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Serum MMA may also be elevated in thyroid disease, bacterial overgrowth in the small intestine, pregnancy, or a rare genetic disorder in infants called methylmalonic acidemia

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And they would be more productive at work

Chen H, Fang Y, Wu J et al (2018) RIPK3-MLKL-mediated necroinflammation contributes to AKI progression to CKD

Cambr A, Zimmermann M, Sauer U, Vivijs B, Cenens W, Michiels CW et al (2015) Metabolite profiling and peptidoglycan analysis of transient cell wall-deficient bacteria in a new Escherichia coli model system