What is Methylmalonic acid?
Methylmalonic acid is a compound that reacts with vitamin B-12 to produce coenzyme A (CoA).
What is Coenzyme A?
Coenzyme A is essential to normal cellular function. Coenzyme A is involved in hundreds of reactions and is required for the metabolism of fatty acids, carbohydrates, amino acids and ketone bodies.
Why perform the methylmalonic acid test?
When vitamin B-12 deficiencies occur, methylmalonic acid levels increase. Measurement of methylmalonic acid through the methylmalonic acid test can provide your doctor with information about an existing vitamin deficiency, especially if the B-12 deficiency is mild or just beginning.
The methylmalonic acid test is more sensitive than the vitamin B-12 test. As a result, it’s better able to identify vitamin B-12 deficiencies at the lower end of the normal range. The methylmalonic acid test is often used along with the vitamin B-12 test or to clarify ambiguous vitamin B-12 test results.
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The methylmalonic acid test may also be ordered if the results of other blood tests are abnormal. For instance, abnormal results from a homocysteine test may prompt your doctor to order the methylmalonic acid test.
What are Symptoms of B-12 deficiency:
- cognitive impairment
- gait or walking abnormalities
- irritability
- jaundice
- peripheral neuropathy
References:
- Biomarkers and Algorithms for the Diagnosis of Vitamin B12 Deficiency (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4921487)
- Biomarkers of cobalamin (vitamin B-12) status in the epidemiologic setting: a critical overview of context, applications, and performance characteristics of cobalamin, methylmalonic acid, and holotranscobalamin II (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3174853/)
Disclaimer:
The information on healthmatters.io is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.

