Autoimmune gastritis due to PA - Pernicious Anaemi...

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Autoimmune gastritis due to PA


Hey all, I was diagnosed with PA over a year ago due to a general check-up and got a full blood count done. My b12 levels were seriously low and iron too.I never really had any symptoms or felt overly tired it was quiet a shock for me. My doctor then referred me on to a GI specialist who recommended a endoscopy. My results found I had widespread non-erosive gastritis and also they found a small lesion in my stomach that was atrophic gastritis and did several biopsies. Everything came back normal with some inflammation there too. I have to go back now soon for a follow up endoscopy and colonoscopy as colon cancer ruins in my family. Its scary how you can have all this going on and only for my doctor recommended an endoscopy I would of never known. Does anyone else have autoimmune gastritis due to b12?

8 Replies

its the other way round - auto-immune gastritis leads to problems absorbing B12 and a B12 deficiency so it had obviously been going on for a long time - it generally takes years and sometimes even decades for an absorption problem to manifest in a full blown deficiency. Infact - PA is a misnomer as it is really a form of auto-immune gastritis - but just happens that it was first observed as a blood disorder.

Thanks for your response!

gastritis means stomach issues resulting in b12 and iron deficiencies.

mine were caused by h pylori.

once h pylori was eradicated my iron improved quickly but i only started absorbing b12 without injections after 8 months. i assume my stomach took a while to heal/repair the functioning of intrensic factor cells.

i have not had a b12 injection since 7-6-18 and prior to then i was getting then every 1 to 2 weeks, as i am in the US and can get at weight loss clinics. i tried to go longer in may of 2018 but by 3 weeks i was having major symptoms so i got 3 or 4 more injection and then after my 7-6-18 injection, i no longer felt the need, so i waited.

i was tested on 8-28-18 (appox 45 days since last injection) and my b12 was over 1300. which was weird as my test on 7-13-18, one week after injection, was only 1074.

i am definitely absorbing on my own now.

best of luck and health


I have widespread atrophic gastritis that is autoimmune and have recently been diagnosed with PA as a result. The gastritis was found first. I seem ok. I need to be checked every year or so to monitor change in stomach cells. I’m just adjusting to this news. Not sure what to make of it really. I don’t understand why if it’s autoimmune and it causes damage it isn’t treated like IBD or Coeliacs disease. The medics seem happy to let it carry on as they believe most people carry this around all their lives and are a asymptomatic. I’m not asymptomatic for sure, it is just about managesble with a very restricted diet. This whole approach doesn’t sit well with me, but there seems nothing I can do!

I hope you can get some answers.

shaylynn in reply to natcap1

I was also just diagnosed with AG and am trying to wrap my head around all of this. Can I ask what your treatment has been other than the restrictive diet.

natcap1 in reply to shaylynn

Hi, I found a consultant that researches AG and PA. He said that I likely have no parietal cells left now. So the AG is at its end point already. This is why I now have PA. In his experience few people present any problematic symptoms of AG. He knows this because people show up with gastric tumors having had no symptoms of having AG. Lots of people might have it and will never know. Any symptoms for me will not be disentangled from IBS symptoms or other functional gut issues I probably have. So no treatment as there isn’t any and even if caught earlier there is no evidence that immuno- suppressants work to stop it. I stress this is auto-immune AG, AG caused by H Pylori is treatable. I will be checked via endoscopy every 2-3 years to check for gastric cancer and neuroendocrine tumors, as AG raises the risk of gastric cancer quite a bit (although overall this is not a common cancer). PA can raise the risk of the other tumors which are not life threatening and new treatment has been found that can shrink them. I am feeling better about things now I know this, but also as I have more B12 shots things are improving.

Hope this helps.

shaylynn in reply to natcap1

Thank you for that info. Very helpful!

I have PA, Atrophic Gastritis (AG) and Intestinal Metaplasia (IM). I have put the question to multiple physicians as to the causal direction of the PA and AG. No clear answer. I have read medical journal articles consistent with Gamit62's comment; i.e., that autoimmune AG causes PA, and the logic of that statement makes sense. Physicians to whom I have posed this question, including a Hematologist with advanced experience with PA, do not know. Frustrating.

If the causality is autoimmune AG->PA, then the AG is progressive in a meaningful way and will continue until the stomach is left with limited digestive-acid-producing capabilities. The implications are dire. If not, if autoimmune PA->AG, the condition is not as progressive, and the AG will spread at a slow pace as the PA antibodies damage the parietal cells in the lining of the stomach responsible for producing B-12. In the latter scenario, as long as PA supplementation (via injections) continues, the pace of damage to those cells should be slow enough to allow for semi-normal life for some time.

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