Pernicious Anaemia Society
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Help on pernicious anemia,what do doctors mean?

Hi please could anyone tell me I have suffered on and off with anemia for about 13 years I also have underactive thyroid. I remember maybe 5 years ago a doctor saying you will have pernicious anemia when you get older?

I am anemic at the moment and have had some bloods done and she mentioned it again,I was stupid and did not ask anymore questions about it as I was there for a different reason.

What do these doctors mean?

I take a b12 1000 at the moment everyday as was suggested to me about 5 years ago when I was deficient in B12.

Thank you :)

6 Replies

I would advise you to call GP this aft and ask for copies of all your recent blood tests with reference ranges. If you have had low B12 you should have been given injections. Also ask if you have been tested for PA antibodies. Once members see blood results we will be able to help you. Lots of very lovely experienced people on this forum!


Thanks for quick reply. I am back in the morning to get some bloods so I will ask then. :)


Hi Lesa. Good advice from Hoxo.

Your doctor probably meant that, as you have autoimmune thyroid disease, you could possibly develop another autoimmune disease, one of which is PA.

Many researchers believe leaky gut/intestinal disease is the ground zero of autoimmune disease and thyroid/PA/B12 def. are often linked both ways with overlapping symptoms. It is a good sign that your GP is aware of this but, you already have anaemia and, if you also have neurological symptoms, (regardless of test results which will now be skewed) you should be treated without delay with B12 injections as defined in the BNF guidelines :

"The BNF advises that patients presenting with neurological symptoms should receive 1000 ug i.m. on alternate days until there is no further improvement".

Here are some more links you may not have seen: :

The above latest BMJ research document is supported by many research papers and has a useful summary. It also tells GP that, once b12 treatment is started, the test results don't mean anything and blood levels are not reflective of how effective the treatment is - it is the clinical condition of the patient that matters....

Best wishes for getting the right treatment.


Just tried to edit my post but something keeps going wrong with the HU site at the moment?! Here is the BMJ link again as I don't think it worked before:


PA is sometimes used as a blanket term for B12 deficiency though more accurately it is an auto-immune response that causes a B12 deficiency by destroying parts of the mechanism that the body uses to absorb B12. The symptoms of PA - in whatever sense your doctor is using it - are the symptoms of a B12 deficiency - classically that includes anaemia but it isn't always present - I've had symptoms of B12 deficiency for over 40 years but have never had anaemia. There is a lot of overlap between symptoms of B12D and thyroid so you may have symptoms that you are attributing to thyroid that could be B12 or even a mixture of the two.

This link takes you to list of symptoms of B12D


Other causes of B12 deficiency are lack of B12 in diet (only found in animal products), lowering stomach acidity - especially as you get older - and various drug interactions.

Although flooding the gut with high levels of B12 taken orally can result in enough being absorbed to passively (outside the ileum) this doesn't work for everyone and the usual treatment for a B12 deficiency caused by an absorption problem is injections. The main thing is trying to find a way of getting enough B12 into the body by passing the gut - eg sublingual, nasal or skin.

The amount you are taking daily is at the low end of effective doses taking orally and trying to use the fact that about 1% of B12 is absorbed outside the ileum. Higher doses might work better ... but they don't work for everyone. Range is usually given as 1000-1000mcg per day


If you were deficient in B12 five years ago, deficient enough for them to mention it, it sounds to me as if they were saying that this is an illness you already have, and in the future it will likely progress to the even more severe anaemia stage. It's best not to wait for that to happen but to have injections to prevent it. My understanding is that if you have PA you should be having injections for life.

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