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Pernicious Anemia: Causes, Symptoms, Treatment, and Cost

Last Updated: Feb 24, 2023

What is Pernicious Anemia?

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A lack of vitamin B12 can result in a specific type of anemia called pernicious anemia. The production of red blood cells and the healthy operation of the neurological system both depend on this vitamin. It is characterized by the inability of the body to effectively absorb this vitamin, which is necessary for the production of red blood cells and the healthy operation of the nervous system.

Anemia results from a lack of sufficient vitamin B12 in the body, which prevents the body from producing enough healthy red blood cells. Pernicious anemia can also lead to a variety of symptoms, including fatigue, weakness, and neurological problems, as vitamin B12 is necessary for the proper functioning of the nervous system.

Types of Pernicious Anemia

There are two types of pernicious anemia: Type 1 and Type 2.

Type 1 pernicious anemia

It is brought on by an autoimmune condition that impairs the stomach's ability to produce intrinsic factor, a protein required for vitamin B12 absorption. The stomach's intrinsic factor-producing cells are attacked and destroyed by the autoimmune disorder, which results in a vitamin B12 deficiency. Autoimmune gastritis is another name for this particular form of pernicious anemia.

Type 2 pernicious anemia

It is brought on by a genetic flaw that interferes with the body's ability to transport vitamin B12 from the intestine to the bloodstream. Type 2 pernicious anemia, which is less frequent than Type 1, can result from mutations in genes related to the transport of vitamin B12.

Both types of pernicious anemia can cause similar symptoms and can be treated with vitamin B12 replacement therapy. However, the underlying cause of the condition will determine the exact treatment plan and the outlook for the individual.

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What are the symptoms of Pernicious Anemia?

Symptoms of pernicious anemia can vary, but common symptoms include:

  • Depression and irritability
  • Difficulty maintaining balance
  • Fatigue and weakness
  • Heart palpitations
  • Loss of appetite
  • Numbness or tingling in the hands and feet
  • Pale skin
  • Shortness of breath
  • Weight loss

Can I have pernicious anemia without having symptoms?

Yes, it is possible to have pernicious anemia without experiencing any symptoms. This is known as asymptomatic pernicious anemia. However, even if you do not experience symptoms, it is still important to get tested for the condition, as it can lead to serious health problems if left untreated.

What causes Pernicious Anemia?

Pernicious anemia is caused by a deficiency in vitamin B12. This deficiency can be caused by a number of factors, including:

  • An autoimmune disorder that affects the stomach's ability to produce intrinsic factor
  • A genetic flaw that interferes with the body's ability to transport vitamin B12 from the intestine to the bloodstream
  • A low-vitamin B12 diet, like a vegetarian or vegan one
  • Gastrointestinal surgery that involves the removal of a portion of the small intestine or stomach
  • Certain medications that interfere with the absorption of vitamin B12

How does pernicious anemia affect my body?

Pernicious anemia can have a number of negative effects on the body. The most severe of these are listed below;

  • Lack of red blood cells from pernicious anemia can result in weariness and weakness.
  • Neurological issues brought on by pernicious anemia include memory and concentration issues, tingling and numbness in the hands and feet, and balance issues
  • Pernicious anemia can lead to nerve damage
  • Pernicious anemia can lead to heart failure
  • Pernicious anemia can lead to an increased risk of infection and cancer
  • Birth abnormalities and pregnancy difficulties including miscarriage can result from pernicious anemia.

What are the Risk Factors of Pernicious Anemia?

Risk factors for pernicious an anemia include:

  • Being over the age of 60
  • Having a family history of the condition
  • Having an autoimmune disorder such as pernicious anemia or autoimmune gastritis
  • Having had gastrointestinal surgery
  • Taking certain medications, such as proton pump inhibitors or metformin
  • Following a vegetarian or vegan diet
  • Having a history of alcohol abuse

How can you prevent Pernicious Anemia?

To prevent pernicious anemia, it is important to maintain a diet that is rich in vitamin B12. This can be done by including the following measures in your daily life;

Do

  • Maintaining a diet that is rich in vitamin B12 can help to prevent pernicious anemia. This can be done by eating foods such as meat, fish, dairy products, and eggs, or by taking vitamin B12 supplements if necessary
  • Regular blood tests to check for vitamin B12 deficiency, especially if you have any of the risk factors for pernicious anemia
  • If you develop signs of pernicious anemia, see a doctor
  • Keep up a fit lifestyle

Don’t

  • Neglect pernicious anemia symptoms
  • Without consulting a physician, don not stop taking vitamin B12 pills
  • Avoid foods that can interfere with the absorption of vitamin B12, such as large amount of alcohol, foods high in phytic acid, and foods high in calcium

It is important to note that preventing pernicious anemia is vital as it can lead to serious health problems if left untreated.

Pernicious Anemia - Diagnosis and Tests

Diagnosis and testing for pernicious anemia involves a combination of physical examination, medical history, and laboratory tests.

Physical examination

The doctor will look for anemia symptoms like paleness, jaundice, and a swollen tongue during the physical examination. Additionally, they will look for neurological signs like balance issues and tingling or numbness in the hands and feet.

Medical history

The doctor will also take a detailed medical history, including questions about dietary habits, family history of anemia, and any medications being taken.

Laboratory Tests

For the diagnosis of pernicious anemia, the following laboratory tests are frequently used;

  • Blood test to determine the quantity and size of red blood cells as well as the level of vitamin B12 in the blood
  • Schilling test to assess body’s ability of B12 absorption
  • Biopsy of the stomach may be done to check for autoimmune gastritis, which can cause pernicious anemia

These tests help to confirm the diagnosis of pernicious anemia and rule out other possible causes of anemia. The doctor will suggest the best course of action if the diagnosis is certain.

What are possible complications of Pernicious Anemia?

Possible complications of pernicious anemia include:

  • Neurological problems, such as numbness and tingling in the hands and feet, difficulty maintaining balance, and problems with memory and concentration
  • Nerve damage
  • Heart failure
  • An increased risk of infection and cancer
  • Pregnancy complications, such as miscarriage and birth defects

Home Remedies for Pernicious Anemia?

Pernicious anemia is a serious condition that requires medical treatment, but there are some home remedies that can help to alleviate symptoms and improve overall health;

  • Maintaining a diet that is rich in vitamin B12 can help to prevent pernicious anemia. This can be done by eating foods such as meat, fish, dairy products, and eggs, or by taking vitamin B12 supplements if prescribed by a doctor.
  • Taking vitamin B12 supplements as prescribed by a doctor
  • Using relaxation methods to reduce stress, such yoga, meditation, or deep breathing exercises
  • Getting plenty of water to drink and exercising frequently can both help to improve general health
  • Avoiding smoking and alcohol
  • Maintaining a healthy lifestyle

It is important to note that these home remedies should not replace medical treatment for pernicious anemia. They should only be used in conjunction with medical care and under a doctor's supervision. Also, it is important to follow a well balanced diet and have regular check-ups with a doctor to monitor the condition.

What to eat in Pernicious Anemia?

To maintain a diet that is rich in vitamin B12, it is important to eat foods that are high in vitamin B12. These include:

  • Meat, fish, and poultry
  • Dairy products, such as milk and cheese
  • Eggs
  • Fortified breakfast cereals
  • Fortified soy products

What not to eat in Pernicious Anemia?

To prevent pernicious anemia, it is important to avoid foods that can interfere with the absorption of vitamin B12. These include:

  • Large amounts of alcohol
  • Foods that are high in phytic acid, such as whole grains and legumes
  • Foods that are high in calcium, such as antacids and calcium supplements

Pernicious Anemia Treatments

Pernicious anemia is a serious condition that requires treatment to prevent serious health problems. Vitamin B12 replacement therapy is the major treatment for pernicious anemia.

Here are some of the main procedure that are recommended by the doctors for the treatment of pernicious anemia;

Vitamin B12 Replacement Therapy

The main treatment for pernicious anemia is vitamin B12 replacement therapy. This can be done through injections of vitamin B12 or through the use of oral supplements. Red blood cell formation and nervous system performance are both improved by vitamin B12 replacement therapy, which helps to return the body's levels of the vitamin to normal. Vitamin B12 replacement therapy is usually recommended for all individuals with pernicious anemia, regardless of symptoms.

Intrinsic Factor Replacement Therapy

In some cases, intrinsic factor replacement therapy may also be used to improve the body's ability to absorb vitamin B12. This therapy involves injecting a synthetic form of intrinsic factor into the bloodstream. Intrinsic factor replacement therapy is typically recommended for individuals who have Type 1 pernicious anemia and have an autoimmune disorder that affects the stomach's ability to produce intrinsic factor.

Surgery

In some cases, surgery may be recommended to remove a portion of the stomach if it is found to be severely damaged by autoimmune gastritis, which is a cause of pernicious anemia.

It is important to note that the treatment plan will vary depending on the individual and the underlying cause of the pernicious anemia. Regular doctor visits are required to monitor the disease and modify treatment as appropriate.

Which doctor to consult for Pernicious Anemia?

You should see a doctor if you think you may have pernicious anemia. A primary care physician or internist can diagnose and treat pernicious anemia. For additional assessment and care, you might also be sent to a hematologist (a blood specialist) or a gastroenterologist (an expert in digestive system issues).

Which are the best medicines for Pernicious Anemia?

Treatment is necessary for pernicious anemia in order to avoid major health issues. The following medications are some of the most popular ones used to treat the condition;

Vitamin B12 Injections

Vitamin B12 injections are one of the best approaches to cure pernicious anemia. Injections provide a high dose of vitamin B12, which is quickly absorbed into the bloodstream. These injections are usually given weekly or monthly. Vitamin B12 injections are usually prescribed to people who have difficulty absorbing vitamin B12 from the gut.

Vitamin B12 oral supplements

Vitamin B12 oral supplements are also effective in treating pernicious anemia. These supplements, which come in tablet, pill, or sublingual form, are often taken every day. Oral supplements are usually prescribed to people who do not want to take injections or to those who are unable to absorb vitamin B12 from the gut.

Intrinsic Factor replacement

Intrinsic Factor replacement is another treatment option for pernicious anemia. This therapy involves injecting a synthetic form of intrinsic factor into the bloodstream. Intrinsic factor replacement therapy is typically recommended for individuals who have Type 1 pernicious anemia and have an autoimmune disorder that affects the stomach's ability to produce intrinsic factors.

How long does it take to recover from Pernicious Anemia?

Depending on the patient and the severity of the problem, pernicious anemia might recover in a variety of ways. With the right care, many patients can make a full recovery in a matter of weeks to months. However, in some cases, it may take longer to see improvement or the condition may be chronic and require ongoing treatment.

Are the results of the treatment permanent?

The results of treatment for pernicious anemia are generally permanent as long as the person continues to follow the treatment plan, including regular vitamin B12 replacement therapy and maintaining a diet rich in vitamin B12. However, in some cases, the condition may recur if treatment is not continued.

Who is eligible for the treatment?

Anyone who has been diagnosed with pernicious anemia is eligible for treatment. Treatment is usually recommended for all individuals with the condition, regardless of symptoms.

Who is not eligible for the treatment?

Pernicious anemia treatment is not restricted to any particular demographics. However, in some cases, treatment may not be effective for individuals who have certain genetic disorders or other underlying health conditions.

What are the post-treatment guidelines?

After treatment for pernicious anemia, it is important to continue to take precautionary measure to ensure a better recovery by adopting the following guidelines;

  • Continue to take vitamin B12 supplements as prescribed by your doctor to maintain adequate levels of vitamin B12 in the body.
  • routine blood tests to check red blood cell count and vitamin B12 levels
  • Maintain a healthy lifestyle by adhering to a nutritious diet
  • Avoid drinking and smoking
  • If you encounter any new or deteriorating symptoms, get medical care
  • Keep all appointments with your doctor as scheduled so you can track your progress and change your therapy as necessary
  • If you are prescribed intrinsic factor replacement therapy, it is important to follow the schedule of injection as directed by the doctor
  • Before modifying your treatment regimen, speak with your doctor
  • If you develop any serious side effects or treatment-related problems, seek medical help right once.

What is the price of Pernicious Anemia treatments in India?

The cost of pernicious anemia treatment in India can vary depending on the type of treatment and the location of the treatment center. Vitamin B12 injections can cost between Rs. 500-1000 per injection, and oral supplements can cost between Rs. 200-500 per month. Intrinsic factor replacement therapy can be more expensive, with costs ranging from Rs. 5000-15,000 per injection.

What are side-effects of Pernicious Anemia treatments?

Although injections and supplements containing vitamin B12 are generally regarded as safe, there are potential side effects. These may consist of;

Intrinsic Factor replacement therapy can cause side effects such as:

  • Pain or swelling at the injection site
  • Allergic reactions to the synthetic intrinsic factor

The adverse effects may be transient in some situations and get better with time, but they may also be severe in other circumstances and need medical treatment.

Pernicious Anemia - Outlook / Prognosis

The prognosis for pernicious anemia is often favorable with appropriate treatment. The majority of people can totally recover in a few weeks to a few months. Pernicious anemia, however, can cause major health issues like nerve damage and heart failure if left untreated.

References

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Written ByDt. Ms. Archana Desai P.G.In Dietitics,BSc - Dietitics / NutritionDietitian/Nutritionist
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