All conditions of anemia result in low or inadequate red blood cell counts, causing patients to have tired blood. This simply means that the red blood cells are inadequate to carry sufficient amounts of oxygen to the tissues of the body for energy. This is true of pernicious anemia as well, a condition resulting from low levels of vitamin B12.
Symptoms of Anemia
The general symptoms of anemia from low B12 and other causes may include the following.
- weakness and fatigue
- headache
- dizziness
- pale complexion
- fast heartbeat (tachycardia)
- shortness of breath
- difficulty concentrating
- cold extremities
People with pernicious anemia are also at risk for developing neurological symptoms if the condition worsens due to treatment-delay or non-treatment. These more advanced symptoms may include the following.
- numbness, burning and/or tingling in the legs, arms, feet and hands
- loss of muscle coordination and muscle weakness
- ringing in the ears
- dizziness and loss of balance
- slowed or erratic reflexes
- irritability, confusion, anxiety and depression.
The Cause of Pernicious Anemia
Pernicious anemia is specifically caused by vitamin B12 deficiency. Vitamin B12 is an important vitamin that plays an essential role in the development of red blood cells. In some countries where diets are inadequate due to low intake of foods rich in vitamin B12, such as liver, red meats, poultry and dairy products, there is a higher risk for the development of pernicious anemia.
The low state of vitamin B12 is often caused by an autoimmune process in industrialized countries, while poor diet is a less common cause. The highest percent of cases in the USA and the UK for example, are caused by this autoimmune process, whereby the immune system turns on a natural substance in the digestive system called “intrinsic factor” and destroys it, rendering it incapable of absorbing proper amounts of vitamin B12 from foods eaten.
When Intrinsic Factor Becomes Deficient
This essential B12 vitamin is absorbed by the body from foods, through the digestive system via intrinsic factor, which is a protein that allows for this absorption process to take place. In some people, especially those who have autoimmune diseases, the body will begin to create “antibodies” (killer cells from the immune system), directed against intrinsic factor. Over time, these antibodies begin to destroy this substance and the body will eventually have inadequate amounts available (deficiency) for absorbing vitamin B12 from the diet.
People who already have disorders – such as autoimmune thyroid disease, celiac disease, Crohn’s disease, Addison's disease (adrenal glands), lupus, rheumatoid arthritis and other autoimmune disorders – are at higher risk for developing pernicious anemia.
Treatment for Pernicious Anemia
Pernicious anemia is treated by replacing the low vitamin B12 level. When a doctor confirms that a person has become anemic, blood tests for the cause of the anemia will then be conducted. If the cause is found to be low B12 levels, the treatment prescribed will be to replace the low vitamin to get it back to a normal level, via one or more of the methods described as follows.
- Vitamin B12 injections to replenish low levels, administered on a regular schedule, such as once-monthly, usually lifelong.
- Oral B12 in the form of tablets or liquid, as long as patients do not have sensitivity (side effects) to the oral form of the vitamin.
- Iron supplements administered to patients needing it in addition to replacement of low B12 levels.
It was once believed that injections were the only method of B12 replacement for severe deficiencies, but recent medical research articles published on the PubMed (U.S. National Institutes of Health) medical research website state that oral B12 in sufficiently high amounts can successfully treat B12 deficiency.
Diagnosing Pernicious Anemia
Blood testing of the B-12 levels is the most definitive test for pernicious anemia. Anemia can be confirmed through a “Complete Blood Count” blood test (CBC), but the test that definitively diagnoses pernicious anemia is a blood test of the vitamin B-12 level. Blood testing labs have normal ranges/values that vary, but if a lab has for example, a normal range for vitamin B-12 of between “200 to 1200 pg/ml” and the patient’s result is “150 pg/ml,” this would indicate B-12 deficiency as the cause of the anemia.
There is also a blood test to detect antibodies against the protein called intrinsic factor, and if this test comes back positive for these antibodies, this will reveal to the patient and to their doctor that the pernicious anemia is caused by an autoimmune process.
Pernicious anemia is an autoimmune disorder and is more common in patients who already suffer from other types of autoimmune diseases. The preceding subheadings can help one to recognize and understand treatment methods for this potentially serious type of anemia caused by vitamin B12 deficiency.
Sources:
Are B12 injections necessary for pernicious anemia? - Dr. Gabe Mirkin MD
MedLinePlus - U.S. National Institutes of Health
Jim Lowrance - James M. (Jim) Lowrance has authored over 100 book and ebook publications since year 2004.
