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Methylmalonic acid (MMA) is a blood test that seems to be a better measure of vitamin B12 deficiency than serum vitamin B12 level

This therapy is commonly used to support metabolic efficiency and overall vitality

If so, these may be signs of a vitamin B12 deficiency

As a diagnosed Pernicious Anaemia patient of 6 years , I do not advise you to use nasal spray instead of B12 injections

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According to the Cleveland Clinic, it is usually seen in people who do not get enough vitamin B12 from their diet or when their digestive tract does not absorb enough