Pernicious Anemia

Pernicious anemia is an autoimmune condition marked by insufficient quantity of RBCs or red blood cells which in turn occurs due to lack of cobalamin or vitamin B12. The disorder is also referred to by other names such asBiermer’s anemia, megaloblastic anemia,congenital pernicious anemia,Addison’s anemia,vitamin B12 deficiency anemia, and combined systems disease.

Lack of RBCs mean that adequate oxygen does not flow to the cells in the body. Hence, most patients tend to feel exhausted or fatigued.Vitamin B12 plays an important role in RBCs production and proper nervous system regulation. It is mostly found in foods like fish, eggs, milk, meat, and dairy and meat products. Pernicious anemia typically affects individuals whose bodies have limited or no ability to absorb the vitamin from ingested food.

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Pernicious anemia is more prevalent in older people. Untreated cases can result in severe complications, including permanent damage of organs and body.

Symptoms of pernicious anemia

Some of the common signs and symptoms of pernicious anemia are listed below:

  • Lack of adequate oxygen flow across the different areas of the body can result in tiredness and weakness. Hence, exhaustion is one of the most visible symptoms of pernicious anemia.

If pernicious anemia remains untreated for a long time, then it can cause serious damage to the body, including organs like the digestive tract, heart, and nerves.

  • Lack of vitamin B12 in pernicious anemia patients can damage nerve cells and result in tingling sensations and numbness of the limbs, walking problems, and balance issues.
    • Low cobalamin triggered nerve damage can also lead to changes in smell, vision, and taste.
    • Other symptoms include memory loss, confusion, and other mental alterations.
  • The heart in people affected by pernicious anemia tends to work harder so that it can supply adequate levels of oxygen to the different organs and tissues across the body.
    • Such additional workload on the heart can lead to fast or irregular heartbeat, cardiac enlargement, heart murmurs and even cardiac arrest.
    • Deficient levels of cobalamin results in increased levels of homocysteine chemical which tends to promote fat deposits in blood cells, thereby laying the conditions for heart attacks or strokes.
  • Pernicious anemia may be marked by shrinking or thinning of the wall lining in the stomach. Stomach wall damage can increase the risk to stomach cancer development.
    • It can damage the surface of the tongue.
    • Patients may also suffer from bloating, vomiting, gas, sudden and rapid weight loss, and appetite loss.

Causes of pernicious anemia

The red blood cells in the body of a person with pernicious anemia do not divide the right way and hence tend to undergo enlargement. Thus, they face problems when trying to move out from the bone marrow.

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Some of the common causes which may result in low levels of vitamin B12, i.e., pernicious anemia are as follows:

  • The most common reason is deficiency or nil presence of a special protein called IF/intrinsic factor in the stomach. This protein is produced by certain cell types called parietal cells.
    • In some pernicious anemia patients, the body tends to produce antibodies that attack and destroy these parietal cells.
    • IF-protein making cells can also get destroyed via a stomach surgery, wherein the stomach is partially or completely removed. Such surgery may be done as treatment for illnesses, for weight loss, etc. But such surgeries may limit or prevent the production of IF-protein thereby hampering the process of absorption of vitamin B12 from food.
  • Absorption of cobalamin may be affected due to underlying presence of digestive disorders like celiac disease, Crohn’s disease, intestinal infections, etc.
  • The type of diet can affect the absorption of vitamin B12
    • Eating a strictly vegetarian diet which may lack sufficient levels of cobalamin.
    • Eating diets with limited levels of eggs, fish, dairy items, milk, poultry, and other foods rich in vitamin B12.
    • Eating undercooked or raw meats which can result in tapeworm infection.
    • Aging-related poor non-nutritious diet. The elderly also tend to suffer from excessive levels of harmful bad bacteria in the stomach which can result in low vitamin B12 absorption and pernicious anemia.
    • Alcoholism-related poor diet
  • Pernicious anemia may occur due to an uncommon genetic condition that affects the patient’s ability to make the IF-protein.

Treatment of pernicious anemia

  • Pernicious anemia is treated with vitamin B12 injections or pills. The elderly or other patients with swallowing problems may be prescribed vitamin b12 nasal sprays and gels.
  • Treatment also focuses on finding the root cause of the disorder and treating it as per standard medical treatment options.
  • Doctors may prescribe dietary cobalamin supplements if needed.
  • Due to increased risk to stomach cancer development, doctors may carry out periodic tests for it.
  • A healthy diet full of eggs, meat, poultry, milk, and other vitamin B12 foods can help prevent adverse symptoms.
  • Not much can be done to treat permanent nerve damage in case of late treatment for pernicious anemia. Associated symptoms like memory loss, etc. may persist in such cases.


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