Pernicious Anemia and Vitamin B12 Treatment

Pernicious Anemia and Vitamin B12 Treatment

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QUESTION: I have suffered for many years with a condition called pernicious
anemia. It seems to be a disease that is in my family as my two other sisters
and brother have it as well. The only treatment offered to me seems to be
vitamin B12 injections. Could you tell me a bit about this disease, and if
you think a single injection each month is sufficient treatment?
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ANSWER: Although Vitamin B12 is readily available in meat, many other animal
protein foods as well as legumes, it can not get into our system without the
presence of a substance named "the intrinsic factor" which is secreted by the
parietal cells which form part of the tissue that lines the stomach. The B12
is stored in the liver in enormous quantities, sufficient for the body's needs
for a three to five year period. Therefore, when the mucosal tissue of the
stomach begins to atrophy and shrink, it takes a long period of time before
the lack of the vitamin can be detected and before the anemia becomes evident.
As the anemia develops the body adapts, hiding the disease for even longer
periods of time. We are beginning to learn that both inherited and immune
factors may play important roles in the development of this condition, and so
the fact that your brother and sisters also have pernicious anemia (PA) is not
unusual. Since the B12 cannot be absorbed through the digestive tract, it is
replaced by injections. In the first stages of treatment, regular injections
are given intramuscularly as frequently as 2 to 4 times a week to allow the
body physiology to resume producing red cells normally, and to replace all the
reserves the liver can hold. This may take about six weeks, but once the
blood tests show a normal picture, the frequency of the injection may be
reduced to once monthly. It would seem that you have now reached this stage
and therefore the once monthly schedule you are on is appropriate. Since this
does not change the underlying cause of the anemia, B12 injections must be
continued throughout life.