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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We read with much interest the article published by Hvas et al.¹ It reaches very interesting conclusions and deserves some careful considerations.

The follow-up study of individuals with slightly increased levels of plasma methylmalonic acid (P-MMA) during a period of up to 3.9 years, with no evidence of clinical manifestations of vitamin B₁₂ deficiency, supports the thesis of its doubtful clinical significance as a marker for vitamin B₁₂ deficiency.^2-3

We reached similar conclusions during a study we performed⁴ to examine vitamin B₁₂ deficiency in a group of healthy elderly patients (aged >60 years) who had partial gastrectomies for more than 5 years. In such a study, levels of urinary methylmalonic acid were measured using the Norman method⁵ together with measurement of total plasma homocysteine. Of the 47 individuals selected for the study, who had no symtoms and normal clinical examination findings, including a Mini-Mental State examination,⁶ 9 individuals (19%) showed . . . [Full Text of this Article]