Pernicious Anaemia Society


Whilst I understand the B12 deficiency and auto immune attack on intrinsic factor, what I'm not clear about is the word anaemia in Pernicious Anaemia. I'm currently taking an iron supplement but want to know whether, besides the B12 deficiency this condition means I will always have an iron (anaemia) problem as well or will the supplement likely be temporary?

6 Replies

Hi Irene, I too have Pernicious Anemia with sub-acute combined degeneration of the Cord. From what I understand "Anemia" in our case is a result of the effect the B12 deficiency has on our production and longevity of our red blood cells.

The red blood cells we produce are fewer, elongated and flatter and don't live as long as normal red blood cells. So, the end result means our red blood cells die off faster and as a result we become anemic.

Maybe someone else understands this differently but this is what I understand it to mean. I'm not sure taking an iron supplement will make much difference as iron deficiency is not particularly the problem we have, but the our bodies inefficiency to take-up B12.

I hope this helps and best wishes in your management of PA.



Hi Irene,

The Anaemia reflects the in-abilety of wrongly formed bloodcels to contain enough haemoglobin. With B12 def the bloodcells become to large, same with folate def and with iron def they become to small all causing an inabilety to contain enough haemoglobin for the body . So in effect anaemia can be caused by B12, and or folate and or iron deficiency or a combination of all 3 or 2 etc. It is quite common to not only be B12 deficient but also iron or folate deficient. WQeel that is my understanding and B6 deficiency can cause problems aswell with bloodproduction, all need to be in oprimum supply for good blood production.

I hope this helps,

Kind regards,


<b>Updated on Jan 27 2011 12:54PM:</b> Oh to answewr re:"will always have an iron (anaemia) problem as well or will the supplement likely be temporary?", no iron supplements should sort out iron def, usually in about 4 months, although PA can involve a lack of acidety in stomach that can mean uptake of iron is bad or other gastric issues can cause iron absorption problems and that would needed to be investigated further I expect.


Thank you both for your response. I do have low ferratin and iron deficiency but in a play on words my gp said this didn't mean I was anaemic. I then asked my endocrinologist and he said I was anaemic and that some problems that I attributed to my thyroid problem were a result of the lack of iron e.g. flattened finger nails.

As the gastric specialist didn't flag that I needed a biopsy to specifically rule out coeliac disease with the last endoscopy I had, I had to have another. It was only when speaking to the doc carrying out this procedure that I mentioned having been diagnosed with PA and she said that was important and carried out some further biopsies as she said there is a specific B12 deficiency gastritus. It's very frustrated that there doesn't appear to be any joined up thinking. The gastro consultant knew about my diagnosis but failed to flag this for the endo. Crazy. Will find out results end of February and will update then. Thanks again.


Do you have your serum ferritin? Could you post it with your iron def and FBC figures?

One thing you should be aware of is that the ranges set for women and men are different. And this is almost certainly wrong. You should look at the ranges they apply to men and apply them to yourself - that is likely to give you a clearer idea of your degree of deficiency.

The reason for this is that when they set the ranges they measured a lot of people who were iron deficient as "normal". Women have lower iron, probably because they eat less, and because of periods, rather than that they need less. Read this if you have time.

BMJ. 2001 Jun 2; 322(7298): 1355–1357.

PMCID: PMC1120434

Why should women have lower reference limits for haemoglobin and ferritin concentrations than men?

There have now been studies substantiating this argument.



I'm currently being reviewed for Coeliac as a result of an Endoscopy. Bloods normal but intra epithelial lymphocytic

Also have PA, Iron Defficiency Anaemia (defo), low folate, and Hypothyroidism which is currently playing up and after 10 years of being stable, my last bloods showed a TSH of 25!!

I have been told by Gastro that I will need permanent Iron and Folic Acid supplementation.

I have also recently been referred to a Neuro for Trigeminal Neuralgia.



So you are one of the unlucky ones with celiac disease plus autoimmune gastritis plus hypo. I am sorry. Did you ever go gluten free? I would have thought that once you have been gluten free for a few years things might improve a bit (i realise that sentence does not sound very cheering....). It sounds as though the gut problems may have been the cause of the hypo.


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