Vitamin B12 deficiency can result in pernicious anemia, according to The Merck Manuals Online Medical Library. Vitamin B12 is normally acquired through diet. Food-bound B12 is released in the acid environment of the stomach and then travels to the small intestine where it binds with intrinsic factor, which is made in the cells of the lining of the small intestine. Intrinsic factor allows the intestine to absorb vitamin B12. Malabsorption of vitamin B12 is usually caused by a lack of intrinsic factor. Pernicious anemia is the result of malabsorption of B12.
Megaloblastic Anemia
Anemia describes the way red blood cells look in pernicious anemia. Megaloblastic anemia describes the appearance of defective red blood cells. Megaloblastic cells are large oval cells with a large nucleus in the center. These cells are malformed because of a B12 deficiency, which results in defective DNA synthesis, according to the Merck Manuals Online Medical Library. Megaloblastic red blood cells are inefficient carriers of oxygen and patients with anemia frequently complain of feeling fatigued. Patients with anemia can be short of breath, have headaches and cold hands and feet. Because there is a lack of red blood cells, the heart has to work harder, and arrhythmia and heart failure can develop.
Nerve Damage
Vitamin B12 deficiency can cause nerve damage as well. Patients complain of numbness and tingling in their hands and feet, muscle weakness and a loss of reflexes according to the National Heart Lung and Blood Institute. Other signs of nerve damage are loss of balance, an unsteady gait and trouble walking. Severe cases may demonstrate spasticity in the arms, legs and feet, as well as loss of position and vibratory sensations.
Patients with B12 deficiency may suffer brain damage. Some patients are irritable and mildly depressed. Other patients may be confused and suffer delirium, confusion and a spastic walk.
GI Symptoms
Vitamin B12 deficiency can cause gastrointestinal symptoms. Nausea, vomiting, heartburn, abdominal bloating and gas, constipation, diarrhea and loss of appetite can occur. Weight loss and an enlarged liver are also symptoms of B12 deficiency. A smooth, beefy, red tongue is another indication of B12 deficiency and pernicious anemia.
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