Symptoms of Pernicious Anaemia

There are three things to bear in mind when discussing the symptoms of Pernicious Anaemia:

Firstly, the symptoms are insidious in that they develop over many years. This means that some patients will attribute their symptoms to advancing age or a busy modern lifestyle – and the consequence of that is that they do not think of mentioning how they feel to their doctor.
Secondly, 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.
Thirdly, many of the symptoms are associated with a wide range of other illnesses which contributes towards the problem with patients receiving a late diagnosis.

There are a number of other symptoms that are not listed here. The following are the most common symptoms. Just because what you experience is not listed here doesn’t mean that it isn’t caused by your Pernicious Anaemia.

Common or early onset symptoms

Shortness of Breath

Usually manifesting as the desire to continually take deep breaths or heavy sighing

Extreme Fatigue

An overbearing tiredness that never really goes away. Waking up tired after a good night’s sleep is often experienced.

Brain Fogs

This leads to a ‘fuzziness’ in thinking, nominal aphasia (forgetting the names of everyday objects), short-term memory loss and confusion (sometimes known as ‘handbag in the fridge syndrome’)

Clumsiness/Lack of coordination

Bumping into things or dropping things

Brittle, flaky nails & Dry Skin

The dry skin can be anywhere on the body

Neurological Symptoms

Balance Problems

General unsteadiness including bumping into walls (the ‘shoulder bumps), and difficulty putting on underwear (the knicker dance), and having to hold on to something whilst showering. Inability to stand up straight with closed eyes or when it is dark

Dizziness/Feeling Faint

Numbness/Tingling/Pins and Needles

These are usually experienced in the feet and hands though they can appear anywhere. Some patients also experience a crawling sensation in their face ‘spider crawling’.

Burning Legs and/or Feet

Known as Grierson-Gopalan Syndrome.

Neuropathic Pain/Fibromyalgia

Usually only on one side of the body.

Vertigo

The inability to cope with heights and wide open spaces. Patients will need a visual reference to compensate with what is probably damage to the brain’s balance mechanism. Often this will mean the patient will have to look at the floor while walking.

Tinnitus

This is extremely common in patients with PA and is probably due to slight nerve damage to the brain.

Sensory Impairment

Loss of smell, taste, touch

Behavioural Changes

Irritability/Frustration/Impatience

A general feeling of unease. Some patients will try to deal with this by seeking isolation for peace and quiet away from noises, crowds and bright lights.

Sudden Mood Swings

This can be completely out of character and is related to the above. This can and does cause problems in domestic and workplace situations.

Depression

Loss of Libido

This can affect both men and women.

Sleep Disturbance

Even though the patient is exhausted he or she is unable to sleep or will need to sleep during the day, often for many hours.

Confusion/Dementia

Oral Cavity Symptoms

Mouth Ulcers

Especially on the inside of the cheeks

Swollen, ‘Beefy’ Tongue

Cracked Tongue

Gastrointestinal Symptoms

Sudden Unaccountable Diarrhoea

‘explosive diarrhoea’; some patients experience this after a bout of constipation; ‘floating Stools’, flatulence.

Poor Digestion

Loss of Appetite/Weight Loss

Other Reported Symptoms

Hair loss

Premature grey hair

Menstrual Problems

Infertility

Vision Problems

Incontinence

Co-existing Conditions

Pernicious Anaemia is an Autoimmune Disease. Autoimmune Diseases are characterised by the body somehow attempting to destroy itself. In the case of Pernicious Anaemia, the body produces an antibody that attacks the protein responsible for extracting vitamin B12 from food (any animal product). Doctors don’t know why this happens nor do they know with any certainty why patients with one autoimmune disease will frequently have other autoimmune condition. Many unlucky patients will have more than one other condition and some will have several.
Here is a list of the most common autoimmune conditions that patients with Pernicious Anaemia will also have:

Diabetes (Type 1)
Graves’ Disease (Hyperthyroidism)
Hashimoto’s Thyroiditis (Hypothyroidism)
Multiple Sclerosis
Psoriasis
Vitiligo

And Finally

The underlying cause of Pernicious Anaemia is the inability to absorb Vitamin B12 from food and consequently the patient will be deficient in B12. 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 the 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, the lucky ones 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 could be 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.