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Pernicious anaemia Q&As

Published by Bupa's health information team, March 2009.

Answers to questions about pernicious anaemia

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

How long will it take for me to feel better after the injections?

It's very hard to say because everyone with pernicious anaemia will respond differently to treatment.

Explanation

It's possible that you will start to feel better immediately and may soon feel as well as you did before the condition began. For other people, it will take longer for the injections to begin to have an effect. There may be times, possibly in the weeks or days before you are due to have an injection, that some symptoms return and you feel worse.

Further information

Sources

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Will I really need vitamin B12 treatment for the rest of my life?

Yes, vitamin B12 has a number of very important functions within the body.

Explanation

One of the most important reasons why you need vitamin B12 is to produce DNA. Not having enough affects many different cells in your body, including red blood cells. If you don't have enough red blood cells, the tissues and organs of your body may not be getting enough oxygen. This leads to the symptoms of anaemia such as fatigue and breathlessness.

You also need vitamin B12 to keep your nervous system healthy. Your nerves are protected by a substance called myelin and vitamin B12 is important for maintaining this. If the myelin covering degenerates, the nerve fibres underneath may also start to break down. This can lead to damage to your nerves, which may be serious and irreversible.

Further information

Sources

  • Vitamin B12. Vegetarian Society. www.vegsoc.org, accessed 25 September 2007
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Will I need to follow a special diet?

No, once you start having injections of vitamin B12, this should provide you with as much as you need.

Explanation

Increasing the amount of vitamin B12 in your diet probably won't make any difference. This is because part of the problem with pernicious anaemia is your small bowel's inability to absorb vitamin B12 properly.

Try to eat a healthy, balanced diet as this is likely to contain sources of vitamin B12. It's mainly found in meat, fish, dairy products and eggs, but isn't present in fruit or vegetables.

Further information

Sources

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What is a bone marrow biopsy, and how is it done?

Bone marrow is the soft tissue found in the middle of most large bones which produces white blood cells, red blood cells and platelets. A biopsy is a small sample of tissue. There are two main sorts of bone marrow biopsy - an aspiration or a trephine biopsy. If you're having a biopsy to see if you have pernicious anaemia, you will probably have an aspiration.

Explanation

A bone marrow aspiration only takes a few minutes and you won't have to stay in hospital overnight after it's done. You will usually be asked to lie on your side and a small area of skin over the back of your pelvis will then be injected with local anaesthetic. This blocks feeling from the area but you will stay awake during the procedure. You may also wish to be sedated before the biopsy so that you feel more relaxed but most people don't need this.

Once your skin is numb, a biopsy needle is put through your skin and into your bone. Your doctor will then use a syringe to remove a tiny amount of bone marrow. The suction involved can be painful, but only for a few moments. The sample will then be sent to a laboratory to look at the type and appearance of the bone marrow cells.

You will need to stay in hospital for a short while afterwards to check that the area isn't bleeding excessively. If you have sedation, you may need to be monitored for a few more hours. Sedation temporarily affects your coordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you're in any doubt about driving, please contact your motor insurer so that you're aware of their recommendations, and always follow your doctor's advice.

After having a local anaesthetic it may take several hours before the feeling comes back into your skin. Take care not to bump or knock the area. Once the local anaesthesia has worn off, your back may be achy for a few days. Your doctor can recommend some painkillers to help ease this.

Further information

Sources

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Is it true that pernicious anaemia causes cancer?

If you have pernicious anaemia, you're about two to three times more likely to get stomach cancer than someone who doesn't have the condition. However, your overall risk is still relatively low.

Explanation

If you have pernicious anaemia, cells in your stomach called parietal cells are attacked by your immune system. Therefore, they can't produce the stomach acid needed to help digest your food and control the amount of stomach bacteria. As a result, the amount of bacteria in your stomach may be higher than usual, producing waste chemicals that may cause cancer (carcinogens).

In its early stages, stomach cancer isn't easy to recognise because the symptoms can be caused by lots of other conditions. Symptoms include:

  • indigestion
  • heartburn
  • loss of appetite

Indigestion or heartburn is often called dyspepsia by doctors. Dyspepsia is very common and only a small proportion of people who have it are found to have stomach cancer.

However, because of the slightly increased risk of stomach cancer, if you have pernicious anaemia and you get symptoms of dyspepsia, it's very important to see your GP. He or she may recommend that you see a specialist for tests. These may include an endoscopy - this allows your doctor to look at the inside of your stomach and is done using a narrow, flexible, tube-like telescopic camera called an endoscope.

Further information

Sources

  • Stomach cancer risks and causes. Cancer Research UK. www.cancerhelp.org.uk, accessed 29 August 2008
  • Guidance for general practitioners and primary care teams: improving outcomes in upper gastro-intestinal cancers. National Cancer Guidance Steering Group and the Department of Health, 2001. www.dh.gov.uk
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The Schilling test involves drinking radioactive vitamin B12 - isn't radiation dangerous?

It's true that radiation can have negative effects on health but radioactivity and radioactive materials are still valuable and commonly used as medical tools. The doses of radiation used in medical tests and treatments are very carefully calculated and regulated so that the risks are as low as possible.

Explanation

Before deciding whether or not to have a test such as a Schilling test, think about the risks and benefits so that you can make a balanced decision.

We are all exposed to small amounts of radiation called background radiation. This is emitted by many things including food, water and the earth. The average UK dose of background radiation is around 2.2milliseiverts (mSV) per year.

At some point, most of us are exposed to small amounts of additional radiation, for example from medical procedures or air travel. Here are a few examples to compare with the radiation from the Schilling test.

Approximate radiation dose (mSV)

An X-ray of a tooth

0.01

A long-haul flight

0.03-0.07

A Schilling test

0.1

A head CT scan

2

Average UK background radiation

2.2 per year

The risk to your health from the small dose of radiation involved in a Schilling test is very low and has the benefit of giving an accurate diagnosis. However, you shouldn't have the test if you are, or could be, pregnant.

Further information

Sources

  • Understanding radiation. Health Protection Agency. www.hpa.org.uk, accessed 4 September 2008
  • Cosmic radiation on selected flights. World Health Organization. www.who.int, accessed 4 September 2008
  • Notes for guidance on the clinical administration of radiopharmaceuticals and use of sealed radioactive sources. Administration of Radioactive Substances Advisory Committee. www.arsac.org.uk, accessed 4 September 2008
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Related topics

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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: March 2009

 

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