Pernicious Anemia Differs from Dietary B-12 Deficiency

Q:  My doctor told me I am anemic. However, my nurse, who comes to my house to give me vitamin B-12 shots, tells me I have "pernicious anemia." I am a shut-in, 88 years old, and unable to get to a library. Please explain to me what exactly this ailment is and what I can do to help myself by paying attention to my diet.

A:  There are dozens of dozens of causes for anemia, the condition where your number of red blood cells is too low, providing less oxygen to body tissues.

Pernicious anemia is a specific kind of anemia due to vitamin B-12 deficiency. The inside lining of the stomach fails to produce "intrinsic factor," a protein required for the small intestine to absorb vitamin B-12. If you have pernicious anemia, it doesn't matter how much vitamin B-12 is in your diet; you can't absorb it.

Most individuals with pernicious anemia need injections of vitamin B-12 as therapy to replenish depleted body stores of vitamin B-12. A physician will manage the treatment required to maintain the vitamin B-12 status of individuals with pernicious anemia.

Nerve and blood cells need vitamin B-12 to function properly, so deficiency can cause a wide variety of symptoms, including fatigue, shortness of breath, rapid heart rate, tingling sensations, difficulty walking, and diarrhea. The anemia also affects the gastrointestinal system and the cardiovascular system.

The onset of the disease is slow and may take decades. One recent study revealed that nearly 2% of individuals over 60 have pernicious anemia. Slightly more women than men are affected. The disease occurs in all racial groups, but occurs most often in people of Scandinavian or Northern European descent.

Pernicious anemia is not preventable, but with early detection and treatment of vitamin B-12 deficiency, complications are readily controlled.

I would ask your nurse if she was telling you that you have "pernicious anemia" as a generalization for anemia due to vitamin B-12 deficiency; sometimes people misspeak. Vitamin B-12 deficiency also occurs if your diet does not contain enough vitamin B-12.

For those who have a simple lack of dietary B-12 (as opposed to pernicious anemia), eating certain foods can help rebuild the stores of B-12 in the body. Good sources of vitamin B-12 include meat, dairy, and eggs. A bowl of fortified breakfast cereal, 3 ounces of red meat or 2 cups of milk will satisfy your daily requirement for vitamin B-12.

I would also ask your doctor to explain your medical problem to you. You deserve a longer explanation than simply "anemia."

Julie L. Mitchell, MD, MS, is an Assistant Professor of Medicine at the Medical College of Wisconsin. She practices at the Froedtert & The Medical College of Wisconsin General Internal Medicine Clinic - East. Her column appears in the Milwaukee Journal-Sentinel.

Some information in this article was made available from Office of Dietary Supplements and the US National Library of Medicine.