Pernicious anemia is a rare type of anemia caused by a lack of vitamin B12. This is an autoimmune condition that occurs when the body cannot naturally absorb B12. Only 0.1% of the general population contracts this disease, and it mostly occurs in individuals above 60 years. If left untreated, this disease can cause serious harm. Through this article, we explore what pernicious anemia is, its symptoms, and how to manage it.

Pernicious anemia and its causes

The term “pernicious” means harmful. Through this autoimmune disorder, the antibodies start attacking a protein called the intrinsic factor, which is produced in the stomach. This is vital for the absorption of vitamin B12 in the small intestine. When the body is unable to produce this factor, it leads to the deficiency of B12, which lessens the production of red blood cells that convey oxygen throughout the body.

Some surgeries require the removal of a part or the whole stomach. This may eliminate the cells that assist in vitamin B12 absorption. Approximately half of the people who undergo gastric bypass to prevent weight gain lose cells that help vitamin B12 absorption. Individuals who have had their small intestine surgically removed in part or whole may lose the ability to absorb vitamin B12, thereby leading to pernicious anemia.

Sometimes, the wrong kind of bacterial growth in the small intestine (SIBO) may ingest vitamin B12 before the body can absorb it. Vegetarians and vegans could get this if their food plan does not include enough B12. Pernicious anemia can be present for a few years before you start noticing any effects in the body. If left untreated, it can cause serious harm to the nervous system. There could also be a genetic component to this disorder. According to a study, people who have a family history of the disease or even those of Northern European or Scandinavian descent are more prone to having this.

Symptoms of pernicious anemia

While not easily detected, there are some symptoms that you should monitor. These may start as mild in the earlier stages but can get very serious over time. These include constipation, diarrhea, bloating, weightlessness, or dizziness when trying to stand up or during exercise. Some may feel breathless, usually during a workout. Patients may suffer from acid reflux or heartburn, swollen tongue, or bleeding gums.

People with more severe or prolonged vitamin B12 deficiency may experience neurological symptoms. Due to damage to the nervous system, they could experience muscle weakness, unsteady gait, and numbness in the hands and feet. Other symptoms include anxiety or depression, dementia or short-term memory loss, irritation, delusions or hallucinations, and loss of vision due to weak optic nerve.

Diagnosis and management of symptoms

After a thorough physical exam, the doctor may suggest some tests to check the current B12 level. The test will determine the complete blood count to understand the extent and type of anemia. It will be an indicator of the reticulocyte count to see if the body’s bone marrow is making new cells or not. The test will also check the lactate dehydrogenase content; a high level can be an indicator of pernicious anemia. Once the results are in, the next course of action is set.

The first and foremost priority is to get your B12 levels up, so the doctor can give direct injections initially before prescribing oral doses. In case of bacterial growth, doctors may give appropriate antibiotics. If diagnosed after experiencing prolonged symptoms, such as dementia or memory loss, patients may never be able to reverse those symptoms as the neurological damage is extensive. In such cases, B12 supplements are prescribed lifelong.

Suggested meal plan

Whether you have been diagnosed with the disease or wish to avoid it, some changes to your food regime will help maintain healthy levels of vitamin B12. Include breakfast cereals infused with vitamin B12. Beef, liver, poultry, and fish are examples of meats that should be part of your regular food plan. You should also regularly eat dairy and egg products such as milk, yogurt, and cheese. Consume soy-based beverages and vegetarian burgers that have been reinforced with vitamin B12. Additionally, do not forget to visit your healthcare provider regularly to check if all your levels are within the required parameters. Do not self-diagnose; it could cause more harm and delay your diagnosis leading to even more complications.