. Department of Health and Human Services; Methylmalonic acidemia
National Health Service [internet]. UK; Blood Tests
Centers for Disease Control and Prevention [internet]. Atlanta (GA): US Department of Health and Human Services; Laboratory Procedure Manual: Methylmalonic acid (MMA)