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Vitamin B12 Deficiency: Pernicious Anemia

Vitamin B12 is essential for the bone marrow’s production of blood cells. Among these cells are the red
blood cells (RBCs) which are responsible for delivering oxygen to the tissues. Therefore vitamin B12
deficiency results in anemia, an RBC deficiency limiting the amount of oxygen in the tissues.

Vitamin B12 deficiency is usually caused by pernicious anemia, a condition in which the digestive system
is altered and cannot absorb vitamin B12. This damage can occur as a result of gastrointestinal surgery,
inherited disease, autoimmune disorders (such as Graves’ disease, systemic lupus erythematosus,
myxedema), or drug action. Among the drugs that may inhibit absorption are histamine blockers, such
as cimetidine (Tagamet) and ranitidine (Zantac).

Multiple symptoms result from malabsorption of vitamin B12. Anemia, mentioned above, is associated
with weakness, pallor, elevated heart rate, and elevated breathing rate (see Anemia). In addition, the
patient may be especially prone to infection and may bruise or bleed easily (see Neutropenia and
Thrombocytopenia). Other symptoms include sore tongue, numbness, and tingling.

Vitamin B12 deficiency is diagnosed with the help of the patient history and physical examination for
symptoms. In addition, laboratory tests are often performed. Treatment includes iron replacement for
life and administration of vitamin B12 injections.