Is pernicious anemia treated best with vitamin B12 injections
Is pernicious anemia treated best with vitamin B12 injections?

Gabe Mirkin, M.D.

Most people with pernicious anemia can a cured by taking a 1000 
microgram pill of vitamin B12 once a day; they usually do not need 
to take injections. Pernicious anemia is due to lack of vitamin B12 
which results in progressive nerve damage that causes forgetfulness, 
loss of ability to concentrate and abnormal nerve sensations such as 
burning, itching or loss of feeling. However, many people with 
pernicious anemia do not have abnormally low blood levels of vitamin 
B12. One study showed that older people have lower blood levels of a 
chemical called homotranscobalamin II that carries vitamin B12 into 
the cells, so they need higher blood levels of B12 to have normal 
tissue levels.

The diagnosis of pernicious anemia is often made late in the course 
of the disease after a person has suffered permanent nerve damage. 
One report showed that two percent of Americans over 60 have low 
blood levels of vitamin B12, but the incidence of vitamin B12 
deficiency causing nerve damage in older people is much higher than 
that, perhaps as high a 50 percent. Many older people who are 
diagnosed with senility actually suffer from lack of vitamin B12. 
Lack of vitamin B12 also can cause heart attacks, so all people over 
60 should be screened for B12 deficiency. Those with normal levels 
of B12 who have symptoms of nerve damage or arteriosclerosis should 
also get a blood test called homocysteine. Low levels of B12 can be 
associated with stomach diseases, absorption problems and infections 
such as Helicobacter pylori. See reports #G123 on Helicobacter and 
#G206 on Celiac Sprue. 

March 1, 2006