Anemia is a medical condition characterized by a decreased number of healthy red blood cells in the body. If you do not have enough healthy red blood cells, your tissues may become deprived of oxygen. There are several types of anemia, and each type develops as a result of some type of nutrient deficiency. Pernicious anemia is a type of anemia caused by lack of vitamin B-12.
Physiology
The cells in your stomach, called the parietal cells, produce a protein called intrinsic factor. When you eat foods that contain vitamin B-12, the intrinsic factor in your stomach must bind to the vitamin in order for it to be properly absorbed. Pernicious anemia can develop as a result of an abnormal autoimmune response that destroys the parietal cells in the stomach. As a result, the stomach can no longer produce intrinsic factor. Pernicious anemia can also develop if you have had all of part of your stomach surgically removed. If you lack intrinsic factor, you cannot properly absorb vitamin B-12 regardless of how much of the vitamin you consume.
Treatment
Because vitamin B-12 cannot be absorbed through the stomach without intrinsic factor, increasing your vitamin B-12 will be useless if you have pernicious anemia. In order to replenish your vitamin B-12 stores, those with pernicious anemia usually require lifelong treatment that involves regular injections of vitamin B-12. Because intravenous vitamin B-12 is injected directly into the bloodstream, it surpasses the stomach and is able to perform its functions. The National Heart, Lung and Blood Institute notes that B12 shots are usually given every day or once a week until vitamin B-12 returns to normal. Once vitamin levels are restored, B-12 injections are reduced to once per month.
Symptoms
If you do receive regular injections of vitamin B-12, you may develop several physical symptoms that affect a variety of your body systems. Initially, those with pernicious anemia experience fatigue, shortness of breath, dizziness, headache, decreased body temperature and pale skin and gums. Some people may even develop an abnormal heart rhythm, or arrhythmia. If left untreated for an extended period of time, pernicious anemia can lead to nerve damage. Nerve damage can cause a variety of physical symptoms including tingling and numbness in your hands and feet, loss of reflexes, muscle weakness, difficulty walking, loss of balance and confusion. Some people also experience negative gastrointestinal health effects, such as nausea, heartburn, abdominal bloating, flatulence, constipation, diarrhea and loss of appetite.
Considerations
The National Heart, Lung and Blood Institute notes that those with pernicious anemia are at an increased risk for developing stomach cancer. If you have pernicious anemia, it is important to get regular screenings for B-12 levels as well as stomach cancer.
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