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Lab test

Methylmalonic Acid and Homocysteine Test

This test measures methylmalonic acid (MMA) and homocysteine together in a serum sample. Quest describes the pair as used in assessing vitamin B12 (cobalamin) and folic acid status, and in evaluating an elevated red blood cell size (macrocytosis).

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About this test

Methylmalonic acid and homocysteine are two substances Quest measures together because both tend to rise when vitamin B12 or folate levels are low. Quest describes the pair as used to help evaluate and monitor B12 and folic acid status, and as often useful when a related blood finding, an elevated erythrocytic index called MCV, is also present.

The sample is 2.7 mL of serum. Methylmalonic acid is measured using mass spectrometry, and homocysteine is measured using an enzymatic method; the two results are reported together from the same specimen.

Test details

CollectionQuest patient service center

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Additional details

What this test looks at

The test reports two values from the same serum sample: methylmalonic acid, measured by mass spectrometry, and homocysteine, measured by an enzymatic method. Quest describes the two together as more useful for evaluating B12 and folate status than either marker read alone.

This test isn't part of the Celio Health store at the moment, so it can't be ordered or requested here. The test menu lists everything that can.

Laboratory results should always be interpreted by a licensed clinician who knows your health history. This page is information about a test, not medical advice.

Frequently asked questions

What does this test measure?

It measures methylmalonic acid and homocysteine together in a serum sample, using mass spectrometry for MMA and an enzymatic method for homocysteine.

How is the sample collected?

Through a routine blood draw that produces a 2.7 mL serum sample.

Do I need to prepare for this test?

No preparation instructions are listed for this test, though people follow any instructions their ordering clinician provides.

Why are MMA and homocysteine measured together?

Quest describes both as used together in evaluating vitamin B12 and folic acid status, and notes the pair is often useful when an elevated red blood cell size (MCV) has also been found.

Is homocysteine relevant to anything besides B12 status?

Quest notes that an elevated homocysteine level is considered an independent risk factor for cardiovascular disease, in addition to its role in evaluating B12 and folate status.

Last updated 2026-09-18 · How we write about lab testing

Educational content

This page is for general educational purposes only. It is not medical advice, and it is not a substitute for consultation with a qualified healthcare professional. Laboratory results should always be interpreted by a licensed clinician who knows your health history. If you have questions about your health or your results, talk with your doctor. If you think you may be experiencing a medical emergency, call 911.