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If the serum B 12 concentration is borderline, total plasma homocysteine (tHcy) or methylmalonic acid (MMA) concentrations may be useful guides to functional B 12 deficiency.[8] Indeed, increased serum MMA and plasma tHcy concentrations indicate an intracellular B 12 deficiency and are regarded as more sensitive variables than serum B 12 for the diagnosis of B 12 deficiency.[10] However, other studies did not show relation between elevated plasma homocysteine and B 12 in MS patients and further studies are needed in this field.[17,18] The median intraindividual variation in measured serum Vit B 12 during two to six weeks was 6-23% in different studies;[19,20] Thus, one measurement may not be accurate enough to draw conclusion about ones vit B 12 status

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