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I missed the "+" on your post. Not sure how helpful the MMA will be but it can't hurt. Don't know how expensive it is though.
There are some newer test but I'm not familiar with how they're used and if they even know how to fully interpret them yet. I'll have to do some research and think on this a while.
The tests to look into are the unsaturated b12 binding capacity, holoTranscoblamin, Trans Coblamin II and deoxyuride suppresssion. I really don't know exactly what they are looking at/for with these. I assume something related to B12 transport. I haven't had a need to dig deep into these. It's supposed to rain all day tomorrow so maybe I'll get a chance.
The only other thing that comes to mind is if she is having problems with her liver or if her disease is causing it.
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Marlene, wife to John DX w/SAA April 2002, Stable partial remission; Treated with High Dose Cytoxan, Johns Hopkins, June 2002. Final phlebotomy 11/2016. As of July 2021 HGB 12.0, WBC 4.70/ANC 3.85, Plts 110K.
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