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Vitamin B12 supplements are part of the treatment of pernicious anemia.
Vitamin B12, a nutrient in red meat, egg yolks, liver and other animal-based foods, is instrumental in the production of red blood cells and myelin, which is the protective coating around your nerves. Pernicious anemia is often used to describe any disorder that causes vitamin B12 deficiency, but it is a specific disease. Pernicious anemia is characterized by immune destruction of the cells in your stomach that produce intrinsic factor, which is a protein needed for efficient absorption of vitamin B12. Regardless of its cause, vitamin B12 deficiency may cause anemia, nervous system damage and other signs and symptoms.
Signs and Symptoms of Anemia
You need a healthy population of red blood cells to carry oxygen to all of your tissues and organs. Vitamin B12 deficiency interferes with the production of red blood cells in your bone marrow. As the oxygen-carrying capacity of your blood declines, you may develop weakness, headache, dizziness, fatigue, poor exercise tolerance, rapid heart rate, decreased mental function or shortness of breath. Older people or those with heart disease may complain of palpitations or chest pain, particularly with exertion. Because pernicious anemia develops slowly, people are often able to adapt to a diminishing supply of red blood cells. So, your doctor may discover your condition through a routine blood count.
Neurological Signs and Symptoms
Your body needs vitamin B12 to make myelin, which surrounds and insulates your nerve cells. Without a protective myelin sheath, your nerves gradually begin to malfunction. In the early stages of pernicious anemia, you may not feel some sensations in your hands or feet or you may not sense which position they're in. As the disease progresses, muscle spasms and problems with balance and walking may develop. Memory impairment, tremors, confusion, depression or paranoia may also occur. During a physical exam, your doctor may notice your reflexes are diminished. Light touch, pain and temperature sensations aren't usually affected in people with pernicious anemia.
Gastrointestinal Signs and Symptoms
One of the classic findings associated with pernicious anemia -- Hunter glossitis -- is not seen as frequently as was once thought. Glossitis, which is characterized by a вЂњbaldвЂќ and tender tongue due to loss of taste buds, is relatively uncommon in people with vitamin B12 deficiency of any cause, including pernicious anemia. Other gastrointestinal symptoms, such as abdominal pain or constipation, may occur.
Vitamin B12 deficiency in general, and pernicious anemia in particular, have been associated with other manifestations, such as poor fertility and recurrent miscarriages in women, male infertility, thinning of the vaginal mucous membranes, persistent or recurrent skin and mucous membrane sores and clotting abnormalities. Some of these disorders may be directly tied to low vitamin B12 levels, while others may be related to the immune processes that lead to destruction of intrinsic factor-producing cells in your stomach lining.
As with all cases of vitamin B12 deficiency, pernicious anemia can usually be addressed by administering high doses of vitamin B12. If nervous system damage has already occurred, it may be only partially reversible, despite high-dose and long-term B12 supplementation. The optimal approach to treating pernicious anemia is a matter of some debate, but most experts recommend injections of some form of vitamin B12 -- cyanocobalamin, hydroxocobalamin or methylcobalamin -- for several weeks to months in people who have symptoms or signs of pernicious anemia.
Once your anemia is corrected, your doctor may recommend you take vitamin B12 supplement pills. Approximately 1 percent of an oral dose is absorbed even when you are not making intrinsic factor, so daily doses of 1,000 to 2,000 mcg are usually enough to maintain your vitamin B12 level. People with pernicious anemia will need to take vitamin B12 supplements for life.