I was diagnosed with PA 15 years ago - after being told for years that my illness was psychosomatic (all in my head). I was fatiqued all the time, falling asleep around 11am in the monring and couldn't sleep at night. My mouth hurt (tingled) and my tongue was red raw and sore and my skin hurt like it was burnt. I was constantly ill as if I had morning sickness - stomach cramps, diagnosed at Ulcerative colitis or IBS. life was pretty miserable... I also suffered depression regularly. My PA wasn't diagnosed because all my other levels are great...
I have injections every three months now and have done since - I now sleep and very rarely get sick in the stomach.
Apparently PA is specifically the result of not absorbing B12 because the body does not have a protein called "intrinsic factor" and without the B12 doesn't get absorbed.
Life has been a damn sight better since....follow thorugh it's very important.
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I am not a medical doctor or professional. Never begin any therapy without first discussing your options with your own, personal physician. The following is not to be interpretated as medical advise.
The following is based on internet reasearch. I am not a doctor, am only repeating what some physicians and/or clinics/hospitals have posted online in various capacities-
Pernicious Anemia has been linked with the following medical conditions, based on several different articles that are available online-a Vegan diet, Pyridoxine Dependancy, Lyme Disease, Cirrhosis, Hepatitis, HIV/AIDS, Cyanide Poisoning, Cobalt Deficiency/Toxicity, Wilson's Disease, Celiac Sprue, EBV, HPV, and Hypothyroidism.
It's impossible for a doctor to run all of these tests, as you know.
As a smoker, that might be one of the first things to look at. Cigarettes contain Cyanide. Some doctors warn smokers about taking B12 in its regular form, Cobalamin, the version found in most multi vitamins.
Actual Cyanide poisoning can disrupt B12 absorption into the cell structure, that's been proven, I believe, so your best bet is to quit smoking. The serum B12 test is reliable, but some are of the opinion that it does not necessarily tell a person what level of B12 they have stored inside the cell.
If you won't quit smoking, at least one article that I've found suggests that smokers would have better luck taking B12 in its coenzymated form, that being Methylcobalamin. That's available OTC. The odds of a 30 year old woman being deficient in B12 is next to nothing unless you're a vegan, however, so I would think that most would feel that you're problem here is related to absorption, not intake deficiency. Again, I'm not a doc, so this is only based on loose interpretation of what some of the medical journals/websites mention online.
In some circles, there tends to be a belief that B12 absorption is dependant on proper levels of Pyridoxine in the system (Vitamin B6). Others suggest that actual B12 cellular absorption requires a proper amount of the co-enzymated form of Folic Acid, which can only be found in leafy vegetables, I believe. A couple of companies have started to release a product called "Metafolin," which evidently utilizes this specific form of Folic Acid in supplement form. But if your Folic Acid level was ok, I doubt that this would be the problem, obviously.
Taking too much Vitamin B6 can cause a problem, too (Toxicity). Ideally, a person always wants to stick close to the RDA for their vitamin intake. Some sources propose that B6 is safe to take up to 100-200mg's daily. I would never take that much of it on a daily basis, personally.
Some doctors will also check the Ferritin level in these cases, which is your iron store, I've read that before, but the last thing a person should ever do in a case like this one is to assume deficiency. Again, these things have to be covered by your doctor.
If you smoke, there's a good chance that your Homocysteine level might be a little high, too, especially now that you're into your 30's. There again, however, you need the blood serum count to know what to do about it. TMG, Zinc, SAME, B6, B12, and Folic Acid have been alledged to be of help for those with high Homocysteine levels, but again, it's not wise for anyone to begin taking any supplements without being told to do so by your doctor.
Than there's the the Cobalt theory, but a person would be crazy to ever take Cobalt in supplement form. It is a known carcinogen, that's the last thing you want to touch unless it's prescribed by your doctor.
Celiac Sprue and Hypothyroidism might be of interest. You're in your 30's now and you're a female, so if you're having problems with metabolism, indigestion, gastrointestinal disturbances, etc, those are a couple of conditions that you might consider? Again, I'm not a doc.
I can all but guarentee you one thing here, though-the smokes are the top suspect. Substances like Cadmium and Cyanide are fairly hard to come by unless you're a smoker. Cyanide might have a direct role with B12 utilization. Whether or not Cadmium deposits within the bile ducts could ever cause something like this, I don't know.
Good luck, ma'am.
Thanks to you both for your comments.
I am getting help with giving up smoking and I do believe that I have a problem absorbing the B12, I have an appointment with my GP tomorrow and we're going to be starting the schilling test soon, so hopefully, the results will show that we can fix this.
Again, thanks for your advice.
This type of Anemia is usually only seen in strict vegans after many many years of no animal prdocuts (which is the only source of B12 in general) and in people with certain genetic disorders or conditions. Usually you get enough B12 in the average diet, but in some people the body can no longer absorb B12 from the food we eat so injections are needed. You may want to consult your doctor about this and do a google search about Pernicious Anemia.
Also I am not a doctor so please take the above as advice only.