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Increased Plasma Methylmalonic Acid Level Does Not Predict Clinical Manifestations of Vitamin B12 Deficiency Arch Int Med 161:1534-1541, Hvas,A.,et al, 2001 See this aricle in Pubmed Article Abstract The prevalence of vitamin B12 deficiency, defined as an elevated concentrations of plasma methylmalonic acid (P-MMA), has been estimated to be 15% to 44% in the elderly. However, we do not know whether an increased P-MMA level actually indi cates or predicts a clinical condition in need of treatment. An increased level of P-MMA did not predict a further increase with time and clinical manifestations related to vitamin B12 deficiency. We therefore challenge the use of an increased P-MMA con centration as the only marker for diagnosis of vitamin B12 deficiency.

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