Vitamin B12 Deficiency Urine Test

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Vitamin B12 Test
Bulk Pricing
  • Test for Vitamin B12 Deficiency in the Safety and Privacy of Home
  • For Early Prevention of Anemia, Hemophilia and B12-Related Disorders
  • Non-Invasive, Pain-Free Alternative to B12/MMA Blood Tests
  • Quick Turnaround Time of 5-7 Business Days
  • No Lab Fees However Additional Postage is Required
  • Due to State Law, This Test Cannot Be Shipped to NY State

Vitamin B12 deficiencies can cause fatigue, poor concentration and a myriad of other symptoms. When the body is deficient in Vitamin B12, a chemical named Methylmalonic Acid (MMA) is produced. Use our Methylmalonic Acid Vitamin B12 Deficiency Urine Test to detect elevated MMA levels, and keep a B12 deficiency at bay.

What is Vitamin B12?

Also known as cobalamin, Vitamin B12 is a water-soluble compound that contributes to normal brain and central nervous system function. Red blood cell production can be stalled if the body detects a lack of Vitamin B12, leading to anemia and other disorders. A Vitamin B12 deficiency may cause irreversible immune damage if not detected early.

Disorders Associated With A Vitamin B12 Deficiency:

  • Pernicious Anemia (Difficulty Absorbing B12)

  • Atrophic Gastritis (Thinned Stomach Lining)

  • Small Intestine Irregularities

  • Immune System Disorders

  • Veganism or Poor Diet

Since it is not naturally produced by the human body, Vitamin B12 is obtained through animal food sources, like meat, dairy and eggs. Adopting a vegan lifestyle can diminish bloodstream levels of B12 if not supplemented through foods like fortified cereals, nut milks and nutritional yeast.

Symptoms of A Vitamin B12 Deficiency May Include:

  • Weakness, Tiredness, Lightheadedness
  • Heart Palpitations and/or Shortness of Breath

  • Digestive/Bowel Problems

  • Vision Impairment

  • Depression, Memory Loss, Behavioral Changes

This test is potentially beneficial for physicians and hospitals to make a judgment diagnosis for symptoms associated with vitamin B12 deficiency, ideally if done along with a homocysteine test. It is also very useful for individuals desiring to be tested by mail from the privacy of their home and investigators or research students seeking to screen a large number of samples for Vitamin B12 deficiency. The Vitamin B12 Deficiency Detection Service employs highly selected ion monitoring isotope dilution gas chromatography coupled with mass spectrometry (GC/MS) in a random spot urine specimen. 

Biology Behind the Test:

Urine MMA levels are directly related to a B12-dependent metabolic pathway. Normally, vitamin B12 acts as a coenzyme, promoting the conversion of methylmalonyl CoA to succinic acid in a metabolic pathway: MMCoA (coenzyme B12) succinic acid. If there is not enough B12 available to act as a coenzyme, then methylmalonyl CoA concentrations begin to rise, and the body converts the methylmalonyl CoA to MMA instead. Decreased availability of B12 leads to increases in blood and urine MMA levels.

Blood/serum MMA-based tests are falsely high in renal insufficiency and intravascular volume depletion while blood/serum B12 tests are mere indicators of the amount of circulating B12 in serum. On the other hand, urinary MMA (uMMA) based test is a functional test as it is an indicator of the amount of tissue or cellular B12 available for physiological activity and thus gives biologically more relevant results. This test is also better than the Schilling Test, which is falsely normal in individuals who are unable to absorb food-bound B12 but can absorb crystalline B12.

Note to New York State Residents

New York State health law prohibits the testing of specimens collected in or mailed from New York, and prohibits the transmission of data from the laboratory to NY physicians or residents. Therefore, direct receipt of lab results for NY residents is not possible. 

B12 Vitamin Testing Methodology 

The laboratory analyzes the sample with urinary methylmalonic acid (uMMA) by gas chromatography - mass spectrometry (GC-MS) using the selected ion monitoring mode with deuterated MMA as an internal standard. The normal value is less than 3.8 micrograms of MMA per milligram creatinine.  


  • Isn't direct measurement of serum B12 levels good enough? Why do we need indirect testing of Vitamin B12 deficiency through urine MMA levels?

Total serum B12 is not sufficiently sensitive or specific to be a reliable indicator of vitamin B12 deficiency as serum B12 level can be high although there is an actual deficiency of B12 available to the cells for proper physiological activity. Serum B12 levels are more appropriately considered to be an indicator of total body stores of vitamin B12.


  • What is methylmalonic acidemia? Can this test be used to detect it?

Yes, this test can be used to detect Methylmalonic acidemia, a rare inherited autosomal recessive metabolic disorder in which functional B12 availability decreases because of mutations leading to defects in vitamin B12 metabolism or in its transport.

  • I am a vegetarian/strict vegan. Should I take this B12 Deficiency test?

Vitamin B12 is the only vitamin that is not found in vegetables and that makes vegetarians or strict vegans more susceptible to its deficiency. If you are experiencing weakness, fatigue or numbness and tingling in the hands and feet, you should consult your physician and take this test.

  • How can a conclusive diagnosis of Vitamin B12 deficiency be made?

If MMA and homocysteine levels are increased, then an early or mild B12 deficiency may be present. This may indicate a decrease in available B12 at the tissue level. However, If only homocysteine levels are elevated, then folate concentrations should be checked. If MMA and homocysteine levels are normal, it is unlikely that there is a B12 deficiency.

  • I used to eat meat and eggs but recently I have shifted over to vegetarian diet. What is the risk of experiencing vitamin B12 deficiency in near future?

As vitamin B12 and folate are stored in significant amounts in the liver, a person on B12 deficient diet may not show any of the deficiency associated symptoms for many months!

  •  What are the recommended dietary intakes of vitamin B12?

Vitamin B12 is safe when is consumed in amounts that do not exceed the recommended dietary allowance (RDA). So it is necessary for one to know the recommended and the safe amounts of B12 in body, that will provide defense against several disorders and also, will not cause any harm. These RDA Levels for Vitamin B12 are as follows (this is is just as a general information, everybody is different so please consult your health care professional for your specific case). <1 year 0.6 Male 0.5 Female 1~3 years 0.9 Male 0.8 Female 4~8 years 1.2 Male 1.2 Female 9~13 years 1.8 Male 1.8 Female 14~18 years 2.4 Male 2.4 Female 19 years and above 2.6 Male 2.5 Female prenancy 2.6 lactation 2.8