Pernicious Anemia

In general, anemia is a condition in which the body has an inadequate amount of healthy red blood cells.  One of the main jobs of red blood cells in your body is to provide oxygen and nutrients to your tissues, so with an inadequate supply there will be problems.  There are many different types of anemia, pernicious anemia being one of them. 

Pernicious anemia is a decrease in red blood cells that occurs when your intestines cannot properly absorb vitamin B12.  In order for your body to produce red blood cells it depends upon vitamin B12.  However, with pernicious anemia that vitamin is lacking which results in decreased production of red blood cells.  You get vitamin B12 from your diet; it comes from eating food such as meat, poultry, shellfish, eggs, and dairy products.  If you are allergic to any of those sources of vitamin B12, it will make it increasingly difficult to consume enough of the vitamin in order to continue adequate production of red blood cells.  Overall, the lack of vitamin B12 consumption over time will end up resulting in pernicious anemia.

There is a special protein in your intestines that helps you absorb vitamin B12, it is called intrinsic factor.  Intrinsic factor protein is released by cells in your stomach, so when your stomach doesn’t make enough of it, your intestines cannot adequately absorb vitamin B12.  So what causes pernicious anemia?

            Causes of Pernicious Anemia

·      Weakened stomach lining, otherwise known as atrophic gastritis

·      An autoimmune condition where your immune system attacks the intrinsic factor protein or the cells in your stomach lining that produce it.  Remember, in an autoimmune condition your body simply attacks itself.

In adults, the symptoms of pernicious anemia are usually not seen until after age 30 with the average age of diagnosis being 60 years.  If you have a family history of this condition, you will have an increased risk of acquiring it as you age.  There are also other certain disorders that increase your risk too, which include:

·      Addison’s disease

·      Chronic thyroiditis

·      Graves’ disease

·      Hypoparathyroidism

·      Hypopituitarism

·      Myasthenia gravis

·      Type 1 diabetes

·      Vitiligo

·      Testicular dysfunction

Speak with your provider if you have any of the medical conditions listed above for further explanation and to determine whether or not you have signs or an increased risk of pernicious anemia.  Some individuals may not have symptoms, and others may just have mild symptoms, which include: 

·      Desire to eat ice or other non-food items (Pica)

·      Diarrhea or constipation

·      Fatigue

·      Lack of energy

·      Light-headed when standing up

·      Light-headed with exertion

·      Loss of appetite

·      Having pale skin

·      Difficulty concentrating

·      Shortness of breath during exercise

·      Swollen, red tongue or bleeding gums

Of the symptoms above, a definitive symptom of pernicious anemia is a swollen, red tongue or bleeding gums.  If you have that symptom your provider will be able to more easily diagnose you condition.  A decrease in vitamin B12 consistently, and for an extended period of time can result in nervous system damage.  The symptoms of nervous system damage can include confusion, depression, loss of balance, and numbness/tingling in the hands and feet. 

To aid in your diagnosis of pernicious anemia, your provider and nurse will complete a complete physical examination.  You may have a few of the following diagnostic tests completed during your examination in order to make a more definitive diagnosis of pernicious anemia; these tests include but are not limited to:

·      Complete blood count (CBC)

·      Schilling test

·      Vitamin B12 level

·      Reticulocyte count

·      LDH level

As far as treatment goes, the ultimate goal is to increase your level of vitamin B12 to get things going as they should. 

            Treatment of Pernicious Anemia

·      If you cannot absorb vitamin B12 by mouth, you will receive an injection of vitamin B12 monthly.  Once injected, the vitamin will assume a different route directly into the bloodstream and will no longer have to depend upon you consuming it by mouth. 

·      Some individuals may have severely low levels of vitamin B12 and may require more injections at the start of treatment to boost their levels.

·      Some individuals may just need to take vitamin B12 supplements in high-doses by mouth.  For these individuals, these high-dose supplements usually do the trick and they are not required to have injections.

·      There is also a certain type of vitamin B12 that can be administered via the nasal route. 

Once you are diagnosed, your provider will determine which path of treatment will benefit you the most in order to increase your vitamin B12 levels.  In addition to medication, your provider will also encourage and recommend to you that eating a well-balanced diet will help to improve your vitamin B12 levels.  If needed, a dietician consult can be carried out to help you incorporate correct and adequate dietary changes into your daily routine. 

Some good news from all this is that those who are diagnosed with pernicious anemia and who are compliant with treatment usually do well.  It is very important to begin treatment as early as possible because if treatment does not start within six months of the onset of your symptoms, nerve damage could occur which could lead to more complications. 

Total Home Health has a program that is right for you related to your diagnosis of pernicious anemia.  Our highly-skilled professionals will adhere strictly to your treatment plan and encourage you to continue to practice routines as recommended by your provider and other members of your health care team.  From all this information, the most important point to remember is that the symptoms of this condition may be vague but you should not wait to seek medical attention if you notice any of them.  Total Home Health is all about prevention and promotion of your health and we like to get you treatment as quickly as possible in order to prevent further complications in the future.  Your optimal health and happiness is our number one goal.  Enroll today and we’ll treat you as one of our own!