Pernicious anemia is a type of anemia caused by vitamin B12 deficiency. Vitamin B12 deficiency is thought to occur as a result of an autoimmune condition when the stomach cannot produce substances for the absorption of vitamin B12.
Vitamin B12 is a beneficial vitamin for the formation of healthy red blood cells and helps optimize nerve function. This vitamin can be obtained from fish, shellfish, meat, liver, eggs, and milk.
In patients with pernicious anemia , vitamin B12 cannot be absorbed by the intestines, because the stomach cannot produce a substance called intrinsic factor. Vitamin B12 that is not absorbed can cause the body to lack red blood cells. If not treated immediately, sufferers can experience permanent nerve damage.
Causes of Pernicious Anemia
Gastric parietal cells function to produce a specific protein called intrinsic factor. These factors are important to bind vitamin B12 so that it can be absorbed by the small intestine. However, due to certain medical conditions, the intrinsic factor is less or even unable to be produced by the stomach.
Some medical conditions that can cause pernicious anemia are:
- Genetic disorders, such as congenital pernicious anemia
- Thinning of the stomach wall (atrophic gastritis)
- An autoimmune disease that causes immune cells to attack the stomach wall
In addition to the medical disorders above, pernicious anemia can be caused by vitamin B12 deficiency which can occur due to the following factors:
- Surgery to cut part or all of the stomach
- Surgery to cut the small intestine
- Long-term consumption of certain drugs, such as metformin, proton pump inhibitors , or birth control pills
- Tapeworm infection
- A vegetarian diet that is low in vitamin B12
Risk factors for pernicious anemia
There are several factors that can increase the risk of a person experiencing pernicious anemia, namely:
- Addison's disease
- Ovarian dysfunction before the age of 40, for example as a result of hysterectomy
- Type 1 diabetes
- Celiac disease
- Myasthenia gravis
- Sjögren's syndrome
- Crohn's disease
- Grave's disease
- Hashimoto's disease
Symptoms of Pernicious Anemia
Pernicious anemia generally does not cause symptoms. However, if symptoms arise, sufferers of pernicious anemia may experience the following complaints:
- Nausea or vomiting
- Diarrhea or constipation
- Tired easily
- Dizziness while standing
- Pale skin
- Shortness of breath, especially when exercising
- Swollen tongue or bleeding gums
If vitamin B12 levels are too low, sufferers of pernicious anemia may experience symptoms such as:
- Numbness or tingling in the hands and feet
- Easily angry and depressed
- Short-term memory impairment
- Balance disorder
- Hard to concentrate
- Hallucinations and delusions
- Blurred vision
When should you go to the doctor?
Immediately check with a doctor if you experience the above symptoms. Examination also needs to be done if you have a family history of pernicious anemia, have undergone gastric or intestinal surgery, and suffer from autoimmune diseases.
You are also recommended to immediately seek medical help if you experience the above symptoms accompanied by a loss of consciousness .
Diagnosis of Pernicious Anemia
To diagnose pernicious anemia, the doctor will ask questions about the patient's symptoms and health history, followed by a physical examination. After that, the doctor will perform the following supporting examinations to confirm the diagnosis:
- Complete blood test , to measure the level of hemoglobin, hematocrit , and see the size of red blood cells
- Vitamin B12 level test, to find out the level of vitamin B12 in the blood
- Antibody test, to find out the presence or absence of antibodies against intrinsic factor and parietal cells that usually arise in pernicious anemia
Treatment of Pernicious Anemia
The treatment of pernicious anemia aims to increase the level of vitamin B12 in the body. Treatment methods that can be given by the doctor include:
- Vitamin B12 injection is done once in 1 month or more, depending on the level of vitamin B12 in the body
- Vitamin B12 supplements, when the level of vitamin B12 in the patient's body is normal
- Treatment for autoimmune diseases , when pernicious anemia is caused by an autoimmune disorder
Complications of Pernicious Anemia
If left untreated, pernicious anemia can cause a number of health complications, including:
- Stomach cancer
- Nerve damage
- Memory disorders
- Heart disease
Prevention of Pernicious Anemia
Pernicious anemia is not always preventable. However, if you suffer from an autoimmune disease, do routine treatment and check-ups. For people who have undergone gastric or intestinal surgery, consult with a doctor regarding proper nutritional intake.
To prevent vitamin B12 deficiency, you can have sufficient intake of foods high in vitamin B12, among others:
- Beef, liver, fish, and chicken
- Milk, cheese, and yogurt
If you follow a vegetarian diet , discuss with your doctor the need to consume vitamin B12 supplements to meet your daily vitamin B12 needs.