Methylmalonic Acid (MMA) is a marker of vitamin B12 deficiency. High levels of MMA can indicate a deficiency of vitamin B12, which can cause anemia and neurological problems.

iollo markers that associate with Methylmalonic Acid (MMA)


Isoleucine, like valine, is metabolized to propionyl-CoA and methylmalonyl-CoA. Elevated isoleucine can occur alongside increased MMA when this pathway is disrupted.


Methionine is a precursor to S-adenosylmethionine, a key methyl donor required for the conversion of methylmalonyl-CoA to succinyl-CoA. Impaired methionine metabolism can contribute to MMA accumulation.


Propionylcarnitine is derived from propionyl-CoA, a precursor of methylmalonyl-CoA in the metabolic pathway that leads to MMA formation. Elevated propionylcarnitine is a strong indicator of a block in this pathway causing MMA buildup.

Succinic acid

Succinic acid is formed from succinyl-CoA, the product of the methylmalonyl-CoA pathway. Decreased succinic acid may be observed when the pathway is blocked, causing elevated MMA.


Valine is metabolized to propionyl-CoA and subsequently methylmalonyl-CoA. Impairment in the methylmalonyl-CoA pathway can lead to both elevated valine and MMA levels.