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.
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.