General Health

Pernicious Anaemia – What You Need To Know!

Pernicious Anaemia India

Our parents often insisted that we eat our greens when we were kids, we were always encouraged to eat healthy for beneficial reasons. Sadly, the current generation struggles with proper nutrition due to many reasons, like financial restraints, cultural and religious beliefs that omit certain food groups and even a stressful lifestyle wherein we chose unhealthier options for a quick bite.

The fact remains whether you’re a vegetarian, vegan or non-vegetarian, without a balanced diet anyone can get affected with anaemia, which has been rampant in our country for years. Although we might think we are eating right, Statistics prove otherwise.

According to a survey conducted by the National Family Health Survey (NFHS) in 2016, Anemia affected 58.6% of children, 58.6% of children, 53.2% of non-pregnant women and 50.4% of pregnant women. Despite having an Anemia control program set up in India for the last 50 years, the recent study from NFHS has shown an alarming increase in these statistics today.

Though you might assume that basic iron deficiency is common with women in our country due to malnutrition and an unhealthy lifestyle. Unknown to many, that Pernicious Anaemia affects more than 1 million people each year in India. This condition is rarely found in men and women below the age of 40, and it mostly affects from 41 onwards till their senior years.

The difference between Anaemia and Pernicious Anaemia is that, although Anaemia is categorised as a medical condition where the blood count is low in normal red blood cells, Pernicious Anaemia occurs when there is a deficiency in Vitamin B-12.

What causes Pernicious Anaemia?

Pernicious means something that has a harmful effect, in a gradual or subtle way, which aptly describes the ailment as in the past, before B-12 treatments were unavailable and this condition was considered fatal. As we know that the lack of Vitamin B-12 leads to Pernicious anaemia, but what causes the decline of this important vitamin body?

The reason why the body suffers a lack of B-12 is because of the Intrinsic factor, which is a protein made in the linings of your stomach that helps absorb this vitamin, a lack of this protein leads to B-12 deficiency. Although this is not being the only root cause for B-12 deficiency, other conditions play a role as well, such as improper diet, certain medicines, surgery, and infections.

So how this works is, that when there isn’t enough Vitamin B-12, the red blood cells are unable to divide normally and are quite large, this creates a problem for the cells to exit the bone marrow, where these cells are produced. Red blood cells are an integral component that carry oxygen to your body, and in the lack of doing so, you will start feeling week and tired.

If Pernicious Anaemia is not treated on time, it can damage the brain, heart and other organs. Pernicious Anaemia is known to cause nerve damage, neurological issues like memory loss and digestive tract problems, and patients who suffer from this for a prolonged period of time are at a high risk of stomach cancer and weakened bones.

The lack of Intrinsic Factor also happens when part of the stomach or all of it has been surgically removed, this kind of surgery reduces parietal cells, (also known as oxyntic cells) are epithelial cells in the stomach that function to secrete hydrochloric acid (HCI) and Intrinsic factors. In some rare cases children are born with an inherited disorder that prevents their bodies from producing an Intrinsic Factor, this is called Congenital Pernicious Anaemia.

Important tell-tale signs on when to seek help!

Anaemia itself share the same symptoms that you would normally find in Pernicious Anaemia, which are fatigue, shortness of breath, dizziness, headaches, pale yellowish skin, chest pain and coldness in hand and feet. Your heart would have to work extra hard since it lacks red blood cells, which can cause further complications such as Arrhythmias (irregular heartbeats), heart murmur, an enlarged heart and heart failure.

However, as the lack of Vitamin B-12 is what turns Anaemia into Pernicious Anaemia, these are very crucial tell tales signs you must look out for. Vitamin B-12 deficiency is known to be liked with nerve damage, which causes tingling and numbness in your hands and feet, muscle weakness and loss of reflexes. The feeling of being unsteady, losing your balance, trouble walking and weakened bones may even lead to hip fractures in severe cases.

When not treated in time, this deficiency can cause serious neurological problems such as confusion, dementia, depression and memory loss. Additional symptoms that involve the digestive tract include nausea, vomiting, heartburn, abdominal bloating, gas, diarrhoea, constipation, weight loss and an enlarged liver. Physical symptoms one can catch are a smooth thick red tongue.

In infants, noticeable symptoms such as poor reflexes, unusual movements like face tremors, troubles feeding due to tongue and throat ailments and irritability can occur, if not treated on time, this may lead to permanent growth issues in infants.

It is essential to never ignore these symptoms by linking them to other minor ailments one might assume you are suffering with, which is why it’s extremely important to properly educate oneself of this disorder and seek proper treatment at the right time. So, how do you know if your physician is giving you the best possible treatment to deal with this? Here’s all that you need to know!

The right diagnoses and treatment are essential!

The first few steps your doctors would do to properly diagnose Pernicious Anaemia.

1. Check your medical record history, as well as your family’s history of ailments if any.
2. A family history of ailments, would include, autoimmune disorders, like Addison’s disease, Type 1 Diabetes, Grave’s disease or vitiligo as research has proved there is a link between these Autoimmune disorders and Pernicious Anaemia.
3. Diagnostic checks to rule out celiac disease or Crohn’s disease, and if you have had any prior stomach or intestinal surgeries, or family history of anaemia and Pernicious Anaemia while taking into account your medications and the diet you’re already on.

The Physical exam would be done to check the following symptoms.

1. Pale of yellowish skin
2. Enlarged livers
3. Listen to your heart to check for rapid or irregular heartbeats, or murmur.
4. Signs of nerve damage, by checking the muscles, eyes, senses and the reflexes work.
5. Check your mental status, coordination and ability to walk, for which the physician would run additional tests.

Finally, when there is reason to believe that you might be indeed suffering from Pernicious Anaemia, the doctor would need to find out if these symptoms are related to the lack of Intrinsic Factor or any other disease which share similar symptoms, so it’s essential that proper tests be conducted to rule out other causes.

The proper Diagnostic Tests that must be conducted.

1. Complete Blood Count (CBC): This is done to check your haemoglobin and Haematocrit levels. Low levels of these two would clearly indicate a sign of Anaemia. This test would also help determine the number of red blood cells, white blood cells and platelets in your blood, any abnormal results is an indication of anaemia, blood disorder, infection or some other ailment.
2. Reticulocyte Count: If your CBC report indicated anaemia, then this test would help to measure the number of young red blood cells in your blood and also show whether your bone marrow is making enough red blood cells at the right rate, as patients suffering from Pernicious Anaemia will have a low Reticulocyte count.
3. Serum Folate, Iron and Iron binding capacity test: This will indicate what type of Anaemia you have, Pernicious or another type.
4. Homocysteine and Methylmalonic acid Levels (MMA): High levels of these two substances clearly would indicate Pernicious Anaemia.
5. Bone Marrow test: This test helps to understand if your bone marrow is healthy and producing enough red blood cells.

Additional tests would include checking the level of B-12 and Intrinsic factor antibodies and Parietal Cell Antibodies. Other than your general physician, specialists who would be involved in the diagnoses as well as for the treatment are a neurologist (nervous system specialist), cardiologist (heart specialist), haematologist (blood disease specialist) and a gastroenterologist (digestive tract specialist).

What to expect, during treatment for Pernicious Anaemia.

Always remember, with the right treatment and care, you can live a normal life and also recover in due time. The important steps your doctor would take as part of your treatment is to prevent further symptoms of anaemia, by stabilizing the levels of B-12, the complications of the heart and nerve damage, and if the source cause of Pernicious Anaemia have been found, to control all the levels of imbalance.

In severe cases of Anaemia, Vitamin B-12 shots will be prescribed and in lower-risk cases, large doses of Vitamin B-12 pills. Please note that, only if your Pernicious Anaemia is caused by another issue other than the lack of Intrinsic Factor, would your doctor prescribe medications to those particular conditions that are preventing your body from absorbing B-12.

At times certain medications are linked with Pernicious Anaemia, which means your doctor would change the type of medicines you’re on and for infants that are nursed by strict vegetarian Mothers, they might be given Vitamin B-12.

How to maintain a healthy blood count the easy way!

In most cases, patients suffering from Pernicious Anaemia may need lifelong treatment and special care for their lifestyle changes. It is imperative that you continue going for regular check-ups with your doctor and diligently take your B-12 supplements as advised.

Pernicious Anaemic patients are always at a higher risk of stomach cancer, so it essential to never skip your doctor’s appointment so they can review your progress and check if further complications would occur. Since Pernicious Anaemia is also hereditary, it is imperative that you inform your family members, siblings and children, so that they too can be cautious and alter their lifestyle to avoid initial symptoms to appear.

Once your doctor start’s your treatment, you will soon see a difference and slowly your body would start responding to the medications. However, there is so much more you can do naturally to keep yourself healthy and in good spirit, by changing your diet to a healthier regime.

The right Diet!

Are vegetarians and vegans at a higher risk of Anaemia or Pernicious Anaemia than non-vegetarians? Sadly, the answer is, yes! An online article published in Fruits & Vegies Org, a study was done that was published in the Journal of Nutrition and Food Science, demonstrated that vegetarian women have higher rates of Iron deficiency than non-vegetarian women.

The study was conducted on healthy 30 vegetarian and 30 non-vegetarian women between the ages of 20-40 years of age. In this intensive research, the results proved that although vegetarian women had lower BMI than non-vegetarian women, around 60% of Vegetarian women had shown signs of Iron deficiency Anaemia while the rest were moderately anaemic.

47% of the non-vegetarian women were only mildly anaemic and 7% of them moderately anaemic. These statistics are important to understand that the lifestyle changes we make due to personal or health reasons, don’t necessarily benefit us. Regardless of your food choice, the important question is, are you truly eating healthy?

How to follow the perfect diet plan, adhering to your personal choice.

New diet trends often attract our attention, as they advocate healthy benefits and also are a more natural and humane way to go! But, when you do decide to follow these trends, do you really adhere to what your body needs first than to what your mind tells you?

Many restrict themselves from eating protein due to cultural, religious, or health reasons, but if you properly plan your diet by finding alternate sources of vitamins and minerals your body is in desperate need of, you’re good to go!

You might be advised to consult a dietician to help you get started, while many can’t afford it or even have the patience to take a timeout from their busy stressful lives to focus on this, there is always help online! Take that little extra interest in searching for foods that are rich in vitamins and minerals that you might have overlooked or have been reluctant to try.

It is true that non-vegetarians have better options for food high in Iron, which is found in poultry and meat, vegetarians need to make that extra effort to add essential foods to their diet in order to properly fortify themselves. It is definitely easier for vegetarians to opt for foods like soybean (aka Soyabean), tofu, dairy products, and leafy vegetables rich in iron, and adding an egg to your diet would help you a long way!

While our Vegan friends can focus on products that contain Iron from dried beans, legumes, dark green leafy vegetables, dried fruits, nuts, seeds, and wholegrain cereals and bread. It also advisable that they nourish themselves with enough calcium as well, by adding a decent amount of soya to their diet.

Whether you’re vegan, vegetarian or non-vegetarian, gluten-free, follow ketogenic diets, fruitarian, pescatarian, or are any other particular food enthusiast, always remember that no matter what you think is the right way to go, understand first what your body needs to get strong and to build its immunity levels.

Periodic check-ups with your physician are essential to keep you alert on the first few warning signs your body might be giving you when things aren’t going just right. Educate yourself on the trends that are out there before you decide to indulge in it, and more importantly, learn to live a happy and healthy life effortlessly and productively through more natural methods sans the gimmicks.

Happy Healing Ya’ll!!!

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