Pernicious Anaemia Society
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Struggling a bit

I thought I had been getting along fairly well with my treatment regime of weekly methylcobalamin injections. I had cut back on folic acid tablets to only once a week and hadn't had a return of mouth ulcers, so I figured that was fine also. In Feb I had a noticeable uptick in my level of fatigue which was followed by a weak/shaky feeling if I stood for more than a couple of minutes. It was discovered that I'm hypoxic.

I've had a bunch of tests done which have ruled out heart problems and seem to have ruled out lung problems as well. That leaves blood as the only other possible troublemaker. Weirdly, my blood test results have all been good. I'm not showing any signs of anemia with one exception; a blood smear was done and it showed hypochromia. I had iron studies done a month ago, and I wasn't low in iron then. I suppose that might have changed in a month, but it seems unlikely.

I know this forum is for PA, and I think my PA is still well treated and that this hypoxia problem is related to something else. The trouble I'm having is that I suck at research and, when I try to look up hypochromia, all I find are references to iron deficiency anemia and results that are microcytic/hypochromic. My results were really normocytic/hypochromic. I'm trying to figure out if a result of "hypochromic 1+" would be severe enough to account for my blood oxygen level dropping to 83% on exertion. Can someone tell me how to go about looking this up?

4 Replies

Not sure if it helps much but found this by searching on normocytic anaemia

This is only an abstract rather than the full articles - but it sounds as if it is the results of something else going on though there seem to be lots of possibilities.


Thank you Gambit. I know I have experienced anemia of chronic disease in the past, so I wonder if that is flaring up again. But if that's the case it might be a secondary cause of the hypoxia, since my iron levels (including TIBC) were good last month and I've been having symptoms since February. This is probably a good time to rest my head on the keyboard and wonder why there have to be so many kinds of anemia?! akldjsf;iejonsaefo;di'a (kidding)

Ironically, since I don't have an official PA diagnosis, no one but me accepts the idea that I might have anemia of chronic disease (ACD) which is triggered by pernicious anemia. Unfortunately, even if that is true, there's no way to "treat the underlying cause" to resolve the ACD.

I hate to think of the amount of damage my body is experiencing due to they hypoxia though. :(


Hi there. Your post caught my eye, particularly when i saw the words mouth ulcers. Have you found anything that has helped with these, as I have basically had them non stop since just b efore xmas and am just about over it.... lol


I found that folic acid really helped me. I don't think I was ever low in folic acid, so I don't know why it helped. It just did. (Well that in combination with getting enough B12.) I was taking 400mcg of folic acid daily for awhile, but I've been able to cut back and they haven't returned.


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