Pernicious Anemia

In addition to diseases of the lymphatic system, diseases of the blood system play a major role in medicine. Pernicious anemia occurs in both the very young and adults.

Pernicious Anemia

What is pernicious anemia?

The term anemia hides a blood disease, which is also known colloquially as anemia. This is certainly because pernicious anemia is visible even externally if the condition is left untreated. See electronicsencyclopedia for Slang Kluver-Bucy Syndrome.

Pernicious anemia is only a disease of the blood-carrying system, which exclusively refers to the red blood cells. The disease is based on reduced maturation and storage of the red blood pigment in the erythrocytes.

If pernicious anemia is not adequately treated, the deficits that occur within the blood supply can be fatal. Another name for pernicious anemia is Biermer’s disease.


The causes that cause pernicious anemia and can trigger a potentially very problematic course lie within processes associated with the production of hemoglobin.

The red blood pigment can only be formed if the appropriate conditions exist. If the basics are missing, such as vitamin B12, the synthesis of hemoglobin is limited or not possible at all. If an undersupply of vitamin B12 occurs due to insufficient oral intake, this can lead to impairment of the so-called hemoglobin synthesis.

Inadequate supply of vitamin B12 can be caused by alcoholism, the intake of gastric protective preparations, as well as various diseases of the stomach and gastric cancer. Nitrous oxide also binds vitamin B12 and increased consumption of vitamin B12 during pregnancy can also cause pernicious anemia.

Symptoms, Ailments & Signs

The lack of vitamin B12 and the resulting anemia develops a variety of symptoms. Depending on the individual, these can occur in different order and intensity. In general, patients are burdened by constant everyday fatigue with an associated loss of concentration. Even light, physical activities quickly become exhausting.

To compensate, normal rest periods extend beyond the usual extent. At the same time, the circulatory system reacts sensitively to stress. A generalized restlessness with increased heart rate and visible pallor is recognizable. Dizziness is less common.

Reddish, smooth tongues are another feature of pernicious anemia. Discomfort in the digestive tract leads to abdominal pain and irregularities in digestion. In addition, VB12 deficiency favors a number of psychological and neurological effects that appear in combination over the long term.

Affected people develop depression, often start to ponder and experience anxiety. People often describe discomfort in the body as pins and needles and a furry feeling in different parts of the body. A typical symptom in humans is permanent irritation of the autonomic nervous system. Superficial muscle twitching without movement influence on the limbs is occasionally noticeable.

Theoretically, any part of the body can also be affected by numbness . Slowly increasing gait insecurity due to coordination and balance problems makes everyday life more difficult for the patient. Signs of paralysis occur in rare cases in severe anemia. However, these are not irreversible and can be cured with appropriate therapy. People perceive the disease as a great emotional burden until the cause is clarified, since symptoms seen individually show similarities with serious clinical pictures.

Diagnosis & History

Pernicious anemia manifests itself in the external appearance of those affected by a striking paleness of the skin and mucous membranes. In addition, the performance of the patients is typical due to anemia and an existing insufficient supply of oxygen.

In addition, the course of pernicious anemia is characterized by neurological abnormalities such as circulatory disorders with tingling and numbness in the extremities and balance disorders. In addition, the clinical picture of pernicious anemia worsens with impaired vision and depression, dementia deficits and a yellowish-grey coloring of the skin.

Other signs are an abnormal smoothness of the tongue surface and an increasing tendency to circulatory collapse. These symptoms are important for diagnosis. In the case of pernicious anemia, this is supplemented by a blood test. Various tests also enable a clear differential diagnosis. In connection with the disease, they include checking the gastric content in the blood plasma, the so-called Schilling test and the determination of special antibodies.


Pernicious anemia can lead to various complications. In particular, most patients suffer from fatigue and weakness, which is due to the lack of oxygen within the body. Without professional treatment, there is a risk of serious problems in various organs.

The heart is often affected by the sequelae of pernicious anemia. So it has to work harder to provide oxygen to organs and tissues. Due to the unusually high performance, symptoms such as heart murmurs, rapid heartbeat, cardiac arrhythmia or enlargement of the heart can occur.

In the worst case, the person affected suffers from cardiac insufficiency (weak heart). A lack of cobalamin can also promote heart disease. This increases the concentration of the chemical substance homocysteine ​​in the body. In the further course, a heart attack or a stroke are possible.

The nerve cells are also often affected due to pernicious anemia. This manifests itself in neurological symptoms such as tingling in the limbs, numbness, difficulty walking and loss of balance. Low levels of cobalamin also affect the senses of taste, smell and vision. Sometimes there are mental changes, such as memory loss or confusion.

When should you go to the doctor?

Headaches, dizziness or abnormal sensations on the skin indicate a vitamin B12 deficiency. A doctor should be consulted if pernicious anemia develops. The disease manifests itself through coordination disorders, paralysis and other typical signs of anemia. If there are accompanying symptoms such as blurred vision or depression, it is advisable to consult a doctor. The doctor can make the diagnosis based on the blood count or a gastroscopy and, if necessary, inject vitamin B12 directly into the patient.

After the injection is performed, the pernicious anemia should resolve without further complications. The usual follow-up examinations ensure that no side effects occur. The patient should consult a nutritionist to avoid recurrence of deficiency. If the symptoms are due to a disease, further examinations and treatments must be carried out. Pernicious anemia can occur, for example, as a result of type A gastritis or an infestation.

Alcoholism and cancer are also possible triggers that must be clarified by further investigations. Internists, gastroenterologists, cardiologists and other specialists are responsible, depending on the cause and type of symptoms. In the case of psychological triggers, a psychologist or psycho-oncologist can also be consulted if the pernicious anemia occurs in connection with cancer.

Treatment & Therapy

The treatment of pernicious anemia is mainly based on compensating for the vitamin B12 deficiency with medication. In principle, the human blood-forming organs require a constant supply of this vitamin. Only in this way can hemoglobin synthesis be made possible.

If chronic inflammation of the gastric mucosa has caused pernicious anemia, vitamin B12 must be administered via the muscles, since the mucosa is not able to absorb this substance. If laboratory tests show an insufficient supply of iron, this deficiency must also be replenished in order to treat the disease.

For better absorption of vitamin B12, appropriate treatment of gastroenteritis should be undertaken. This therapy is unavoidable when the gastric mucosa is not able to metabolize the vitamin B12 ingested through food.

Outlook & Forecast

The prognosis for pernicious anemia depends on the initiation of therapy. Anemia treated early has the best chance of recovery. The disease can be cured by increasing vitamin B12 intake, and the symptoms subside. Treatment too late can result in irreversible damage. The prognosis is unfavorable, and there is no prospect of complete recovery at this point. Diagnoses that are not made in a timely manner and/or improper treatment can cause depression, exhaustion and neurological deficits. In the worst case, pernicious anemia can become life-threatening. For a favorable prognosis, the patient must take the disease seriously and follow the advice of his family doctor.

Pernicious anemia requires consistent intake of vitamin supplements throughout life. Those affected can positively influence the prognosis by strictly adhering to the prescribed vitamin dosage. In order to counteract or prevent pernicious anemia, a specialist can regularly check the vitamin balance. This is done by taking blood samples. Changes in the blood count are recognized in good time and can be successfully treated at an early stage. In addition to vitamin tablets, changed lifestyle habits and a healthier diet contribute to a favorable prognosis.


Prophylaxis against pernicious anemia initially includes adequate intake of vitamin B12 through oral intake of appropriate foods or dietary supplements.

If there is an increased need for vitamin B12, this should also be compensated for by preparations containing vitamin B12. A change in diet and treatment of a diagnosed folic acid deficiency is also important to avoid pernicious anemia. If there is a suspicion of inflammation of the gastric mucosa, a complete blood count is important in order to prevent the disease.


Even after the treatment of pernicious anemia, constant follow-up examinations are necessary. Unfortunately, it is not possible to cure the disease, but it can be well controlled with permanent aftercare measures. The main part of the follow-up care is that the patient receives regular intramuscular injections of vitamin B12 throughout his life.

This is because the vitamin B12 present in food can no longer be reabsorbed by the small intestine as part of the disease. Without lifelong follow-up care, pernicious anemia would always be fatal. In the initial treatment of the disease, high doses of vitamin B12 are injected intramuscularly within the first three weeks.

After that, increased blood formation begins, which in turn causes a secondary iron deficiency. After the treatment of the acute illness, follow-up care initially consists of monitoring the blood count, injecting vitamin B12 and administering additional iron supplements. After this intensive treatment, fresh vitamin B12 usually has to be injected every two months for the rest of your life in order to prevent renewed anemia.

As part of the aftercare, however, possible irreversible consequences of pernicious anemia such as cardiovascular diseases or mental disorders are constantly monitored and treated. Since pernicious anemia is usually based on an autoimmunologically induced inflammation of the gastric mucosa with an increased risk of gastric cancer, the stomach should also be examined regularly.

You can do that yourself

Since pernicious anemia is often caused by one’s own misconduct, patients can also do a lot to help them recover quickly.

Vegans and vegetarians who only eat small amounts of animal foods have to get used to taking vitamin B12 supplements regularly and consistently. The easiest and most efficient way to do this is with dietary supplements. These preparations are available as tablets, effervescent tablets or in drop form. Since vitamin B12 is stored in the liver, it is also possible to have the substance injected at regular intervals. This option is particularly useful for people who have difficulty absorbing the vitamin when ingested.

In addition to food supplements, appropriately fortified foods can also be consumed. Here, however, it is important to calculate how much vitamin B12 is actually supplied. If the amount is not sufficient, toothpaste enriched with vitamin B12 can also be used. This is available in organic supermarkets and health food stores and is also ideal for ensuring supplies when travelling.

A good natural source of vitamin B12 is eggs. Ovo and lacto-ovo vegetarians can increase their egg consumption. If you rarely eat animal foods, the extra cholesterol you take in should be harmless. At the same time, attention should be paid to an adequate supply of iron, since acute iron deficiency exacerbates the course of pernicious anemia.