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The body therefore needs all three forms in equal measure and fortunately they are interconvertible

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According to the NIH, you absorb only about 50% of the B12 you take in

Research consistently shows an inverse association between serum B12 and serum MMA levels, although researchers havent found specific cutoff points for determining B12 deficiency by way of serum B12 or MMA levels using cross-sectional data (Bailey, 2011, Bailey, 2013)

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In a case series study from New York of people with overt neurological symptoms from B12 malabsorption, MMA levels ranged from 755 to 187,000 nmol/l (Lindenbaum, 1988)