to measure "storage".. What they measure is what is in the blood.

One could say your stores are filled up and the rest is floating around, OR
that you are not storing any and it is all floating around in the blood.

There is no way to measure that.

The MMA test will tell if you are USING B12 however. Which is a bit different.

Never heard about an MMA test.

The next time I go and see my doctor, should I request an MMA test: Or is this one of those extra ordinary tests that you have to get pre-authorized from insurance companies etc. etc.???


Thanks much

here is more info.

http://www.labtestsonline.org/unders.../mma/test.html

At a recent seminar I attended, the lecturer said she was having all the patients in the nursing homes get this test when admitted. She claims it is about $40...so I don't know if your insurance pays for it and that it tells more than serum levels.

It shows if the B12 is being utilized in the MMA metabolic system.
Sometimes B12 shows in the blood, but it is not available to the tissues.
The MMA shows if it is being used properly in the MMA system.

I remember when the Drs. did not ever say You don't need b12 and yes
Mel ,it seems like we felt so much better,and clean house,we felt good.
Drs. are not all bad,but the no. thing they go by,,For instance
that Cholesterol think,i've watched it go lower and lower Drs. yell at
you,my 92 year Aunt,eats so well can out run that heart Dr.and he said well
you weigh 110 well ,it has to be hereditary,nooo kidding..When she came for a month to take care of me ..Dr. John said I would love to be in your shape,
he asked her out to dinner,she said what about Sue ANSWER Your pretty,
fun and ect. My Aunt insited I had to go,she liked him but she liked me better.
She's so sweet.

If B-12 is so benign and that excesses are not harmful, what is the commotion? I can understand it for other vitamin #'s but for B-12? Isn't that like a high number of Vit C?
Mrs. D. Is everyone so either naieve or ignorant? [Yes, you have trained me well?] This reaction is absolutely silly ...to understate things -especially among the medical professional community.
It IS true that one eliminates excess B-12 as well as Vit-C so if one shows excess amounts in testing it is meaningless other than there must be more in the individuals' system to asorb. Such testing does not truly INDICATE WHAT the system IS asorbing. Am I correct? Testing for true asorbtion is quite different, again, am I correct? Many thanks in advance - j
's

The serum B12 numbers can be all over the place, as they only measure the B12 available in the bloodstream. A low number is bad, of course, as that would mean there isn't much around to BE used, but a high number doesn't guarantee that the cobalamin is making it into the methylation pathways (that's what the MMA--methylomaic acid--test helps determine).

On the other hand, I imagine a good deal is making it into Melody's metabolic pathways, as she does have a significant reaction from taking B12.

It's possible Mel's system is now flooded with B12 and she could make do with a little less dosage. I know that when my B12 serum levels were measured at 1864, I cut down from 2500mcg/day to 1000mcg/day, without apparent ill effects.

I wonder what Mel's levels would've been if she hadn't stopped taking the methylcobalamin five days before the test.

Seriously, though, my wife's PCP once questioned her high B12 levels (they're not quite as high as mine, but she takes less), and I immeditely asked, "other than masking a possible folate deficiency--and you can see my wife's folate levels are quite good--is there any known reason that a high B12 level should be cause for concern, especially when the level is explained by the patient knowingly supplementmeting with large doses?" The doctor couldn't answer, and I said "the reason you're having trouble coming up with this is there is no known B12 toxicity level--in fact, some European and Japanese studies have dosed people with neurologic disorders up to 36mg a day with no ill effects . . ." and the doctor started to laugh (they learn about me very quickly).

I think you can try asking them that question, Melody--let's see what answer you get.

Glenn:

I already did ask that question (I won't mention which doctor but it wasn't Dr. Fred).

I asked the Doctor, "what do you think about Methyl B-12", and his exact response (and he gave a grunt), was:

"Ugh, I WOULD NEVER TELL A PATIENT TO TAKE ANY B-12 UNLESS THEY WERE ANEMIC"

I said 'but it is supposed to have a positive effect on people with Diabetic Neuropathy", whereupon he grunted again and said "I don't believe it, I was never taught this in medical school, they never mentioned it would help neuropathy, and it's only prescribed for people with severe anemia".

He was so adamant I never brought up the subject again. NEVER!!!!

The only doctor (a neurologist) who LISTENED to what I said about Methyl B-12, (and sorry, don't remember her name), was a neurologist who was heading up a neuropathy department in one of the hospitals in NYC I believe.

She was the guest speaker at one of the Neuropathy support group meetings that were held in the CBS building. This was last year.

She was introduced and she said "we are just learning about how to treat neuropathy and I'm here to answer all your questions and to listen to you".

I then raised my hand and I politely said: "If I tell you that taking large doses of Methylcobalimin has successfully treated the burning in my feet due to diabetic neuropathy, are you going to pooh pooh me and say "Ah, I don't believe that one bit". ?????

And she replied very nicely. "Absolutely not, I would never be so arrogant as to not listen to you, and learn something new, THAT'S WHY I'M HERE TONIGHT.

So I explained to her what I had learned from this board, I explained that I had started with the 1000 and within 2 weeks knew I would be taking the 5000 and the results, in my book, (and only affecting me at this point), were nothing short of a miracle.

Now I still have some burning, but something triggers it, whether it's the crazy weather, or my son calls us up. That does it for me.

But usually (and this is how I judge me having a GOOD PN DAY)....when I don't notice my feet doing their thing, and I'm cleaning my house, going shopping, or just watching tv, and I don't even think about my feet, that means they are not burning.

I don't get the pins and needles or buzzing. That was in the beginning and that was ONLY WHEN THE PODIATRIST USED THAT VIBRATING THING ON MY FEET.

I never had one single symptom up until that office visit and then BOOM!!! it all started.

I once asked him about that and he said

No, it wasn't me, you have neuropathy, and it's good that you have pain, pain is good"


AHA!!!! really??? pain is good?? Try telling that remark to the hundreds of people who are going out of their mind with PN pain on a daily basis.

I will never understand why that particular doctor (who shall remain nameless) said: "UGH, B-12, I WOULD NEVER, blah blah.

I wonder why??

And he was adamant. I couldn't change this guy's mind for all the tea in China.

I wouldn't even try.

Hello Melody,

There is nothing at all unusual to have a B12 level of 2000 ng/L while on treatment. The reported level does not represent your actual body stores because you have recently been on treatment. I have explained this in a quote at the end of this message. Stopping treatment for five days is not sufficient to ensure that your serum B12 is in equilibrium with body stores. Results of my current research show that, in my case that might not be typical, even stopping oral B12 for four weeks was not sufficient, after taking very small doses.

Do you have diabetic neuropathy that is somehow being improved by massive doses of B12? Or, do you actually have vitamin B12 deficiency?

Unfortunately, because you have been on treatment, you cannot now use methylmalonic acid or homocysteine for diagnosis of B12 deficiency. Please see the quote at the end of this message for an explanation. You can, however, still use methylmalonic acid and homocysteine to test for effectiveness of treatment.

The doctor who said this to you:

has no idea about vitamin B12 deficiency, but is typical of most of those I have seen.

I have suffered significant, and probably irreversible, neurological damage as a result of undiagnosed vitamin B12 deficiency, but have never had any haematological evidence of it. You are welcome to read more about doctor's reactions, on the Doctors-Apathy page of my web site (URL at end of this message).

According to experts, about 30% of patients with B12 deficiency have no haematological signs. For example, Lindenbaum et al found:

and concluded:

Here is a link to the abstract of the article, my reference BA12:

Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis, J Lindenbaum, NEJM Volume 318:1720-1728

You can find links to many articles about B12 deficiency, on the References page of my web site.

I have previously explained, in some detail, how to use methylmalonic acid and homocysteine to test for effectiveness of treatment, on the following thread:

http://neurotalk.psychcentral.com/thread41358.html

I have copied an edited version of my post on that thread, to the end of this message. I suggest that you read the original thread to see the context of my message.

You are welcome to ask me any questions here on your thread. If you prefer, you may contact me for a private discussion by sending an Email from the Contact page of my web site.

Paul
**********************************
*********************************************

For the benefit of anyone else reading this, please note that you cannot use either MMA or tHcy for diagnosis of B12 deficiency after receiving any form of B12 treatment, because it is then not possible to obtain a valid “before” result. My suggestion on this thread is specifically for testing effectiveness of treatment only. The following explanation is copied from the General Advice page on my web site:

If anyone wishes to discuss my advice about testing first, then I suggest starting a new thread, perhaps called "why test first?", rather than using this one.

I suggested to MELODY that she could reduce her doses now, is that
she has posted many times that she has financial contraints in her home.

By saving some $$ she might then be able to try benfotiamine (this is showing good results in diabetics). I was going to suggest that soon for her.

The Jarrow 1mg works out to about 9 cents a day.
The 5mg is more expensive.

I think it is barbaric that doctors think you must have anemia for an
intervention!

Hooray! Sounds like you are storing. It would be very unusual if you were not.

I would take a 5000 mcg once or twice a week to maintain. The brand I use is more cost effective in the 5000 mcg dose, and besides it tastes better.

MMA testing is probably not necessary, but usually as people are B12 deficient for a while they MMA goes up. Can't hurt to test MMA and Homocysteine, since together they will detect most need for B12, folate, and B6.

I wonder how many more decades will pass before most medical people have even a portion of the basics regarding B12.

Hi, all!

rose