### Pernicious Anemia: Causes, Symptoms, and Treatments Pernicious anemia (PA) occurs when your body can't produce enough healthy red blood cells due to a lack of vitamin B-12. This condition was once considered fatal, but today it can be easily treated with B-12 supplements, either in pill form or as injections. With proper treatment, you can live without symptoms. #### Why Your Body Needs Red Blood Cells Healthy red blood cells are essential because they carry oxygen to all parts of your body. Without enough of them, your tissues and organs won't function properly. Vitamin B-12 plays a crucial role in this process. In PA, your body produces an antibody that destroys a stomach protein called intrinsic factor (IF), which is necessary for absorbing vitamin B-12. #### Risk Factors for PA Certain health issues and lifestyle choices can increase your risk of developing PA: - **Medications:** Some drugs, like antacids or those used to treat type 2 diabetes, can interfere with B-12 absorption. - **Diet:** A strict vegetarian diet can put you at risk since you may not consume enough B-12-rich foods like eggs, milk, and poultry. - **Family History:** If someone in your family has PA, your risk is higher. #### Symptoms of PA PA can manifest in various ways, including: - Feeling rundown and short of breath - Nerve damage - Enlarged liver - Balance and walking issues - Mental status changes #### Diagnosis and Treatment Your doctor will ask about your family history, symptoms, diet, and medications. During a physical exam, they will check your heart, liver, and signs of nerve damage. Blood tests will be ordered to check hemoglobin levels, red blood cell size and shape, and the amount of active B-12 in your blood. Over-the-counter vitamins don't contain enough B-12 to treat PA. Your doctor will prescribe a special supplement, often given as an injection. Initially, you may need injections every other day, but over time, this may be reduced to once a month. B-12 can also be prescribed as a pill, nose spray, nasal gel, or sublingual medicine. Dietary changes to include more B-12-rich foods will also be recommended.