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Best tests to determine B12 deficiency & need Methylmalonic Acid (MMA) Homocysteine Active B12 (Holotranscobalamin - holoTC) If both the MMA and Homocysteine test results are high, then you may not be getting enough B12 intracellularly (even if your blood serum tests show B12 as high) Unfortunately most medical professionals test for B12 sufficiency using a blood serum test