What causes pernicious anemia And can it be cured permanently

Are you constantly tired, short of breath, or noticing unexplained paleness? It might not just be an iron deficiency—it could be Pernicious Anemia, a serious type of anemia caused by a severe vitamin B12 deficiency due to poor absorption in the body.Pernicious anemia is a chronic condition that requires accurate diagnosis and early treatment to prevent dangerous neurological complications such as numbness and loss of balance.In this Dalili Medical article, we take you through a complete guide to understanding the causes of pernicious anemia, its early symptoms, and the latest treatment options, including B12 injections and supplements.Keep reading to discover who is most at risk and how to spot the first warning signs before the condition worsens.

❓ What is Pernicious Anemia?

Pernicious anemia is an autoimmune condition that prevents the body from absorbing vitamin B12, leading to a deficiency in red blood cells responsible for carrying oxygen.

⏳ Is Pernicious Anemia a chronic disease?

Yes, it is a chronic condition that requires lifelong treatment—usually through regular vitamin B12 injections.

What’s the difference between Pernicious Anemia and regular B12 deficiency?

Regular B12 deficiency: Usually caused by poor diet or digestive issues.
Pernicious anemia: Caused by an autoimmune issue that blocks B12 absorption, regardless of dietary intake.

⚠️ Is Pernicious Anemia dangerous?

Yes, if left untreated, it can lead to:

Permanent nerve damage
Heart complications
Memory and mood disorders
✅ The good news: Early treatment can prevent all of these complications.

✅ Can Pernicious Anemia be cured?

It cannot be completely cured, but it can be 100% managed with regular B12 injections and ongoing medical follow-up.

Does Pernicious Anemia affect pregnancy?

Yes, untreated cases may lead to:

Premature birth
Poor fetal growth
That’s why treatment before and during pregnancy is essential.

What are the key symptoms of Pernicious Anemia?

Don’t ignore these signs:

Chronic fatigue
Pale skin
Tingling or numbness in hands and feet
Memory or concentration issues
Shortness of breath with little effort

Does Pernicious Anemia affect the nerves?

Yes, it can cause peripheral nerve damage if not treated in time, leading to:

Numbness
Tingling
Weakness in limbs
Balance problems

Does Pernicious Anemia cause hair loss?

Yes, vitamin B12 deficiency can weaken hair follicles, leading to hair loss.
This can be reversed once treatment begins.

Is Pernicious Anemia life-threatening?

If untreated, it can lead to:

Serious neurological damage
Heart disease
Increased risk of stomach cancer
But with proper and early treatment, it is fully manageable.

What’s the difference again between regular B12 deficiency and Pernicious Anemia?

Regular deficiency: Caused by poor diet or absorption issues
Pernicious anemia: Caused by an autoimmune disorder that blocks absorption, even if the diet is rich in B12

How does Pernicious Anemia impact pregnancy?

Without treatment, it can result in:

Premature delivery
Low birth weight
Regular monitoring and treatment are essential during pregnancy.

How can you prevent complications of Pernicious Anemia?

Regular check-ups
Strict adherence to B12 therapy
Routine blood tests
Watch for any neurological or psychological symptoms

❤️ Does Pernicious Anemia cause irregular heartbeats?

Yes, the lack of oxygen caused by low red blood cells can lead to palpitations or arrhythmia, especially during physical exertion.

What’s the link between Pernicious Anemia and chronic fatigue?

Fatigue is a core symptom due to reduced oxygen delivery and energy production.
It improves significantly after starting B12 injections.

When Should You See a Doctor?

If you experience symptoms such as severe fatigue, tingling in the limbs, yellowing of the skin, difficulty concentrating, or digestive issues, it’s essential to consult a doctor early to get an accurate diagnosis.

Who Is at Risk of Pernicious Anemia?

Not everyone is at risk of developing pernicious anemia, but certain groups are more vulnerable due to autoimmune issues or problems absorbing vitamin B12. Here are the key risk groups:

1. Older Adults

As we age, the stomach produces less “intrinsic factor,” a protein needed to absorb vitamin B12, increasing the risk of deficiency.

2. People with a Family History

If a close family member has pernicious anemia or an autoimmune disorder, your risk is higher due to genetic predisposition.

3. People with Autoimmune Diseases

Some autoimmune diseases cause the body to attack its own tissues, including stomach cells. These include:

Type 1 diabetes
Hashimoto’s thyroiditis
Vitiligo
Systemic lupus erythematosus (SLE)
All of which increase the risk of developing pernicious anemia.

4. People Who Have Had Gastrointestinal Surgery

Surgeries that affect the stomach or intestines can interfere with B12 absorption, such as:

Partial stomach removal
Weight-loss surgeries (like gastric bypass)
Resection of the small intestine

5. Strict Vegans

Those who consume no animal products may develop vitamin B12 deficiency, since it's naturally found only in animal-based foods. However, this is a dietary deficiency—not autoimmune-related.

6. People with Chronic Gastritis

Chronic atrophic gastritis can damage cells that produce intrinsic factor, leading to poor B12 absorption and a higher risk of pernicious anemia.

❓ Causes of Pernicious Anemia: Why Can’t the Body Absorb B12?

Pernicious anemia occurs when the body cannot absorb vitamin B12 properly—despite it being present in the diet. This vitamin is essential for making healthy red blood cells. The main causes include:

1. Lack of Intrinsic Factor

This is the primary cause of pernicious anemia.
Intrinsic factor is a protein made in the stomach that binds to vitamin B12 to help the body absorb it in the small intestine.
Without it, the body cannot use B12 even if you consume enough.

2. Autoimmune Disorders

In pernicious anemia, the immune system attacks the stomach cells that produce intrinsic factor.
This autoimmune process is the most common cause and occurs without any external cause.

3. Genetics

If you have a family member with pernicious anemia, your risk is higher—especially if you also have autoimmune conditions.

4. Aging

With age, the stomach’s ability to produce intrinsic factor declines, making the elderly more prone to B12 deficiency.

5. Gastrointestinal Surgeries

Operations such as stomach removal or small intestine resection reduce the body's ability to absorb vitamin B12.

Types of Pernicious Anemia

Although "pernicious anemia" is a specific type of anemia caused by vitamin B12 deficiency, it can be categorized based on its cause or stage:

1. Autoimmune Pernicious Anemia (Most Common)

Occurs when the immune system attacks the stomach cells responsible for producing intrinsic factor, preventing vitamin B12 absorption.

2. Hereditary (Congenital) Pernicious Anemia

A rare form that affects children from birth due to a genetic defect. It is usually diagnosed early and requires long-term treatment.

3. Post-Surgical Pernicious Anemia

Develops in individuals who have undergone surgeries such as gastric bypass or stomach resection, which impair intrinsic factor production.

4. Late-Onset with Aging

Not caused by an autoimmune issue, but rather by the stomach’s gradual decline in producing intrinsic factor with age.

⚠️ What Are the Complications of Untreated Pernicious Anemia?

Pernicious anemia is more than just a B12 deficiency—it can lead to serious health issues if left untreated. Here are the major complications:

1. Neurological Issues

Long-term B12 deficiency affects the nervous system and can lead to:

Tingling or numbness in hands and feet
Balance and coordination problems
Difficulty concentrating or memory loss
Permanent nerve damage if untreated

2. Mental and Psychological Disorders

The brain is affected by low B12 levels, leading to:

Mood swings
Depression or anxiety
Memory problems
In severe cases: hallucinations or behavioral changes

3. Heart Problems

Low red blood cell count reduces oxygen supply to the heart, possibly causing:

Heart palpitations
Cardiac strain
In rare cases: heart failure

4. Increased Risk of Stomach Cancer

Pernicious anemia is often associated with chronic inflammation of the stomach lining, which may increase the long-term risk of gastric cancer.

5. Pregnancy Complications

Untreated B12 deficiency during pregnancy can lead to:

Developmental issues in the baby’s nervous system
Premature birth
Low birth weight

⏳ Stages of Pernicious Anemia

Pernicious anemia doesn’t appear overnight—it progresses through several stages, from silent onset to severe complications:

1. Silent Stage (Pre-Symptomatic)

Vitamin B12 levels begin to drop with no clear symptoms
May last for months or even years
Often only discovered through routine blood tests

2. Early Symptoms Stage

Mild symptoms start to appear, including:

Fatigue
Pale skin
Slight increase in heart rate
These signs are often overlooked or misattributed.

3. Apparent Anemia Stage

Blood tests now clearly show anemia. Symptoms may include:

Shortness of breath
Persistent dizziness
Overall weakness
At this stage, immediate treatment is crucial.

4. Nerve Damage Stage

If left untreated:

Nerve damage begins
Tingling or numbness in limbs appears
Balance and concentration issues arise
Some neurological symptoms may become permanent.

5. Chronic Complications Stage

In cases of severe neglect, pernicious anemia may progress to:

Irreversible nerve damage
Serious mental health disorders
High risk of developing stomach cancer

Treatment of Pernicious Anemia: Effective Steps to Recovery

The treatment of pernicious anemia mainly focuses on replenishing vitamin B12, as the body cannot absorb it naturally from food. The primary treatment steps include:

1. Vitamin B12 Injections (Main Treatment)

Intramuscular injections are the most effective method.

Initial phase: Daily or weekly injections for several weeks
Maintenance phase: Monthly injections for life or as prescribed by a doctor

✳️ Goal: Rapid B12 Replenishment and Improved Blood Cell Production

2. Vitamin B12 Tablets (Oral or Sublingual)

Used in mild cases or after the initial injection phase.
Less effective due to poor absorption in the digestive tract.
Very high doses may gradually help compensate for the deficiency.

3. Treatment of Neurological Symptoms

If nerve-related symptoms appear (such as numbness or loss of balance), treatment must begin immediately.

Delaying treatment may lead to permanent nerve damage that is difficult to reverse.

4. Important Dietary Support

While diet alone can't treat pernicious anemia, consuming B12-rich foods helps prevent relapses:

Liver
Red meat
Eggs
Milk and dairy products
Fish

5. Regular Medical Monitoring

Routine blood tests to monitor hemoglobin and red blood cell counts.
Regular measurement of vitamin B12 levels.
Evaluation of improvement in both neurological and blood-related symptoms.

✅ Ongoing follow-up is essential to ensure successful treatment and avoid complications.

Can Pernicious Anemia Be Treated with Herbs? Here's the Full Truth

Although natural herbs may support overall health, they cannot cure pernicious anemia on their own.
This type of anemia results from vitamin B12 malabsorption, which requires medical injections or supplements, under professional supervision.

✅ Bottom line: Herbs are not a substitute for medical treatment, but they can help relieve general symptoms and boost immunity.