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Treating “Deadly” Anemia, Pernicious Anemia

Dr. Mehreen Zaman Niazi

2 min read

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Vitamin B12 helps the red blood cells divide so they can easily transport oxygen throughout the body. Therefore, a continued deficiency of the vitamin can lead to reduced red blood cell production and body-wide oxygen supply, resulting in chronic fatigue and weakness; or anemia. Pernicious anemia was highly fatal in the past due to the unavailability of B12 treatment.

However, with effective treatment options and gastroenterologist treatment plan, the risk has been greatly minimized.


Pernicious anemia may be easily treatable, but since patients often get used to the symptoms, like headaches, weakness, and chest pain due to the condition’s slow progression, it can lead to the following complications if left untreated:

  • Damage to the heart, brain, and other organs
  • Nerve damage
  • Memory loss and dementia
  • Digestive tract problems
  • Increased risk of gastric cancer
  • Fractures in the upper forearm, back, and upper legs due to weakened bones
  • A false positive Pap smear test in women, resulting in mistreatment for a UTI or chronic gynecological condition when no such condition is present.


While pernicious anemia caused by a lack of Intrinsic Factor (a protein produced in the stomach which facilitates B12 absorption in the small intestine by binding to it) cannot be prevented in most cases as it is either autoimmune in nature, genetic, or results from partial or complete stomach removal, the risk can be reduced in the following cases:

  • Regular B12 testing in older individuals or in case of a strict vegan diet and chronic or recurrent gastric issues for early detection and treatment.
  • Older individuals with B12 absorption issues due to reduced stomach acid and IF production, strict vegans, or those with previous stomach surgery may be prescribed B-complex supplements.
  • Those following a strict vegan diet, or with a previous stomach or intestinal surgery may also be recommended B12-fortified foods like breakfast cereals and soy-based beverages. Natural B12 food sources such as beef, poultry, fish, liver, eggs, and dairy products may also be recommended.


Treatment is generally focused on replenishing the missing B12 stores in the body by preventing or treating anemia and its symptoms, preventing or managing any complications, and treating the core cause (if it can be found). Popular treatment methods include:

1-B12 Injections:

For severe anemia, B12 injections are initially administered into the muscles daily or weekly, depending upon the severity. After blood levels of B12 have been increased significantly, the injections are reduced to once a month. These injections can also be self-administered in most cases.

Limiting physical activity is usually recommended during the first few weeks of treatment. Some patients may be prescribed regular B12 supplements in pill or spray form after B12 levels have been fully or near-stabilized.

2-B12 Pills:

The main treatment for early-stage or less severe anemia, patients are generally recommended regular B12 supplements in large doses. These supplements are often prescription-grade, as OTC supplements and multivitamins often do not have sufficient B12 content to treat pernicious anemia.

For people with trouble swallowing pills, these supplements are also available in nose gel or spray form, or as dissolvable medicine to be put under the tongue. Children born to strict vegan mothers may be given supplements from birth.

3-Anemia Due to Medication:

If certain medications like type 2 diabetes drugs, Proton Pump Inhibitors (PPIs) and antacids are the cause of anemia, then dosage or medication may be changed along with temporary supplementation.

4-Other Causes:

Medication may be prescribed for other conditions that may be causing problems with B12 absorption, such as treating a tapeworm infection, celiac disease, and Crohn’s disease, or reducing harmful bacteria in the small intestine.


In most cases, pernicious anemia requires lifelong treatment. However, it usually does not interfere with daily lifestyle as treatment generally consists of supplementation and regular checkups. Moreover, early stage complications like nerve damage can be reversed in most people with timely treatment.

However, pernicious anemia increases the risk for stomach cancer, so remember to get regular screenings to help prevent or detect the condition in its early stages.

Pernicious anemia is also genetic, so have your close relations, that is parents, siblings, and children, get regular B12 testing for prevention or early detection.

You can also book an appointment with a top Gastroenterologist in Rawalpindi, Karachi and Islamabad through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your gut-related concerns.

Disclaimer: The contents of this article are intended to raise awareness about common health issues and should not be viewed as sound medical advice for your specific condition. You should always consult with a licensed medical practitioner prior to following any suggestions outlined in this article or adopting any treatment protocol based on the contents of this article.

Dr. Mehreen Zaman Niazi
Dr. Mehreen Zaman Niazi - Author Assist. Prof. Dr. Mehreen Zaman Niazi is among the Best Gastroenterologists in Lahore. Dr. Mehreen Zaman Niazi is a Hepatologist practicing in Lahore. With MBBS, FCPS (Gastroenterology) and 10 years of experience in the field, she offers sound medical advice and services to patients for a range of medical conditions.

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