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Concentrations of MMA in dried blood spots increase with storage at room temperature so care must be taken to store dried blood spots below −80°C prior to analysis
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“Elevated MMA is a specific marker of vitamin B12 deficiency while Hcy [homocysteine] rises in both vitamin B12 and folate deficiencies.” So, “metabolic B12 deficiency is strictly defined by elevation of MMA levels or by elevation of Hcy in folate-replete individuals,” that is, in those getting enough folate
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