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Serum cobalamin levels do not strictly correlate with physiologic deficiency, in part because traditional assays measure total serum cobalamin, even though the fraction bound to transcobalamin II (holotranscobalamin II) is physiologically most important
When B12 levels are equivocal, additional testing with methylmalonic acid (MMA) and homocysteine levels can provide greater diagnostic accuracy, as both are elevated in true B12 deficiency
"Methylcobalamin is the active form that the body directly uses for things like DNA synthesis and nerve health and is better for nerve-related issues," Agyeman says
A discussion with your healthcare provider can also help you decide, considering your health needs and lifestyle
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