Pernicious anemia is a type of anemia that used to be deadly.  Pernicious, means deadly, this type of anemia was deadly due to the lack of available treatment.  Nowadays it is very well treated with B12 shots.  Anemia is when the body does not have enough healthy red blood cells.  Red blood cells are important because they carry oxygen through the whole body. 

Pernicious anemia is when there is a decrease in red blood cells due to the intestines not being able to absorb vitamin B12 efficiently.  Vitamin B12 is crucial for red blood cell production and function in the body.  Pernicious anemia is rare.  


Causes of Pernicious Anemia

Pernicious anemia is when your body cannot absorb vitamin B12.  This can happen if you have an autoimmune process where you are unable to produce an intrinsic factor in the stomach.  Intrinsic factor helps your body to absorb vitamin B12 in the small intestines. 

Another cause of Pernicious anemia is weakened stomach lining. 

In extremely rare cases Pernicious anemia may be passed along in a family, this is known as congenital Pernicious anemia.  In congenital Pernicious anemia babies do not produce enough intrinsic factor. 

People of Scandinavian or Northern European origins have a higher risk of getting Pernicious anemia. 

Having someone in your family with it also raises your risks. 

If you have one of these conditions you are also at a higher risk of developing Pernicious anemia; Addison’s disease, Grave’s, hypothyroidism, hypoparathyroidism, myasthenia gravis, type 1 diabetes, testicular dysfunction, or celiac disease. 

Pernicious anemia can also occur after gastric bypass surgery. 

A person on a vegetarian diet can also be at higher risk of Pernicious anemia because of the lack of foods with vitamin B12. 


Symptoms of Pernicious Anemia

Symptoms usually progress very slowly.  You may not notice symptoms until after the age of 30, though it is most common to be diagnosed after the age of 60. 

Symptoms that coincide with Pernicious anemia are fatigue, weakness, headaches, chest pain, weight loss, and pale skin. 

Vitamin B12 deficiency symptoms you may also have are nausea, vomiting, confusion, constipation, loss of appetite and heartburn.

If you have prolonged vitamin B12 deficiency you may suffer from neurological symptoms such as unsteady gain, peripheral neuropathy, muscle weakness, depression, memory loss, and dementia.  


Diagnosis of Pernicious Anemia

Diagnosis is confirmed by a few tests.  A complete blood count to check hemoglobin and hematocrit levels.  Vitamin B12 levels will be checked as well, which can be done with a blood draw as well.  A test checking the intrinsic factor and parietal cell antibodies will help know what is the best course of treatment. 

Your doctor will also want to know what your family history is.  

Treatment of Pernicious Anemia

Treatment is focused on raising the vitamin B12 levels up to normal range.  This can be done with vitamin B12 injections.  Injections may need to be daily or weekly depending on where the vitamin B12 levels are at.  Checking vitamin B12 levels will be crucial.  Injections can be either self given, or done by a doctor or nurse. Once the B12 levels return to normal monthly shots may be sufficient.

Oral vitamin B12 supplements are also an option as long as your Pernicious anemia isn’t caused by inability to absorb vitamin B12.  If your Pernicious anemia is caused by no intrinsic factor in the stomach then shots are the only treatment.

Treating symptoms immediately as they start is important.  Not treating Pernicious anemia can cause permanent nerve damage.  Not starting treatment within six months of symptoms starting can lead to further complications. 

Those who get treatment for their Pernicious anemia usually do well, and live a full life. 


Complications of Pernicious Anemia

Pernicious anemia may cause gastric polyps, gastric cancer, or gastric carcinoid tumors.  People with Pernicious anemia are at a higher risk of having fractures of the back, upper leg, and upper forearm.  Brain and nervous system problems can continue or become permanent if left untreated.  In women, Pernicious anemia can cause a false positive on their pap smear.  



Pernicious anemia used to be deadly due to the fact that treatment wasn’t readily available.  Today treating vitamin B12 deficiency can be done orally, injections, or even a nasal spray.  Once you are diagnosed with Pernicious anemia your doctor will be able to start you on a treatment plan that is best for you.  Starting treatment early is key to having no nerve or brain damage that becomes permanent.  Pernicious anemia is no longer deadly when you get treatment.  



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