What is Pernicious Anaemia?
A part of blood is made up of a fluid called Plasma. There are three constituent parts of plasma:
- White Blood Cells – these are part of the body’s defence mechanism and help to fight off infections.
- Platelets – these help the blood to clot.
- Red Blood Cells – these carry oxygen through the body via a substance called Haemoglobin.
In order that the Red Blood Cells are able to perform effectively they need Iron and the Vitamin B12. If a person has a lack of iron in their diet, or have lost a lot of blood through bleeding or very heavy periods, they can develop iron-deficient anaemia. This is what most people understand anaemia to mean. The treatment of iron-deficient anaemia is simple and effective and usually involves iron supplements in the form of tablets.
If the body is unable to absorb Vitamin B12 the Red Blood Cells will not be able to reproduce (millions are made every hour), and instead of being saucer-shaped, they will become larger and rounder which inhibits their ability to carry oxygen around the body. The failure to absorb Vitamin B12 results in Pernicious Anaemia.
Why can’t I absorb B12?
A healthy person will have a small protein in their gut called Intrinsic Factor. This Intrinsic Factor binds to food and extracts Vitamin B12 (Cobalamin). The B12 is then used to reproduce Red Blood Cells which retain their desired shape. A person with Pernicious Anaemia has a substance in their gut that destroys the Intrinsic Factor. This is called Intrinsic Factor Antibody which ‘kills off’ the Intrinsic Factor that is needed to extract B12 from food. This is an extremely simple explanation of a very complex chemical process that takes place in the gut.
So why not give me Intrinsic Factor?
It would be of no use – the antibodies would simply destroy it.
So how can I absorb B12?
B12 is found in all animal products including dairy products. If you have Pernicious Anaemia you won’t be able to absorb B12 from food. Instead you will be given injections of B12 in one of two forms. Hydroxocobalamin is used in the U.K. and is available only on prescription. In Australia, Canada, the U.S.A. and some European countries it is given in the form of Cyanocobalamin which is available over the counter. These injections are given into a muscle so that the B12 is released gradually into the bloodstream - by-passing the stomach. The usual treatment regime for treating Pernicious Anaemia is an injection of Hydroxocobalamin every three months with Cyanocobalamin being given monthly. Some patients require more regular injections.
Why can’t I just take B12 tablets?
They would not be absorbed because you will not have any Intrinsic Factor which is essential in the chemical process.