Vitamin B12 Deficiency Anemia - Pernicious and Macrocytic
A lack of vitamin B12 results in an anemia in which the red blood cells are larger than normal. About 90 percent of macrocytic anemias in temperate climates are due to B12 or folic acid deficiencies. The production of red blood cells depends on these vitamins. Vitamin B12 is also essential for the maintenance of the brain and especially the spinal cord.
Microorganisms in the soil, gut, and mouth produce vitamin B12. Plant foods do not contain sufficient significant amounts, but it is present in meat, milk, eggs, and their products. The amount the body needs partially correlates with the protein intake. Thus the higher the intake of protein, the more B12 will be required. Complete vegetarians face a higher risk for B12 deficiency, but they have the same risk for pernicious anemia.
Vitamin B12 is absorbed from foods containing it and from amounts produced in the mouth and intestines; it is stored in the liver. If the stored B12 is depleted, a deficiency may occur. A protein produced in the wall of the stomach, called intrinsic factor, greatly aids the vitamin’s absorption. This factor combines with B12 and acts as a transfer agent, guiding the vitamin across the gut lining into the blood. Pernicious anemia results from lack of intrinsic factor, not just from a lack of the vitamin entering the intestine. Lack of intrinsic factor may arise from an atrophy of the cells producing it or from extensive surgery in which large portions of the stomach wall or intestine have been removed. In certain areas of the world, a tapeworm may deprive the person of B12.
The onset of the disease is often subtle, and in addition to the usual symptoms of anemia, frequent indigestion, poor appetite, and weight loss occur. The tongue may be smooth, sore, swollen, and it may feel too big for the mouth. Tingling of the hands and feet, along with diminished coordination and balance, are common, making walking in the dark difficult. Changes in behavior, nervousness, depression, memory loss, irritability, and confusion may occur.
What you can do.
B12 deficiency from anemia is a serious problem and you should look into it as soon as possible. Permanent damage to the nervous system may develop. Should you have a true pernicious anemia, you will have to take B12 for the rest of your life. Otherwise, be sure to eat foods providing B12 or take a supplement.
Things your doctor may do.
Your Physician will call for lab tests to determine the severity of the anemia and the level of B12 in the blood. He will prescribe B12 injections, frequently to begin with, and then at monthly or quarterly intervals. A health professional may teach you to inject yourself. The anemia and many of the other symptoms should improve promptly, but problems caused by nerve degeneration may take months to get better.
