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Pernicious Anaemia Society
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I started to have pain on my left side, under rib cage. It started off just as pain and three months later I am now having symptoms of anemia. The doctor said I didn't have anemia but all the right numbers are leading to that. I think that I am b12 deficient but no one has tested me. I was so weak and felt like I was going to fall out that I went and had a b12 injection and I felt better then I had been. It got to the point where I couldn't walk up a flight of stairs without feeling out of breath. They said my spleen was not enlarged but I can feel it. Not physically but something. I guess I am wondering has anyone had issues with your spleen and b12 deficiency.

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Hi there. I have pernicious anemia and sometimes have pain under my rib cage. Don't know what causes it. I have a B12 injection every 3 months and take folic acid tablets, metformin for pre-diabetes and tablets for high blood pressure and an aspirin a day to prevent blood clots. I also have arthritis as a result of the PA and asthma was makes me breathless very quickly when I venture outdoors. I am only 54 and I feel about 80. The old ladies of the bus get up to give me a seat. I seldom go out now and feel like a prisoner in my own home. If you are not happy with your treatment from your GP I recommend you change your GP. I had to wait 2 years to see a neurologist and now I have irreversible nerve damage in my left leg. If you don't get the treatment you require quickly it could get worse and affect you in later life. I can assure you it is imperative to get treated for B12 deficiency because it can lead to stomach cancer if left untreated and leave you virtually paralised. The PAS is the best place for information on the disease. Hope this helps. Please let me know how you get on. Take care. Best wishes from Sandra in bonnie Scotland.


I can assure you it is imperative to get treated for B12 deficiency because it can lead to stomach cancer if left untreated

Not quite.

Autoimmune Metaplastic Gastric Atrophy (AMGA) is the problem that causes PA. The immune system kills off Gastric Parietal Cells. If you have PA (which is a specific cause of a B12 deficiency) then you will have AMGA.

Treating the B12 deficiency will not do anything to the AMGA, so will not reduce any risks associated with it.

People with AMGA are at greater risk of getting Type 1 gastric carcinoids (aka Neuroendocrine Tumours, or NETs) - but it's a small risk. Even if you do get NETs (like I have) then they're not very scary. They tend to sit around doing nothing much at all.

My treatment is to have a gastroscopy once a year, just to have a look at them and check out how they're behaving. The last one was a couple of weeks ago and all looked fine.

So, people with AMGA have a small chance of getting NETs (which are different from stomach cancer), and people with NETs have a very small chance of them misbehaving and becoming cancerous.

Indeed, for people of my age the 5-year survival rate if you have NETs is actually higher than if you don't have them! I guess it's because all the other tests I've had - CT, octreotide scan, PET/MRI - will also find other possible nasties. So I know I have NETs, but I also know I don't have cancer in my lungs, liver pancreas, etc.

So, if you have AMGA there's a very, very small chance of stomach cancer - but it's not zero. Which is why I would recommend everybody with PA have a gastroscopy every 5 years, or so. Just to check.

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I also have the rib pain--- but on my right side. I've no idea if it's related to the B12 deficiency.


I have intermittent pain the same area as you. I've been having it for a few years (long before my B12 deficiency diagnosis). Had an MRI and they said everything was fine. I think it's interesting that at least a few of us have had this same symptom, though! Does yours come and go?


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