Pernicious anemia And Anemia … what’s the difference

[BarbieWorldFantastic]

Sorry to come across dim but I can’t seem to find the answer on Google.

I recently had blood tests at the GP surgery.

It came back low for B12 (level was 72) Folate and Iron.

Iv been prescribed 6 B12 injections in a 2 week period and then one every 12 weeks for the rest of my life.

Iv also been given iron and folate tablets to take for 4 months once I have started getting the B12 injections (next week).

The doctors also requested a stool sample and more bloods for inflammation markers to see why my body is not absorbing what it should. I’m in my early 30s.

Now my GP just said I have anemia but when googling Pernicious anemia keeps coming up?

Is there much of a difference.

My B12 level was 72.

Not an expert, so happy to be corrected but I've been deficient/anaemic myself so I think I've got the gist of it.

Anaemia generally just means problems with the red blood cells due to a deficiency, normally iron, sometimes folate/b12 (they're all related in some way I don't entirely understand.) Normally you solve the deficiency, you solve the anaemia.

If the deficiency is down to diet, you do it by getting more through food/supplements. If iron is low due to heavy periods etc, you would try and help that.

Sometimes these deficiencies are caused by not absorbing the iron/b12/folate that IS in your diet. Gut diseases like coeliac or chrons, surgeries like gastric bypasses etc might mean that you have to supplement for life.

'Pernicious anaemia' is just the name of a specific autoimmune disorder which prevents absorbtion of b12. It's just confusing that the name also has anaemia in it. Think of it as anaemia with a little a is the symptoms you're currently having, and the blood test results etc. Pernicious Anaemia is potentially the cause of this. b12 injections etc will solve the anaemia, reduce your symptoms etc. But (if it is PA) you will always have PA, hence the GP talking about injections for life.

If you’ve been prescribed B12 injections for life then I think it’s likely you have pernicious anaemia, rather than just being anaemic. Basically it means that your body can’t absorb B12 from dietary sources or regular supplements, it has to be given straight into your bloodstream via injection for it to be effective. DD was diagnosed with it a few years ago, really it doesn’t affect her at all. Just a bit annoying having to get an injection every 3 months!

Thanks :)

I will ask the doctor when I go there next

@BarbieWorldFantastic can I ask if these injections are painful as I’m on the same track as you - 6 injections in 2 weeks starting tomorrow ect ect. Worried about feeling shit as no one around to take care of me atm and I have the DC.

I was told many years ago I had pernicious anaemia when I had a folate deficiency. Was given folic acid tablets, forgot all about it and no one has mentioned it since and I havent had deficiencies since.

Really annoys me that nothing is ever explained properly and even when it is the next medical practitioner will contradict it.

Can you have high b12 levels but still have PA? As if your body doesn't absorb it so it just floats about?

I have pernicious anaemia. Yes, the injection is a bit stingy but it’s literally just for a few seconds and then it’s fine.

@soupfiend mine is def PA I’m afraid. Doctor called me up when I was at hairdressers and it completely blindsided me as was expecting my results to be normal or relate to another ailment I have. I am really lucky .. my doctor is really lovely and spends his time. I just had lots of questions afterwards. And I’ve been reading up and freaking myself out!

Yes I suppose what I meant was, I associate with b12 or iron but I was told I had this when I had folate deficiency. I dont really understand it

I think from what I’ve read the B12 isn’t absorbed from the stomach into the blood stream which is what causes the issue. So it’s not a condition that is diet related from my humble reading.

Your Dr has prescribed you B12 for pernicious anaemia and the folate is because you also have regular anaemia (low anaemia).

There is a specialist test which indicates whether the low B12 is definitely PA. I doubt a regular GP would do that due to the cost. More likely, he’s just assuming you have and getting you on the injections. No issue whether you have/have not as the body flushes out any excess B12 but without the official test he can’t say you have it!

Your Dr sounds quite switched on as he’s running additional tests. Signs of inflammation could indicate autoimmune conditions. A lot of autoimmune conditions result in B12 and Iron deficiencies.

In the past, I was classed as having PA and regular Anaemia. I stopped taking iron and B12 for a long time and recently when I was tested both results showed no issue and my levels were very good. My diet is good, but no different to what it’s always been.

Sorry I meant , you have regular anaemia due to low iron on your tests

Pernicious anaemia is specifically an autoimmune condition in which your immune system mounts destructive responses against a glycoprotein called intrinsic factor (IF) and molecules on the parietal cells in the stomach which secrete IF. IF is essential for absorption of vitamin B12 in the small intestine: if you don't have IF, B12 can't bind to the transporters in the small intestine that carry it from the intestine into the blood. You therefore develop a deficiency of B12, pretty much regardless of how much of it you ingest in food or tablets.

Vitamin B12 is required for a couple of biochemical reactions that are important in production of red blood cells (difficult to explain without illustrations). When B12 levels are low, you produce smaller numbers of large, misshapen red blood cells, so you have fewer red cells and the ones you have carry oxygen less efficiently.

Anaemia more generally is a state of your blood having inadequate oxygen-carrying capacity. This may result from a lack of red cells (e.g. acute blood loss, bone marrow disorders or chronic disease), a lack of haemoglobin in red cells (e.g. because of iron deficiency, including chronic blood loss), malfunctioning haemoglobin (e.g. thalassaemias and sickle-cell disease), disordered production of red cells (e.g. B12 or folic acid deficiency) or breakdown of red cells in the bloodstream (e.g. malaria, hereditary spherocytosis, autoimmune haemolytic anaemia).

I had to have B12 injections as very low B12 - but that corrected it. And I just keep an eye on it now, eat shellfish and take sublingual B12. It was a blip. I didn't have further tests done but have a FBC blood test done every now and then...

https://pernicious-anaemia-society.org/articles/testing-for-pernicious-anaemia/#:~:text=Anti%2Dintrinsic%20Factor%20Antibody%20Test,having%20auto%2Dimmune%20Pernicious%20Anaemia.

I am back from having first jab. The doctor did do the blood test and confirms it’s PA as when they opted for tests had other symptoms they needed to investigate. I did feel sick and a bit faint after the injection and so had to have a lie down. I took water and chocolate with me as I know how I am with these things. I just feel really tired now lol.

I also had my first B12 injection today. It hurt more than I expected tbh but I feel my eyes are far less dry and an hour later I got my period!
I am due in 2 days, so maybe just enhanced the hormones...?

I am also very tired and was hoping I'd have energy to finally tackle the jungle garden I've had no energy for (it's getting so bad it's nearly as tall as me). I think I need a nap instead.

@PanicAttax do you feel better today? I feel ok just a bit down reading all the info on PA, bit overwhelming! Re the garden … I’ve been told will feel like Wonder Woman after the initial 2 week doses! So wait! Or do a little at w time .. I did 10 mins weeding today and thought of you!

I'm still enjoying having tears in my eyes (!) as they were so dry before. I also got a bit of a runny nose, but nothing negative. I haven't noticed any huge difference in energy yet. Had to go to the hospital for a CT earlier but they cancelled it because my thyroid bloods haven't been put on the system from last week (looks like they've been lost) so they don't want to do contrast. I was so tired by the time I walked home but decided I should at least re-paint the front door. I get a bit weird about not 'doing' stuff so if I am up and about I will try to do what I can. I got quite dizzy by the end but at least I feel I did something and it was very much needed! That's my limit today, so the garden will have to wait!

I'm not reading much at the moment as I can't seem to focus well or retain much. My eyes kind of zone in and out and I have to start a paragraph several times quite often!

How are you feeling and when is your next injection? Mine's tomorrow late morning - I'm intrigued to see what happens this time! Well done for doing the weeding!

@PanicAttax snap mine is tomorrow late morning too! i am still doing multiple school runs, working from home and all the rest that comes with being single parent. I never knew till you said about the dry eyes, I just thought it was due to working on my laptop all day! I just thought my tiredness was normal and saying that my Dp always remarks how energetic I am compared to him but things make sense now like if I’ve been sitting down when I get on my feet my joints hurt ect. Thank god I remember most things or I would have got sack as my work requires a lot of problem solving and analysis! I feel ok today but I felt depressed yesterday after all my “reading” so decided to F it all, what ever will happen will happen so I just need to look forward to things I have planned with DC, DP and family. Good luck for tomorrow feel free to dm me if you want to compare notes xx

Hi all, wondering if anyone can help. I was diagnosed with PA today following bloods. I have been feeling tired etc but also have tingling in my hands and feet. I cannot start the injections for two weeks as I am on holiday next week and need the 6 doses within two weeks. Do you think this is ok to wait two weeks before starting them? I am worried because I have neurological symptoms and I don’t want them to get worse and be irreversible. Is two weeks a dangerous amount of time to wait?

I don't think anyone can give timescales on these things tbh and everyone reacts differently to being deficient. I know some pharmacies let you pay £29 for a B12 injection so it might be worth googling it and getting one in before you go for your peace of mind? You can't OD on it or anything, you just pee out excess.

I felt so tired and unwell and had horrible achey joints and needed the vitamin b12 injections. After the two week loading dose I didn't really notice any improvement until I had the first 3 monthly dose. The injection hurts like hell. The nurse confirmed the b12 injection is a kicker but I stick with it as the alternative is unthinkable. As dramatic as it sounds I feel like I have my life back.

@ithinkilikethislittlelife I'm glad to hear this - I had my 6 loading ones about 2 weeks ago now and although I do feel a bit better I don't know if it is that or my thyroid meds doing the heavy lifting (or both!) as I still have a lot of brain fog and can't be up and about for more than a couple of hours at a time. I really wanted to buy another injection in between while I wait for the next but it said at the pharmacy you can't buy one if you've had one within 28 days from GP, so I asked to consult Dr to let me have one and he put a face to face appt in for 2 weeks time instead, annoyingly, so I will have another 2 weeks of being mostly bed bound. I can't wait to get my life back. I've been off work ill since January and am very depressed as a result.

Panicattax: I felt so low about the 6 loading doses not "working" but one of the nurses assured me that they don't always and it's the regular three monthly jab that may prove the kicker. In my case she was right. I hope this is the case for you 🤞🏻

I was diagnosed during covid. The doctor was willing to let me have the six doses in a packet and inject myself at home- I got a colleague who is a HV to do it. Could always ask if you are away with someone who could do it.
My doctors worry was obviously covid can effect breathing.