Have you been feeling overly tired of late? Suffering from an unexplained shortness of breath? Having bouts where you are light headed or getting heart palpitations? It could be that you have pernicious anaemia. ‘Pernicious’ means a harmful affect, more often in a gradual way, and having anaemia means you have a lower than normal level of red blood cells. The name pernicious anaemia is used, however, for the specific condition where the body cannot absorb Vitamin B12 into the body, via the gastro-intestinal tract, leading to a severe lack of the vitamin. Apart from the symptoms already mentioned, you could also suffer from a sore mouth and tongue, experience weight loss and have bouts of diarrhoea. You could also experience numbness and tingling in your fingers and toes, as Vitamin B12 is a requirement for healthy nerve growth, so if a deficiency isn’t corrected, there may be weakness and balance problems, memory loss and confusion.
Vitamin B12 is vital to help manufacture new red blood cells. When Vitamin B12 is deficient, less red blood cells are produced that are much larger in size (megaloblastic) and they do not last as long as normal. This means that the person becomes anaemic. Pernicious anaemia develops when the body becomes unable to absorb vitamin B12 properly from food. What usually happens is a protein called an intrinsic factor (made in the stomach) attaches to vitamin B12 and carries through the intestinal wall into the blood stream. In cases of pernicious anaemia, the cells in the stomach that produce intrinsic factor have become damaged and vitamin B12 is no longer absorbed. The Vitamin B12 deficiency develops which leads to pernicious anaemia.
You can get pernicious anaemia several different ways. One is through the result of an autoimmune disorder, where the body attacks itself. Typically this is genetic and is more likely to occur if someone in your family has already had other auto-immune diseases of the hormone glands such as thyroid disease or diabetes. Stomach surgery, ulcers in the stomach or cancer in the stomach that affect the number of intrinsic factor-producing cells may also result in pernisious anaemia. One of the commonest causes is simply thinning or atrophy of the cells that line the stomach, which occurs with age. This partly explains why pernicious anaemia is most common in older people – around one in 8,000 people over the age of 60 has pernicious anaemia and it is much more common among those over 80. Pernicious anaemia also affects women more than men. Diet is another important factor in reasons why some people contract pernicious anaemia. For some people do not eat enough food that contain Vitamin B12. Vegans and some vegetarians are most likely at risk as Vitamin B12 is found in foods of animal origin, such as meat, fish, cheese, eggs and milk. A strict vegetarian or vegan, who do not eat any animal proteins in their diet, should make sure they supplement it with vitamin supplements of B12. Other causes of B12 deficiency include certain medicines (especially some used for tuberculosis), heavy infestations of intestinal parasites, and rare metabolic disorders.
If you think you may be suffering from pernicious anaemia then you should visit your doctor who can give you a simple blood test to diagnose anaemia. The red blood cells will be examined to see whether they’re larger than normal. If they are, a Schilling test, this measures the body’s ability to absorb vitamin B12 from the bowel, will determine whether it’s pernicious anaemia. Treatment for pernicious anaemia is usually an injection of B12 to raise the levels of the vitamin immediately. Then typically every three months or so, you will require injections on a regular basis for the rest of your life, to top up the vitamin, as your body cannot absorb it by itself.
For more information about pernicious anaemia please visit the Pernicious Anaemia Society.