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Vitamins

Methylmalonic Acid (MMA) (Urine)

MMA Urine is a non-invasive functional B12 assessment. For active individuals, this convenient test may help detect cellular B12 insufficiency that could impair oxygen transport, recovery, and endurance without needing a blood draw.

Doctor's Assessment Included

Reference Ranges

No established reference range

There is no established Dutch reference interval for urine methylmalonic acid (creatinine ratio); the standard functional vitamin B12 marker is blood MMA.

Unit: mg/g

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

What It Measures

This test measures the concentration of methylmalonic acid excreted in urine. When B12 is insufficient, MMA accumulates in the body and is excreted in greater amounts through urine, making this a useful functional indicator of B12 availability.

Why It Matters

Active individuals can use urine MMA testing as a convenient way to monitor B12 function between blood tests. Elevated urinary MMA may indicate that B12 optimisation is needed to support training demands and recovery without the inconvenience of a blood draw.

When to Test

This test may be considered when B12 deficiency is suspected, as a follow-up to borderline blood B12 results, or when a non-invasive assessment is preferred. It may also be used to monitor B12 treatment effectiveness. Discuss with your healthcare provider.

Symptoms

Low Levels

Low urinary MMA levels generally indicate adequate vitamin B12 function at the cellular level. This is typically considered a normal finding suggesting your body has sufficient B12 for its metabolic needs.

High Levels

Some people with elevated urinary MMA may experience symptoms associated with B12 deficiency, including fatigue, weakness, cognitive difficulties, and neurological symptoms such as tingling in hands and feet. A healthcare provider should evaluate these findings.

Lifestyle Tips

If urinary MMA is elevated, your healthcare provider may recommend increasing B12 intake through diet or supplementation. B12-rich foods include meat, fish, eggs, and dairy products. Regular monitoring can help track improvements over time.

Frequently Asked Questions

How does urine MMA compare to blood MMA testing?
Both tests measure methylmalonic acid as a functional B12 marker. Urine MMA offers a non-invasive alternative to blood testing and can provide similar information about cellular B12 status. Your healthcare provider can advise which test is most appropriate.
Is urine MMA affected by hydration levels?
Hydration can influence urine concentration and potentially affect results. Your healthcare provider may request a first-morning sample or adjust interpretation based on urine concentration markers. Follow the collection instructions carefully.
Can I use urine MMA to monitor my B12 supplementation?
Yes, urinary MMA can be a useful tool for monitoring how well B12 supplementation is working. Decreasing MMA levels over time may indicate that your body is receiving and utilising adequate B12. Discuss monitoring frequency with your healthcare provider.

Tests with related values

These panels measure values from the same category as this marker.

Health Checkups

InsideTracker

A 36-biomarker performance and longevity panel inspired by InsideTracker Ultimate — covering heart, hormones, metabolism, inflammation, recovery and iron status.

SHBG (Sex Hormone Binding Globulin) TSH (Thyroid Stimulating Hormone) ALT (Alanine Aminotransferase) LDL Cholesterol GGT (Gamma-Glutamyl Transferase) Cortisol DHEA-S Estradiol (E2) Free Testosterone Total Testosterone Folate (Folic Acid) Vitamin B12 Calcium Ferritin Iron (Serum) Magnesium Magnesium (Intracellular) Potassium Progesterone Sodium Transferrin CRP (C-Reactive Protein) Glucose (Fasting) HbA1c (Glycated Hemoglobin) ApoB (Apolipoprotein B) HDL Cholesterol Total Cholesterol Albumin AST (Aspartate Aminotransferase) Vitamin D (25-OH) Insulin (Fasting) Leukocyte Differential Creatine Kinase (CK) Transferrin Saturation Triglycerides Basic Blood Count
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Complete Health

360 Health

Broad health panel: hormones, thyroid, vitamins, lipids, liver, kidney, and blood count.

HbA1c (Glycated Hemoglobin) TSH (Thyroid Stimulating Hormone) Triglycerides Urea (BUN) Creatinine eGFR (Estimated Glomerular Filtration Rate) Free T4 (Thyroxine) LDL Cholesterol Liver Function Test (LFT) SHBG (Sex Hormone Binding Globulin) Vitamin B12 Vitamin D (25-OH) Total Testosterone Free T3 (Triiodothyronine) Ferritin HDL Cholesterol Albumin Total Cholesterol Basic Blood Count
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Whoop

A 44-biomarker comprehensive health panel inspired by WHOOP Advanced Labs — a deep look at metabolism, cardiovascular risk, hormones, liver, kidney and inflammation.

SHBG (Sex Hormone Binding Globulin) TSH (Thyroid Stimulating Hormone) ALT (Alanine Aminotransferase) LDL Cholesterol Cortisol DHEA-S Estradiol (E2) Free Testosterone FSH (Follicle Stimulating Hormone) LH (Luteinizing Hormone) Total Testosterone Bicarbonate Calcium Chloride Ferritin Iron (Serum) Magnesium Potassium Sodium Transferrin CRP (C-Reactive Protein) Homocysteine Glucose (Fasting) HbA1c (Glycated Hemoglobin) ApoB (Apolipoprotein B) HDL Cholesterol Omega-3 Index Total Cholesterol Albumin HOMA-IR ALP (Alkaline Phosphatase) AST (Aspartate Aminotransferase) Bilirubin (Total) Total Protein Urea (BUN) Creatinine Vitamin D (25-OH) eGFR (Estimated Glomerular Filtration Rate) Insulin (Fasting) Leukocyte Differential Transferrin Saturation Lipoprotein(a) Triglycerides Basic Blood Count
€499,-

Methylmalonic Acid (MMA) (Urine)

€98,-