Pernicious anemia



What is pernicious anemia?

Anemia is a condition occurs when the quantity of red blood cells (RBCs) is low. Pernicious anemia is one of the vitamin B-12 deficiency anemias, which is caused by an inability to absorb the vitamin B-12 needed for your body to make enough healthy red blood cells.

The reason why this type of anemia is called “pernicious” is that it was once considered a deadly disease due to the lack of available treatment. Today, though, the disease is relatively easy to treat with B-12 injections or supplements. However, if left untreated, vitamin B-12 deficiency can lead to several severe complications. 

How common is pernicious anemia?

Pernicious anemia is actually a rare condition, with a prevalence of .1 percent in the general population and 1.9 percent in people who are older than 60 years, according to the Journal of Blood Medicine. Please discuss with your doctor for further information.


What are the symptoms of pernicious anemia?

Pernicious anemia progress slowly and it seems to be difficult to recognize the signs and symptoms because you may have become used to not feeling well.

Commonly overlooked symptoms include:

In some rare cases of pernicious anemia, people may have neurological signs and symptoms. These can include:

  • An unsteady gait
  • Spasticity, which is stiffness and tightness in the muscles
  • Peripheral neuropathy, which is numbness in the arms and legs
  • Progressive lesions of the spinal cord
  • Memory loss

Other signs and symptoms of a B-12 deficiency, which can overlap with pernicious anemia, include:

  • Nausea and vomiting
  • Confusion
  • Depression
  • Constipation
  • Loss of appetite
  • Heartburn

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consulting with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.


What causes pernicious anemia?

Many doctor believe that there are three primary causes of pernicious anemia

Lack of vitamin B-12

Vitamin B-12 plays a role in creating RBCs, so the body requires an adequate intake of vitamin B-12. Vitamin B-12 is found in our daily meals such as meat, poultry, shellfish, eggs, etc.

Lack of IF

IF (intrinsic factor) is a type of protein enables your body to absorb vitamin B12. This protein is created by cells in the stomach. After you consume vitamin B-12, it travels to your stomach where it binds with IF. The two are then absorbed in the last part of your small intestine.

If these cells are destroyed due to the attack of your own immune system, the body can’t make IF and can’t absorb vitamin B-12.


Without enough vitamin B-12, the body will produce abnormally large red blood cells called macrocytes. Pernicious anemia is a type of macrocytic anemia. It’s sometimes called megaloblastic anemia because of the abnormally large size of the red blood cells produced.

Risk factors

What increases my risk for pernicious anemia?

There are many risk factors for this condition, such as:

  • Having a family history of the disease
  • Being of Northern European or Scandinavian descent
  • Having type 1 diabetes, an autoimmune condition, or certain intestinal diseases such as Crohn’s disease
  • Having had part of your stomach or intestines removed
  • Being 60 years or older
  • Being strictly vegetarian and not taking a B-12 supplement

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is pernicious anemia diagnosed?

If your doctor suspects that you may experience this condition, a physical examination will be performed. After the exam, your doctor will order some tests, include:

Complete blood count

This test measures vitamin B-12 and iron levels in blood serum.

Vitamin B-12 deficiency test

Your doctor can assess your vitamin B-12 levels through a blood test. Low levels indicate a deficiency.


Your doctor may also want to see if there has been any damage to your stomach walls. They can diagnose this through a biopsy. The biopsy involves removing a sample of the stomach’s cells. The cells are then examined microscopically for any damage.

IF deficiency test

Intrinsic factor deficiency is tested through a blood sample. The blood is tested for antibodies against IF and the stomach’s cells.

How is pernicious anemia treated?

The treatment for pernicious anemia is a two-part process. Your doctor will treat any existing vitamin B-12 deficiency and check for iron deficiency.

Vitamin B-12 injections can be given daily or weekly until the B-12 levels return to normal (or close to normal). During the first few weeks of treatment, your doctor may recommend limiting physical activity. After your vitamin B-12 levels are normal, you’ll only need to get the shot once per month. You can administer the shots yourself or have someone else give them to you at home to save you trips to the doctor.

After your B-12 levels are normal, your doctor may recommend you take regular doses of B-12 supplements instead of the injection. These come in pills, nasal gels, and sprays.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage pernicious anemia?

The following lifestyles and home remedies might help you cope with this condition:

  • Eating foods high in vitamin B12 can help prevent low vitamin B12 levels. Good food sources of vitamin B12 include:
  • Breakfast cereals with added vitamin B12
  • Meats such as beef, liver, poultry, and fish
  • Eggs and dairy products (such as milk, yogurt, and cheese)
  • Foods fortified with vitamin B12, such as soy-based beverages and vegetarian burgers
  • If you’re a strict vegetarian, talk with your doctor about having your vitamin B12 level checked regularly

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: August 25, 2017 | Last Modified: August 28, 2017

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