Pernicious anemia


Last Updated December 20th, 2021

Understanding Pernicious anemia

Anemia is the decrease in the red blood cells in your body. Pernicious anemia is anemia due to vitamin B12 deficiency. Eventually, the body is unable to make healthy red blood cells.

How vital is Vitamin B12 to my body?

Vitamin B12 is a water-soluble vitamin that participates in the metabolism (a process of building vital blocks of growth, development, and waste removal) of every cell in your body. It helps in:

  • It converts the carbohydrates into glucose for energy production.
  • It reduces stress, depression and maintains a healthy nervous system.
  • It curbs the unhealthy cholesterol and protects us from heart diseases.
  • It offers protection from breast, colon, prostate and lung cancers.
  • It is vital for healthy skin and hair. It helps in cell reproduction and skin renewal constantly.

What exactly happens in Pernicious anemia?

Vitamin B12 insufficiency prevails in Pernicious anemia. This is the main reason why red blood cells become too large and do not divide normally. The red blood cells will have trouble coming out of the bone marrow (a sponge-like tissue in the bones where the new red blood cells are produced). So obviously, there will be insufficient red blood cells in your body to convey the oxygen to your body. As a result, you will land up feeling tired and weak.

How prevalent is Pernicious anemia?

Around 0.1% of the general population have this condition. In fact, 1.9% of subjects over the age of 60 years have Pernicious anemia. 20 – 50% of the vitamin B12 deficiency cases in adults have Pernicious anemia.

Causes of Pernicious anemia

There are many causes why Pernicious anemia occurs. Some of them are the lack of the intrinsic factor, malabsorption and a diet lacking in vitamin B12.

Lack of Intrinsic Factor

Intrinsic factor (IF) is a protein synthesized by the cells of your stomach. This factor helps in the absorption of vitamin B12 in the intestine. If the production of this factor is terminated, the body will be disabled to move the vitamin B12 into the small intestine for absorption resulting in the absence or inadequate levels of vitamin B12.

Autoimmunity is a state where the body’s immune or defense responses are directed to killing the body’s own cells and tissues. Sometimes, certain types of autoimmune disorders kill the cells that produce the Intrinsic factor. So, this terminates the production of the intrinsic factor in the stomach leading to no vitamin B12 absorption followed by vitamin B12 deficiency as a resultant. Sometimes the lack of intrinsic factor can also be in cases where a part of the stomach is surgically removed.

In some cases, there are children born with a genetic disorder where the intrinsic factor production is disabled.

Malabsorption in the small intestine

Malabsorption is a condition where nutrients are unable to be absorbed into the small intestine. There are many reasons why malabsorption occurs. Sometimes, in older adults, you will see that there are too many inappropriate bacteria are present in the gut. These bacteria tend to use up the available vitamin B12.

There are certain genetic disorders or certain diseases that intervene with vitamin B12 absorption into your body. The use of certain medications, tend to alter the bacterial growth and some of them even block the vitamin B12 absorption into your intestine. Removal of a part of the intestine via surgery can also cause malabsorption. Consumption of contaminated or raw fish can result in tapeworm infections that feed on the vitamin B12 making it unavailable to your body.

Low supply of vitamin B12 from the diet

Insufficient inclusion of vitamin B12 in the diets (especially those people who are vegetarians or vegans) can be a major causative for Pernicious anemia.

What kind of food sources are good vitamin B12 suppliers?

There are wide varieties of food resources you can rely on for vitamin B12. You can rely on food sources like lamb, veal, beef kidneys, clams, sardines, beef, yogurt, cheese, soy products, feta cheese, scallops, milk, chicken, etc. Cereals or other foods fortified with vitamin B12 is also an option to be considered especially for vegetarians.

Am I at risk?

The following categories fall in the high-risk pool for pernicious anemia

  • Strict vegetarians who do not eat any animal or dairy products and also do not take vitamin B12 supplements.
  • Breastfed babies of strict vegetarian mothers are also prone to having pernicious anemia because of insufficient vitamin B 12 in the body.
  • Those who are of an older age
  • Alcohol addicts are prone to Pernicious anemia too.
  • Individuals who have a family history of the disease
  • Those who have type 1 diabetes, an autoimmune condition, or certain intestinal diseases
  • Patients who have had their intestines removed surgically

What are the signs that indicate I may have Pernicious anemia?

If you have Pernicious anemia, you will have the following symptoms:

  • Constipation
  • Jaundice
  • Bleeding of gums
  • Loss of appetite
  • Fatigue (people tend to wake up tired despite getting enough sleep.)
  • Shortness of breath
  • Feeling dizzy
  • Cold hands and feet
  • Chest pain
  • Pale or yellow skin
  • Balancing troubles (for example, struggling to put on your pants or socks while you’re standing)
  • Burning sensation in the legs or feet that increases in the night
  • Depression
  • Trouble focusing
  • Weakness
  • Headaches
  • Chest pain
  • Weight loss
  • Premature hair greying

In rare cases, some people may have the following neurological symptoms:

  • An unsteady walking pattern
  • Spasticity (stiffness and tightness in the muscles)
  • Peripheral neuropathy (numbness in the arms and legs)
  • Progressive lesions of the spinal cord
  • Loss of memory

What are the complications?

Prolonged condition of Pernicious anemia can result in some fatal complications. Your doctor will monitor you regularly.

Some of the serious complications include:

  • Gastric cancer
  • Nerve damage
  • Problems linked to your digestive tract
  • Psychiatric and neurological complications
  • Heart damage

How is it diagnosed?

Normal vitamin B12 levels are of the range of 200 – 900 ng/ml in the blood. If you tend to have the vitamin B12 levels of lower than the given range and if you exhibit certain symptoms of pernicious anemia, it is better to consult a doctor. When you consult your doctor, the following tests will be performed depending on the symptoms you state.

A complete blood count test to measure the vitamin B-12 and iron levels in blood serum. A blood test for determining the vitamin B12 levels. You may be asked to enroll for a biopsy (a tissue removed from your body). The biopsy is done to obtain a tissue sample of the stomach cells to examine for any damage.

Intrinsic factor deficiency test may be recommended via your blood sample and stomach sample.

Schilling test: A Schilling test (named after Robert F. Schilling) is a test to check if the body is absorbing vitamin B12 properly or not. Here, the urine samples are collected 24 hours after the radiolabelled vitamin B12 administration. Urinary excretion of 8 – 40% radiolabelled urine is considered normal.

How is it treated?

If you have severe Pernicious anemia, your doctor may recommend shots or injections at first. These shots are administered in the muscle every day or every week until the level of vitamin B12 in your blood increases. Upon normalization of your vitamin B12 in your blood, your doctor might recommend you to get a shot only once a month.

The doctor may recommend large doses of vitamin B12 pills. If a patient has less severe pernicious anemia. The patient can use vitamin B12 nose gel and sprays if he/she has trouble swallowing the pills. This is usually suggested for those patients who have had a stroke and for elderly people.

Depending on the improvement of your symptoms, your doctor may advise you to curtail your physical activity till the vitamin B12 levels stabilize.

Depending on the cause for this disorder, your doctor may suggest you take certain medications in order to treat the impairment in the absorption of vitamin B12 in your body. The doctor will also prescribe vitamin B12 supplements to infants of strict vegetarian mothers.

Facts

  • More females than males are affected by Pernicious anemia.
  • Without treatment, some of the triggering factors can become permanent.

Facts

  • The term “pernicious” means “deadly.” It was termed in this manner because earlier, the treatment for vitamin B12 was not available.
  • It is often hereditary.

Facts

  • Vitamin B12 is not found in fruits.

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Dos and Don'ts

Dos
  • Eat a vitamin B12 supplemented diet if you are a vegetarian.
  • If you show certain symptoms, get it checked at the earliest.
  • Follow the instructions given by your doctor with regards to the medications or the vitamin B12 supplements.
Don'ts
  • Ignore any symptoms.
  • Indulge in a strictly vegan diet (completely devoid of milk and milk products).
  • Increase your physical activity if your Vitamin B12 levels are too low.

 

 

 

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Caralluma Fimbriata: How to eat this cactus to lose weight Caralluma fimbriata is a miracle cactus that can be safely consumed by most for losing weight and boosting…
Tamarind: The top health benefits of this staple Asian ingredient Did you know this sweet and sour pulpy fruit does more than just add a tangy flavor to…
Piaget stages: Do they accurately describe the way the human brain develops?  A common assumption was that children are less competent thinkers as compared to adults, but this was refuted…
Coffee Enema: Turn your favorite morning beverage into a powerful colon cleanser The wonders of coffee are not just limited to waking you up every morning. You can now use…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
amylase test
Amylase Test Amylase test is done by checking the level of this protein in the blood sample and also in…
chloride test
Chloride Test A chloride test of the blood checks the level of chloride in body, an important factor governing the…
malarial antigen test
Malaria Antigen Test A malaria antigen test is a rapid diagnostic test (RDT) that can detect malarial antigens (proteins) in your…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
shiitake mushrooms healthy
What are Shiitake Mushrooms and why should you eat them? Shiitake Mushrooms are well known for their smoky and robust taste. However, did you know they are replete…
Optavia diet
The features of an Optavia diet The Optavia diet endorses pre-packaged meals and snacks called "fuelings" that are tasty, low in calorie, and incorporates…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
Jackfruit: Slice your way into higher immunity, better digestion, & more… Native to the South East Asia, the jackfruit is a fruit brimming with thousands of health benefits. Discover…
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
Epley maneuver: Why is this the best protection from the symptoms of vertigo? Epley maneuver is an exercise that can treat the symptoms of benign paroxysmal positional vertigo (BPPV).  It was…
The Cabbage Soup Diet: The healthiest way to instant weight loss Cabbage soup diet rapid weight loss diet for those who want to shed those extra pounds in less…
Atkins diet weight loss
Atkins Diet: The right steps to carb control that can help you lose those pounds fast The Atkins diet is a high fat, low-carb diet with proven weight loss benefits that is flexible enough…
myelogram
Myelography Myelography is an important diagnostic tool that is used to investigate and identify abnormalities in the spine and…
Coconut sugar: What is it and is it healthier than table sugar? In the long list of things that the wonderful coconut gives us, coconut sugar is another remarkable addition.…
Mood swings
The real reasons for your mood swings and how to overcome them Are you prone to heated moods frequently? Do you also feel bouts of depressive feeling creeping up on…
Quinine: How gin and tonic came to be known as a potent health elixir The discovery of quinine-containing tree bark is sometimes considered the most serendipitous medical discovery of the 17th century.
These are the top foods to increase your hemoglobin count It is important to add iron-rich foods into your diet in order to increase hemoglobin. Deficiency of hemoglobin could…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
ANTIPHOSPHOLIPIDANTIBODY(APL)_IgG
Antiphospholipid (APL) antibody-IgG The Antiphospholipid Antibody testing is a blood test used to determine an autoimmune disorder called Antiphospholipid syndrome linked…
valproic acid test
Valproic Acid Test Valproic acid test is performed to generally check for psychiatric and even neurological conditions such as bipolar disease…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
Rubella IgM test
Rubella IgM Test The Rubella IgM test is a blood test that is performed to diagnose the presence of the rubella…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
sodium blood test
Blood Sodium Test A blood sodium test measures the amount of sodium (an important electrolyte) in your body. It is also…
Okra: How can this nutrient-dense vegetable help you fight diabetes? Okra is a food which is rich in nutrients and minerals which are extremely essential for a healthy…
hidden benefits walking
9 benefits of walking we bet you didn’t know! Did you know walking can be the miracle pill for eternal youth? Everyone knows walking is good for…
stress depressed anxiety
Are you depressed or just stressed? Know when to see a doctor Why are some people more anxious than others? Is being depressed the same as feeling sad? Have you…
acne removal tips
Anatomy of acne: 7 instant steps to kiss those zits goodbye Blackheads, whiteheads, or pimples-call them what you may. Acne is never good news.Did you know some of the…