Pernicious anemia, also known as Biermer's anemia, is a type of anemia where the human body is unable to produce enough healthy red blood cells due to insufficient Vitamin B12. Vitamin B12 is vital for the proper development of red blood cells. Pernicious anemia is also referred to as a form of megaloblastic anemia which is caused by impaired uptake of vitamin B 12 due to the lack of intrinsic factor (IF) in the gastrointestinal tract. In this condition large, immature, nucleated cells known as mega oblasts circulate in the blood, and do not function as blood cells.
Vitamin B12 is essential for cell differentiation and regular division of blood cells. In people suffering from pernicious, due to Vitamin B12 insufficiency, red blood cells don't divide normally, become too large and have trouble getting out of the bone marrow making it difficult for oxygen (carried by red blood cells) to reach all parts of the body. This results in tiredness, fatigue and weakness.
Severe pernicious anemia can have serious and often long lasting repercussions such as damage to the heart, brain, and other organs in the body. Pernicious anemia also can cause other complications, such as nerve damage, neurological problems such as memory loss and digestive tract problems. Cobalamin deficiency, macrocytic anemia and other neurological complications are some of the disorders that are associated with insufficient absorption and metabolism of vitamin B 12, which is the main cause of pernicious anemia.
Pernicious anemia that occurs at birth is inherited and the person having this disease tends to inherit two copies of defective genes; one from each parent. This disease begins slowly and mainly occurs in children. This type of anemia usually does not appear before age 30 in adults.
Pernicious means deadly. The anemia is so named because it was often a fatal condition in the past. First with liver therapy and now with Vitamin B12 medications and supplementation it has become possible to overcome pernicious anemia.
Pernicious Anemia Vitamin B12
Pernicious anemia and inadequate intake of Vitamin B12 are very closely connected. The main cause of being affected by this anemic condition is due to Vitamin B12 deficiency. Healthy red blood cells are essential to carry oxygen throughout the body. And sufficient Vitamin B12 is required for the production of healthy red blood cells. When there is Vitamin b12 deficiency the red blood cells don't divide normally, become too large and have trouble getting out of the bone marrow. This affects the oxygen supply resulting in fatigue, weakness or tiredness.
Vitamin B12 deficiency can cause nerve damage, muscle weakness and loss of reflexes. The person suffering form Vitamin B12 deficiency may feel unsteady; have trouble walking as well as experience loss of balance.
Pernicious anemia as a result of Vitamin B12 deficiency can result in neurological problems such as confusion, dementia, depression, and memory loss or digestive tract problems such as nausea, vomiting, heartburn, abdominal bloating and gas, constipation or diarrhea, loss of appetite, and weight loss. An enlarged liver and a smooth, beefy red tongue are also signs of vitamin B12 deficiency and pernicious anemia.
As for adults even in children and infants, Vitamin B12 deficiency can cause serious complications such as poor reflexes or face tremors, tongue and throat problems. If vitamin B12 deficiency isn't treated, infants can have permanent growth problems.
Pernicious Anemia causes
Pernicious anemia is mainly caused due to lack of intrinsic factor, infections, imbalanced diet as well as surgery. Intrinsic factor is a protein produced in the stomach that helps in the absorption of Vitamin B12. Vitamin B12 and intrinsic factor (IF) are generally absorbed in the lower part of small intestine. Due to inadequate intrinsic factor, the intestine cannot absorb adequate quantity of Vitamin B 12.
Another reason for lack of intrinsic factor could be autoimmune response, where the immune system makes antibodies (proteins) that mistakenly attack and damage the body's tissue.
In pernicious anemia, the body makes antibodies that attack and destroy the parietal (pa-RI-e-tal) cells in the stomach lining that make intrinsic factor. Without intrinsic factor, Vitamin B12 cannot be moved in the small intestine making absorption difficult resulting in Vitamin b12 deficiency.
In some are cases, children are born with an inherited disorder that prevents their bodies from making intrinsic factor. This disorder is called congenital pernicious anemia.
Weakened stomach lining also known as atrophic gastric mucosa is another cause which leads to pernicious anemia. Pernicious anemia may also lead to autoimmune disorders such as Addison’s disease, chronic Thyroiditis, Graves ’ disease, Hyporparathyroidism, Hypopituitarism, Type 1 diabetes, testicular dysfunction and vitiligo.
Other causes for pernicious anemia also include gastrointestinal disease, stomach removal surgery, surgery of small intestine, malabsorption of Vitamin B12 in small intestine, celiac surgery and Crohn’s Disease. Intestinal parasites and metabolic disorders are some the major causes for pernicious anemia.
Poor diet during pregnancy or inadequate diet during infancy and inadequate nutritional diet can also lead to pernicious anemia. People develop pernicious anemia because they don't get enough Vitamin B12 in their diets. Vegetarians, vegans as well as breast fed babies of vegetarians and vegans are more at risk of developing pernicious anemia due to Vitamin B12 deficiency.
The best food sources for vitamin B12 are meat, poultry, fish, eggs, and dairy products. Dietary supplements are excellent source of vitamin B12.
Pernicious Anemia symptoms
The major causes of pernicious anemia are due to Vitamin B12 deficiency. Due to Vitamin B12 deficiency the body cannot produce enough healthy red blood cells which lead to anemia and neurological problems.
The most common symptom of all types of anemia is fatigue. This symptom is due to the body not having enough red blood cells to carry oxygen to its various parts. Lack of red blood cells means the heart has to work harder to move oxygen-rich blood through the body. This can lead to arrhythmias (ah-RITH-me-ahs), heart murmur, an enlarged heart, or even heart failure.
Common symptoms of pernicious anemia include bleeding gums, diarrhea, fatigue, sore mouth, and impaired sense of smell, loss of appetite, rapid heart rate, and shortness of breath.
Other symptoms of pernicious anemia may include pale or yellowish skin, a low-grade fever, and dizziness when standing up. In severe cases pernicious anemia can also lead to heart failure and cancer.
How can Pernicious Anemia be prevented?
Pernicious anemia due to lack of intrinsic factor cannot be prevented. But if the pernicious anemia is due to other dietary factors, then a well-balanced diet, rich in Vitamin B12, folic acid, iron and other nutrients can go a long way in helping prevent pernicious anemia.
Including excellent sources of Vitamin B12 such as eggs, meat, poultry, shellfish, milk, orange juice, fortified cereals, barley, sprouts, broccoli, peas etc. help the body receive adequate amount of Vitamin B12.
Early diagnosis is another step towards taking acre of pernicious anemia. Being well informed about the history of pernicious anemia among family members allows a person to work with a doctor to develop a plan for early detection.
With proper treatment and care pernicious anemia can be treated and those suffering from it can recover, feel well, and live normal lives. Vitamin B12 supplements are generally used to overcome pernicious anemia.