Pernicious Anemia

Foods High in Vitamin B12

Salmon is a good choice to eat to take in vitamin B12 naturally.
Salmon is a good choice to eat to take in vitamin B12 naturally. | Source

Rare Form of Anemia

Pernicious Anemia is a little known disease that afflicts many people in the United States and around the world. In 1996 approximately 399,455 people were living with pernicious anemia. That translates to roughly 1 out of every 680 people who are living with this disease. Pernicious Anemia is routinely misdiagnosed, leaving sufferers searching for answers.

How To Acquire Pernicious Anemia

There are three main ways of acquiring pernicious anemia.

  1. A protein in the stomach called intrinsic factor. This protein is made by the cells in the lining of the stomach. When this protein is not produced B12 is not absorbed by the body resulting in pernicious anemia.

  2. Eating a vegetarian diet lacking in B12 or eating a poor diet.
  3. Intestinal disorders such as Crohn’s disease interfere with bodily absorption of B12.

What is Pernicious Anemia?

Anemia is a blood disorder in which the blood cells are unable to get enough oxygen. The most common symptom of anemia is exhaustion or being tired. Pernicious Anemia is an autoimmune disease that may be diagnosed in childhood, but rarely appears before the age of thirty. You can't prevent pernicious anemia caused by a lack of a protein called intrinsic factor. Without intrinsic factor, you won't be able to absorb vitamin B12 and will develop pernicious anemia. Patients with pernicious anemia are unable to absorb vitamin B12 (cobalamin) into their system from food.

  • The inability to absorb B12 into the digestive tract is permanent. There is no cure for this disorder.

Symptoms of Pernicious Anemia

  • Tiredness
  • Exhaustion
  • Weakness
  • Confusion
  • Heart Palpitations
  • Shortness of Breath
  • Low B12 level
  • Nausea
  • Diarrhea
  • Difficulty concentrating
  • Tingling in hands and feet

National Institute of Health Findings

According to the National Institute of Health, some people develop Pernicious Anemia from a poor diet. For these people, eating foods high in B12 will be effective. Steps can be taken to prevent the disorder if caused by dietary factors.

Because pernicious anemia is so rare doctors usually find it in the search for other causes such as heart disease, neurological disorders, and other forms of anemia. Pernicious anemia is known by many other names. These are megaloblastic anemia, Vitamin B12 deficiency anemia, combined systems disease, and congenital pernicious anemia.

Oraganization for members with Pernicious ANemia
Oraganization for members with Pernicious ANemia | Source

Untreated Pernicious Anemia

People with untreated pernicious anemia for the long term may be subject to heart failure, heart attacks, strokes, stomach cancer, confusion, and memory loss. If left untreated the patient will have difficulty with activities involved in daily living and may suffer damage to the heart, nervous system, and digestive tract. The condition may ultimately be fatal if left untreated over long periods of time.

Foods Rich in B12

Food Item
Portion Size
Vitamin B12 (mcg)
Beef liver, braised
3.5 ounce
Atlantic Mackerel cooked dry heat
3 ounce
3 ounce
Caviar or fish eggs are ten times richer in B12 than chicken eggs.

Pernicious Anemia Explained

B12 Injection

 500 mcg B-12 (as 1/2 cc) drawn up in a 1/2 cc U-100 27 gauge x 1/2" insulin syringe,
500 mcg B-12 (as 1/2 cc) drawn up in a 1/2 cc U-100 27 gauge x 1/2" insulin syringe, | Source

More Risk Factors

Genetic risk factors:

  • Scandinavian or Northern European descent
  • Have a family history of the condition

Some common risks or causes:

  • Weakened stomach lining (atrophic gastritis)
  • An autoimmune condition in which the body's immune system attacks intrinsic factor protein or the cells that make it.

Getting Treatment

Because this disorder is rare many people discover their doctor to be resistant to even getting tests for B12 levels. Be persistent. You know your own body and the risks of being untreated are high. So do not allow your doctor to discount your need to know. If necessary insist on getting the blood test that will validate your concerns. Inform your doctor if you are taking para-aminosalicylic acid, colchicine, neomycin or phenytoin (also known as Dilantin), as these may affect your test results. Folic acid can also mask a B12 deficiency so be sure to inform your physician.

Be proactive about your treatment. If your doctor refuses treatment find one who will give you the treatment you need.

Get the facts about the disease.
Get help.


Pernicious anemia is easily treated with regular vitamin B12 injections. Depending on B12 (cobalamin) levels when diagnosed it may be necessary to receive injections weekly to get levels back to normal then monthly. Get regular blood tests to stay on top of your B12 level.

While there is no cure for this disorder, regular injections of vitamin B12 will prevent further damage to the body systems. Sufferers will notice immediate results within hours of being injected with vitamin B12.

Patient Discussion About B12 Injections

Some Affects of Low B12 Levels

According to the National Institute of Health low B12 levels may cause false pap smears. Some blood tests may be affected by low B12 levels. These tests are:

Tests for Pernicious Anemia

Possible Disease Progression

The disease may cause gastric polyps, gastric cancer or gastric carcinoid tumors. While rare the possibility is there if the disease is left untreated.

Alternative Names for Pernicious Anemia

Macrocytic achylic anemia; Congenital pernicious anemia; Juvenile pernicious anemia; Vitamin B12 deficiency (malabsorption).

More by this Author

Comments 7 comments

Peter Geekie profile image

Peter Geekie 4 years ago from Sittingbourne

Dear Smireles

Excellent article and well researched

Voted up

kind regards peter

Smireles profile image

Smireles 4 years ago from Texas Author

Thank you for your comment Lahoma Howard. This is an older article and with changes in medical treatment it is quite possible that my information may be out of date. I will research and update. I appreciate your input.

Lahoma Howard 4 years ago

I recently was diagnosed with PA. You have an error in your blog post- B12 is Cobalamin NOT Folate, in fact supplementing folate to someone with anemia due to B12 deficiency can lead to a masking of symptoms on a CBC and delayed diagnosis. Also - the name pernicious anemia technically only belongs to the autoimmune disease that destroys stomach parietal cells and intrinsic factors, the others are considered megaloblastic anemia due to B12 deficiency. The incidence of this disease from what I read at the Mayo clinic website states that 10-20 people in 100,000 will have this disease, or 1-2 out of 10,000 people (this is true pernicious anemia) the incidence of B12 deficiency anemia I believe is much higher and mostly because doctors refuse to diagnose b12 deficiency even when the symptoms are overt and follow the textbook. It is much more lucrative to give us all kinds of pills and line us up for MRI's and other expensive tests before doing a simple 50$ antibody test and a serum B12 test.

Julie 7 years ago

It took ages for my diagnosis of PA and I truly believe I've suffered some long term physical damage as a result. Happy to say though at long last I managed to get my Doc to let me have regular 'monthly' B12 injections (3 months is standard in the UK) and I'm actually self injecting too. Please everyone be persistent and hopefully you'll get what you need.

Jen's Solitude profile image

Jen's Solitude 7 years ago from Delaware

Your hub is very informative. I have a good friend who has Crohn's and she receives injections regularly, now I understand what type of anemia she has. Thanks for the info!


Smireles profile image

Smireles 7 years ago from Texas Author

Thank you. My sister and niece are both diagnosed with Pernicious Anemia and practically have to beg for B12 shots! My 22 yr old niece was being tested for heart disease and was better in 2 hours after her first B12 injection. Nor more problems!

Liz P profile image

Liz P 7 years ago from West Midlands

This is a really good hub, very helpful about a topic I truly believe isn't as rare as doctors would have us believe it is!

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