Symptoms of Pernicious Anaemia
There are several things to bear in mind when looking at the symptoms of Pernicious Anaemia:
- Pernicious Anaemia predominantly results in neurological and anaemia signs and symptoms, but neuropsychiatric symptoms are often the first manifestation. Even though the name Pernicious Anaemia suggest anaemia is always present, this is often not the case. Neurological and neuropsychiatric symptoms often occur (long) before anaemia is present so the absence of anaemia should not be a reason not to consider Pernicious Anaemia.
- The symptoms often develop (slowly) over many years. This means that doctors and patients might attribute the symptoms to advancing age or a busy modern lifestyle.
- The symptoms vary in severity from patient to patient; and some patients will have all or nearly all of the them while others will have just a few.
- Many of the symptoms are associated with a wide range of other illnesses which contributes towards the problem with patients receiving a late diagnosis.
- Some patients will have only a few of the symptoms, while some will have many. The following list includes most symptoms, though not all. There are a number of other symptoms that are not listed here. Just because what you experience is not listed here doesn’t mean that it isn’t caused by Pernicious Anaemia.
Neurological Symptoms
Paresthesia: abnormal sensation, typically tingling or pricking (‘pins and needles’)
Numbness in hands and feet, reduced skin sensation
Impaired fine finger movements
Ataxic gait (unsteady, staggering gait)
Balance problems/loss of sense of position
Reduced or absent reflexes
Clumsiness/lack of coordination
Aphasia (problems with speaking, writing, reading)
Sensory loss (loss of taste, smell or hearing)
Positive Romberg sign (unable to maintain balance with eyes closed)
Burning legs and/or feet
Lhermitte’s sign (electric sensation that travels down your neck and back)
Blurred vision
(Neuro) Psychiatric & Psychological Symptoms
Memory and concentration problems
Dementia, confusion
Brain fog/decreased mental concentration
Irritability, emotional lability
Personality changes, mania, paranoia
Depression
Psychosis, delirium, paranoia
Anaemia or Anaemia-like Symptoms
(Extreme) Fatigue
Shortness of breath
Dizziness/feeling faint/vertigo
Postural hypotension (drop in blood pressure upon standing)
Pallor
Gynecological and Urological Symptoms
Infertility
Loss of libido/impotence
Menstrual problems/pains
Incontinence
Cystitis, bladder inflammation, bladder infections
Pyelonephritis (kidney infection)
Gastrointestinal Symptoms
Loss of apetite
Glossitis (pain, redness, swelling in mouth and tongue)
Diarrhoea
Weight loss
Nausea, vomiting
Stomach problems, heartburn, discomfort
Other Symptoms
Fever
Sleep disturbance
Tinnitus
Hair loss/premature grey hair
Brittle nails
Ongoing Symptoms
It is widely assumed that once that deficiency is corrected then the patient will feel well again and his or her symptoms will disappear. Whilst this happens with some patients the vast majority of members of the Pernicious Anaemia Society will still experience symptoms with various degrees of intensity. Some will not experience any lessening of the symptoms and will be faced with having to make some life-changing decisions relating to their work and family life. Others will see a lessening of their symptoms and some will see their symptoms disappear altogether. Nobody knows for sure why this is so but it is likely that the later the patient received his or her diagnosis the less likely it is that the symptoms will be alleviated once replacement therapy injections of B12 have been given. Another reason for continuing symptoms could be found in the possibility of co-existing conditions (other auto-immune conditions) or co-existing deficiencies (folate, iron) that are regulalry found in patients with Pernicious Anaemia. Read more
See also our Symptoms Checklist