Pernicious Anemia

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Other names for Pernicious Anemia

Megaloblastic anemia due to B12 deficiency
Vitamin B12 deficiency anemia
Addison-Biermer disease

Synopsis of Pernicious Anemia

Pernicious anemia is a type of megaloblastic anemia caused by the body’s inability to absorb vitamin B12 (cobalamin), which is essential for red blood cell formation and nervous system function. This condition is most often autoimmune, where antibodies attack intrinsic factor or the gastric parietal cells that produce it, both of which are necessary for B12 absorption in the small intestine. Left untreated, pernicious anemia can lead to severe fatigue, cognitive changes, neurological issues, and heart problems.

Types:

  • Autoimmune pernicious anemia: Most common, due to intrinsic factor antibodies

  • Congenital pernicious anemia: Rare inherited form affecting infants

  • Secondary B12 deficiency anemia: Due to diet, surgery, or gastrointestinal diseases

Common Causes:

  • Autoimmune gastritis leading to intrinsic factor deficiency

  • Long-term use of proton pump inhibitors (reduces stomach acid needed for B12 release)

  • Gastrointestinal surgery (e.g., gastric bypass)

  • Chronic malabsorption syndromes (e.g., celiac disease)

  • Vegan diets with no B12 supplementation

Severity Causes:

  • Prolonged undiagnosed deficiency leading to irreversible nerve damage

  • Coexisting conditions such as hypothyroidism or other autoimmune disorders

  • Advanced age, which naturally reduces B12 absorption

  • Lack of treatment or poor adherence to supplementation

When to See a Doctor:

  • Persistent fatigue, weakness, or lightheadedness

  • Tingling or numbness in hands and feet

  • Pale or jaundiced skin

  • Cognitive changes, depression, or memory loss

  • Rapid heartbeat or shortness of breath

Natural remedies for Pernicious Anemia

Vitamin B12-rich foods: For individuals with mild malabsorption but intact intrinsic factor, increasing intake of B12-rich foods like eggs, dairy, fish, and fortified cereals may help maintain adequate levels.

Methylcobalamin supplements: A bioavailable form of vitamin B12 that can be taken sublingually or via injection (in severe cases). It bypasses the gut and is better absorbed in people with intrinsic factor deficiency.

Folate (vitamin B9): Folate works alongside B12 in red blood cell production. Supplementing folate can help alleviate symptoms of anemia and support neurological health when B12 is supplemented concurrently.

Iron and vitamin C: Iron supports red blood cell synthesis, and vitamin C enhances iron absorption. These can be included in the diet through foods like leafy greens, citrus, and lean meats to help compensate for anemia-related fatigue.

Probiotic support: Probiotic strains like Lactobacillus and Bifidobacterium may support gut health and improve B12 absorption where partial digestive imbalance exists.

Avoid alcohol and smoking: Both substances impair nutrient absorption and can exacerbate symptoms. Reducing or eliminating these may improve outcomes alongside supplementation.