Our bodies use vitamins and minerals to produce healthy cells throughout the body, and our blood cells are not different. When there is a deficiency in a key vitamin the body will develop illnesses or diseases. One such deficiency is pernicious anemia. This occurs when the body doesn’t make enough red blood cells because of a lack of vitamin B12. This usually isn’t the result of a lack of vitamins in the diet but rather in people whose bodies have lost the ability to absorb vitamin B12 from food.
In this condition the development of blood cells is stunted and they don’t divide properly. Because they are too big they can’t exit the bone marrow. This all happens because the body doesn’t have enough vitamin B12 to use. B12 is found in foods such as meat, fish, eggs, milk and other dairy products.
Individuals can develop this condition from a lack of protein in the stomach that helps the body to absorb the vitamin B12. This protein is called an intrinsic factor made by special cells in the lining of the stomach. Those who have a problem have their cells destroyed by the body’s own immune system or as a result of stomach surgery. The lack of intrinsic factor is the most common cause of pernicious anemia.
The second cause if from those who live on a strict vegetarian diet low in B12 or a diet that is poor due to aging or alcoholism. The third cause is mal-absorption from the intestinal tract as the result of intestinal infections or diseases such as Crohn’s disease, Celiac disease or an overgrowth of bacteria in the intestines.
In the years before the cause was determined this disease was often fatal. Because there were no specific treatments available the individual eventually died from the anemic condition. Now the treatment is simple injections of vitamin B12. Unfortunately, the side effects of the condition are still severe if the disease isn’t caught or treated in a timely fashion. It can cause permanent damage to the heart, lungs and kidneys. Pernicious anemia is very common in older adults.
People who suffer from pernicious anemia will have symptoms that affect the heart, nerves and digestive tract. When a person has anemia the heart must work harder to pump oxygen around the body to the organs and tissues. This added stress can cause heart murmurs, fast or irregular heartbeat, an enlarged heart or even heart failure.
The lack of vitamin B12 or folic acid can also cause other problems for the heart. The lack of B12 will raise the level of homocysteine in the body, a chemical in high levels that will add to the buildup of fatty deposits in the blood vessels that leads to heart attacks and strokes.
Individuals who suffer from vitamin B12 deficiencies will also cause nerve damage. This damage will lead to tingling and numbness in the hands and feet which will result in problems with walking and balance. It can also lead to changes in taste, smell, vision, memory loss and confusion, sometimes confused for dementia.
A lack of vitamin B12 can also change the surface of the tongue or shrink the lining of the stomach. This puts people at risk for stomach cancer and ulcers.
Another name for pernicious anemia is megoblastic anemia. It is most common in individuals who are of northern European descent. Other symptoms of the anemia can include weak muscles, difficulty walking, weight loss, diarrhea, lack of energy, increased heart rate or irritability.
The condition is often discovered during a medical examination through a routine blood test. In addition to a physical examination and medical history the physician may also order the Schilling test which measures vitamin B12 levels in the urine after the ingestion of radioactive vitamin B12. With normal absorption there will be extra excreted through the urine while in those who have impaired absorption there will be little or no B12 excreted in the urine.
Today, those who suffer from pernicious anemia face a rather positive outcome if the condition is caught before there is permanent damage done to the body. Although there is an easy treatment the condition must be diagnosed first before damage can happen.
RESOURCES
National Heart Lung and Blood Institute: What is Pernicious Anemia
National Heart LUng and Blood Insitute: How is Pernicious Anemia Treated
University of Chicago Medicine: Megaloblastic (Pernicious) Anemia