Pernicious Anaemia – Understanding the Condition
Pernicious anaemia is an autoimmune condition in which the body’s immune system attacks stomach cells that produce a protein vital for the absorption of vitamin B12.
Vitamin B12 is absorbed into the body through the stomach. In order for this to happen, gastric parietal cells in the stomach release a protein called intrinsic factor. People with pernicious anaemia produce antibodies which attack the gastric parietal cells so that not enough intrinsic factor is made. Without intrinsic factor, vitamin B12 cannot be absorbed from the stomach. This deficiency causes anaemia because the body cannot produce fully functioning red blood cells which are vital for carrying oxygen around the body.
Red blood cells need three essential ingredients to perform their main function of transporting oxygen from the lungs to cells throughout the body and these are:
- Folate – also known as Folic Acid or Vitamin B9. This is found in leafy green vegetables, peas and dried beans. Marmite and breakfast cereals also contain high concentrations and it is sometimes added to bread.
- Iron – This is found in red meat, fish, poultry, lentils, beans, black eyed peas and beefy drinks such as Bovril.
- Vitamin B12 or Cobalamin – This is found in meat, fish and dairy products such as eggs, milk and butter.
How common is pernicious anaemia?
Pernicious anaemia is the most common cause of vitamin B12 deficiency in the UK. It is more common in people over 60 years of age and more prevalent in women than men. Doctors do not know why some people produce the antibodies that destroy the parietal cells in the stomach. If you suffer from another autoimmune condition such as Addison’s disease or vitiligo, you are more at risk of developing pernicious anaemia.
What are the symptoms of pernicious anaemia?
It is important to remember that symptoms vary from person to person but may include:
- Shortness of breath
- Extreme fatigue
- Poor concentration
- Memory loss
- Confusion and forgetfulness
- Clumsiness and lack of co-ordination
- Brittle or flaky nails
- Dry skin patches or psoriasis
- Mood swings and heightened emotions
- Dizzy or faint spells
- Numbness or tingling especially in the hands, arms, legs and feet
- Fibromyalgia or neuropathic pain, often on only one side of the body
- Coeliac disease or sensitivity to wheat
- Sleep disturbance
How is pernicious anaemia diagnosed?
If your GP thinks you may have vitamin B12 deficiency anaemia, they will carry out a blood test by taking a sample from your arm to measure all the different types of blood cells in the sample. They may also recommend a further test called the intrinsic factor antibody test which looks for the antibodies which attack the stomach cells. If you test positive for the antibodies, you will be diagnosed with the condition.
What are the treatment options?
The NHS recommends that patients are given injections of vitamin B12 in the form of a substance known as hydroxocobalamin. These are usually given every three months for the rest of the patient’s life. These will be followed by blood tests to ensure that the level of vitamin B12 in your body are starting to rise and that they reach a normal level.
Some patients use alternative forms of vitamin B12 to supplement their treatment between injections. These can include sublingual lozenges, sprays or drops, skin patches or nasal sprays. Sublingual supplements are placed under the tongue and are absorbed through the mucosal membrane that lines your mouth. These supplements should always be discussed with your doctor as the will have an effect on your blood tests.
For more information and advice from the Pernicious Anaemia Society please click on the link.
If you would like to read more about Vitamin B12 deficiency, please follow the link above to our earlier article.
Finally, don’t suffer in silence, if you are at all concerned about your symptoms, speak to your GP who will advise you on the best way to treat your condition.
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