Pernicious Anaemia Society
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Pernicious anemia/Low Iron/Hair loss/Oxygen in the blood

So the title pretty much sums up what I want to ask in this question so forgive me if I am wrong in my assumsion.

Ever since I have had pernicious anemia my hair has been getting thinner and thinner over the years. It scared me so I've done countless research on it and even it's what prompted me to self inject b12 (among other symptoms). So when you have pernicious anemia it goes hand in hand with lack of oxygen in the blood right? It is also stated how lack of oxygen and blood flow can in fact cause hair loss.

Pernicious anemia seems to go hand in hand with a lot of other diseases that cause hair loss, namely the most important iron anemia and hypothyroid problems.

I am wondering how would one correct this problem if they had pernicious anemia and possibly low iron but no signs of hypothyroid? I have read and been told that iron needs to be above 70ug but too much iron can be very dangerous/harmful too.

Does anyone know of other ways to tip the balance with low oxygen in our blood due to these conditions? I am thinking of something wacky like oxygen mask (not sure it would work) but I am open to suggestions.

12 Replies

Hi Krealan,

Were you diagnosed with PA by a doctor and tests? If so, are you being given B12 injections on a regular basis? How often are you getting injections? How long since you were diagnosed? Have you had your folate levels tested? You need folate to help the B12 work. It's a good idea to take a multi vitamin with all the other B vitamins in it, which includes B9 a.k.a. Folate.

The reason for all these questions is because if you were officially diagnosed with PA, then you should be given B12 injections for the rest of your life. This is the protocol in the U.K. & the U.S. And if you are getting injections on a regular basis,, your symptoms should be resolving!

I have no experience with thyroid issues as I don't have them. I don't believe everyone who has PA automatically has thyroid issues. Again, were you tested for thyroid problems?

Sorry if I sound as if I am grilling you, I'm not really, :-) just trying to ask for specific info which will help people on this forum give you the best help!

Low iron can cause hair loss also. When I was low in iron and B12 my hair was thinning also.

If your tests show you are low in iron, your doctor should prescribe iron tablets and monitor your levels.

B12 injections should clear up the low oxygen problem and your cells also need good iron levels for oxygen also.

It is cellular oxygen so I'm not sure how much an oxygen mask would help. I'm not a medical professional just someone who is B12 deficient, also iron deficient until I got tested and treated. I get B12 injections on a very regular basis.

Please post again with a little more info on your situation! Looking forward to hearing from you again.:-)


The symptoms of PA are the symptoms of the B12 deficiency it causes. I don't actually know if I have PA or some other absorption problem but I do have an absorption problem. My symptoms go back 40+ years but were mainly neurological and neuro-psychiatric. I have never to my knowledge been anaemic - certainly never had iron based anaemia and my blood oxygen levels are good unless I have a chest infection - which I haven't had since I started treating myself. However, my hair was also getting very thin before I started treatment for B12 but has now thickened up a lot - but it does take time - just because your hair grows very slowly.

It is quite natural to lose some hair every day - because hair follicles die and fall out and are replaced. The more likely role of B12 in hair loss (in my opinion - and I'm not a bio-chemist) is likely to be the part it plays in cell reproduction and hence replacing the hair follicles as they fall out. Thinning is probably something to do wth the actual operation of the hair follicle itself.

B12 is marketed as a treatment for thinning but doubt it works unless an undiagnosed deficiency is the cause.


Hi Krealan.

I have Hypothyroidism and my hair was sadly breaking off and over shedding and getting thinner, hairs all over the floor :(

My Dr concluded my feritin blood test level of 41 was normal, I vaguely recall being advised by my thyroid members that 90 would be a good level to aim for to restore my hair. (but please don't go by that, do your own research) members also advised me to take some biotin, selenium and zinc. For some reason I never took zinc, though did take some in a vitamin B complex, maybe it wasn't enough ?

It wasn't until I twigged on and started taking a separate zinc supplement, recently, for several months now, that my hair has slowly started to thicken up again, but I still have months to wait till all my layers catch up with each other.

I also take a good high dose B12 supplement too as my B12 blood level was under 400.


Yes!!! I barely have any hair left!

b12 injections, folate or Thyroid meds have not helped it grow back

So frustrated. Doctors are no help !


Ps- it was finally explained to me that since biotin is a b vitamin it is unlikely to be absorbable for someone with PA, unless injected.

Hopefully this will help someone else from spending tons of money and time on biotin.


Biotin in food tends to be bound to protein and needs to be released by digestive enzymes. Gastric atrophy and the resultant lack of stomach acid makes this difficult.

But biotin supplements will not be protein bound and there should be no problems with absorption.

1 like

I actually did a lot of research on gastic atrophy and started to supplement with HCL betaine for the stomach acid boost. It was very expensive always having to keep taking them.

My skin did actually improve a lot while I was on HCL betaine though. It took it to the next level.


I tried betaine HCL (tablets and capsules) but I ended up on lime juice. About 25 ml in orange/tomato/tonic seems to do the job.

I found it difficult to adjust the dose with the betaine HCl and I think I overdid it once - killing off much of the bacteria in my gut.


Just to give you a bit more information on me I am a twenty seven male and I have had pernicious anemia for going on seven years, the doctor told me I had antibodies to the IF. I was put on booster injections when I was twenty and left to rot on one injection every three months.

I know I am male and sometimes males lose their hair but I'm not going to lie I am feeling a lot of anxiety about this issue. I believe it to be a medical issue not just a genetic way of life because I have not felt right for years.

I started to self inject b12 when I was about twenty five. It never seemed to get better even with self injecting every week with methyl or hydroxo recently. I went back and forth to the doctor all the time for years but always told this "it's fine" or "it's okay" in regard to my blood tests.

I have never taken folate and never knew or was told it was needed in combination with the b12. Same goes with iron tablets because I'm scared to because, I read it can be dangerous. Recently I have started to inject hydroxo twice a week to try and test the waters and I've realized my mood has been better and energy levels but it could be a placebo effect.

It is noted that my sister is twenty three and has recently been diagnosed with pernicious anemia and when they checked her iron she was at 22 and the doctor told her "it's fine" which from what I believe is not ....

She then went on to check her bloods again and it was a very low 7ug ..... Why are doctors so incompetent when it comes to this stuff because she went to see another doctor and the doctor told her in order to grow hair it needs to be about 70ug or above.

So my question is could me and my sister have the same problems, only I am older and they have had more of an impact on me? Not sure if it's worthy of a mention but we both had quite dramatic greying of our hair at about 21-22 each, could this be another sign that we share symptoms?

I wish so much that I could get diagnosed with iron anemia and get on iron and it be the answer to all my prayers because right now I am feeling, depressed, sick and completely fed up.

PS B-complex seems to give me really aggressive acne (I have tried it in the past)

I will be willing to answer any more questions :) I should have my blood tests back soon and then we can go from there.


PA does tend to run in families.

Premature greying is more common amongst people with PA but nobody has ever established a link to B12 deficiency so it could just be genetics.

Some people don't respond to methyl - could be a number of reasons for that so it may be that switching to hydroxo was what you actually needed. Some people do need to keep their levels really high - myself included - I do this by a mixture of injection and nasal spray.

Premature greying runs in my family from my fathers side - but not quite as dramatic as your sister and yourself - late 20s and 30s. There is no formal diagnosis of PA within the family - just myself with an absorption problem and my brother certainly benefiting from supplementation. Symptoms in our family tend to focus on the neurological/neuro-psychaitric side rather than the anaemia side.

It may be that continuing with hydroxo starts to turn around the hair loss.

My cousins inherited early hair loss from their father - don't think it has anything to do with B12 in their case and were all bald by the time they hit their 20s so it may be that there are other things going on in your family. Certainly appreciate that hair loss can be really distressing for anyone regardless of their sex.

As before it may have nothing to do with iron levels - and PA doesn't necessarily affect iron levels - though do have to confess that I've supplemented a small amount of iron for years - but I'm female and started it because it helped with period pain etc. Suggest that you talk to your GP about the idea of taking an iron tablet and if they feel it would be risky - or a pharmacists - small doses should be okay.


This was very informative thank you! I read that certain people don't respond to methyl that is why I am taking hydroxo now and I really hope I see a different (I'm not sure how long that might be).

Does having low iron run in families? I know it affects females more than males due to periods etc.

I honestly wouldn't care if I were to go bald through genetics or whatever (ok maybe a little lol) but I just have this nagging feeling saying in my head it is a medical reason. No males in my family are bald even well into their 60's-70's my father died when he was 47 with a lot of dark hair and my mother's father who they say you should look at to get some sort of idea if you will go bald died in his 70's with a full head of salt and pepper hair.

Everything points to the fact that it is a medical issues including the fact that I just don't feel right in myself, I have so many symptoms that it is hard to mention. I have terrible depression and I read that is also a sign of something not right in the body. I mean of course I would feel depressed I am a 27 year old who feels like a 70 year old at times. My eyes burn constantly I don't know why, eyes blurry and after no lie four hours of being awake I am exhausted and feel as if I need sleep.

Everyone makes jokes that I am so lazy but I just know deep down it is not me it is this stupid condition :(


Hi again, Krealan,

Just wanted to say that if you have been diagnosed with PA, then most likely you will have an absorption problem as the body attacks its own gastric parietal cells - that is why it is an autoimmune disease.

So, if your sister and your iron levels are low, this could be the reason why- an absorption problem. 22 is very low- I felt crap when my levels were 30 and felt much better when they got to 76. I did this under a doctors supervision. Your sisters doctor is so wrong- can she switch to anther GP?

When I was found low in B12 , I was also low in iron and vitamin D. I have to take sublingual D drops because my body does not absorb D oral (through the stomach) capsules. I have not been tested for PA yet but my mom had it so I think I do too.

I am in the U.S. where I get a prescription from the doctor for B12 and my husband injects me. I have to keep levels very high, so I feel best when I inject every other day. This is not uncommon- many people on this site have to do multiple injections in a week and some even daily. So I think an increase in whatever form of B12 injections would be good. I hope your sister is getting B12 injections as well- and enough of them!

I hope you can get your low iron treated! and you can get folate by eating lots of leafy green veggies and/or take a supplement of folic acid (folate) of 400 mcgs a day. You don't have to worry about high folate levels if you take only 400mcgs a day.

As far as a B vitamin goes, I use a food based multi vitamin and a food based B complex. The food based vitamins are much more digestible and do-able for me. Garden of Life brand Vitamin Code raw B complex and multi. I think you can get them on Amazon. I get mine from Swansons vitamins online and they are an international company, too. I only take a half dose of the B complex as the whole dose -2- capsules makes me feel a little ill. Plus the bottle lasts longer that way- less expensive!

Best of luck with it all :) glad to hear you are feeling better on more frequent B12 injections and I hope the addition of folic acid by itself or in a multi or B complex really boosts the positive effects of the b12. Keep us posted on how you are doing!


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