Is pernicious anemia treated best with vitamin B12 injections?

Most people with pernicious anemia can a cured by taking a 1000 microgram pill of vitamin B12 once a day; they usually do not need to take injections. Pernicious anemia is due to lack of vitamin B12 which results in progressive nerve damage that causes forgetfulness, loss of ability to concentrate and abnormal nerve sensations such as burning, itching or loss of feeling. However, many people with pernicious anemia do not have abnormally low blood levels of vitamin B12. One study showed that older people have lower blood levels of a chemical called homotranscobalamin II that carries vitamin B12 into the cells, so they need higher blood levels of B12 to have normal tissue levels.

The diagnosis of pernicious anemia is often made late in the course of the disease after a person has suffered permanent nerve damage. One report showed that two percent of Americans over 60 have low blood levels of vitamin B12, but the incidence of vitamin B12 deficiency causing nerve damage in older people is much higher than that, perhaps as high a 50 percent. Many older people who are diagnosed with senility actually suffer from lack of vitamin B12. Lack of vitamin B12 also can cause heart attacks, so all people over 60 should be screened for B12 deficiency. Those with normal levels of B12 who have symptoms of nerve damage or arteriosclerosis should also get a blood test called homocysteine. Low levels of B12 can be associated with stomach diseases, absorption problems and infections such as Helicobacter pylori. See reports #G123 on Helicobacter and #G206 on Celiac Sprue.

Checked March 1, 2006

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