What is anemia? Anemia is a common blood disorder, which is caused when there is a drop in hemoglobin or hematocrit in the blood. Hemoglobin is the part of blood that distributes oxygen from the lungs to tissues in the body. Hematocrit is the measurement of the percentage of red blood cells found in a specific volume of blood. Anemia is usually a symptom of a disease rather than a disease itself. Anemia may be a symptom of another disease. The following are the most common symptoms of anemia. However, each individual may experience symptoms differently. Symptoms may include: abnormal paleness or lack of color of the skin increased heart rate (tachycardia) breathlessness, or difficulty catching a breath (dyspnea) lack of energy, or tiring easily (fatigue) dizziness, or vertigo, especially when standing headache irritability irregular menstruation cycles absent or delayed menstruation (amenorrhea) sore or swollen tongue (glossitis) jaundice, or yellowing of skin, eyes, and mouth enlarged spleen or liver (splenomegaly, hepatomegaly) impaired wound and tissue healing The symptoms of anemia may resemble other blood disorders or medical problems. Because anemia is often a symptom associated with another disease, it is important for your physician to be aware of symptoms you may be experiencing. Always consult your physician for a diagnosis.

What is megaloblastic (pernicious) anemia?

Megaloblastic (pernicious) anemia is a rare disorder in which the body does not absorb enough vitamin B12 from the digestive tract, resulting in an inadequate amount of red blood cells (RBCs) produced.

What causes megaloblastic (pernicious) anemia?

Megaloblastic (pernicious) anemia is more common in individuals of northern European descent. Megaloblastic (pernicious) anemia results from a lack of intrinsic factor in gastric secretions (a substance needed to absorb vitamin B12 from the gastrointestinal tract). Vitamin B12 deficiency results.

The inability to make intrinsic factor may be the result of chronic gastritis, or the result of a gastrectomy (removal of all or part of the stomach). Megaloblastic (pernicious) anemia may also be associated with type 1 diabetes, thyroid disease, and a family history of the disease.

What are the symptoms of megaloblastic (pernicious) anemia?

The following are the most common symptoms for megaloblastic (pernicious) anemia. However, each individual may experience symptoms differently. Symptoms may include:

• weak muscles
• numbness or tingling in hands and feet
• difficulty walking
• nausea
• decreased appetite
• weight loss
• irritability
• lack of energy or tiring easily (fatigue)
• diarrhea
• smooth and tender tongue
• increased heart rate (tachycardia)

The symptoms of megaloblastic (pernicious) anemia may resemble other blood conditions or medical problems. Always consult your physician for a diagnosis.

How is megaloblastic (pernicious) anemia diagnosed?

Megaloblastic (pernicious) anemia is usually discovered during a medical examination through a routine blood test. In addition to a complete medical history and physical examination, diagnostic procedures for megaloblastic (pernicious) anemia may include additional blood tests and other evaluation procedures, including the Schilling test.

The Schilling test is performed to detect vitamin B12 absorption. In the Schilling test, vitamin B12 levels are measured in the urine after the ingestion of radioactive vitamin B12. With normal absorption, the ileum (portion of the small intestine) absorbs more vitamin B12 than the body needs and excretes the excess into the urine. With impaired absorption, however, little or no vitamin B12 is excreted into the urine.

Treatment for megaloblastic (pernicious) anemia:

Specific treatment for megaloblastic (pernicious) anemia will be determined by your physician based on:

• your age, overall health, and medical history
  
  
• extent of the disease
  
  
• your tolerance for specific medications, procedures, or therapies
  
  
• expectations for the course of the disease
  
  
• your opinion or preference

Treatment may include vitamin B12 injections. Foods that are rich in folic acid include the following:

• orange juice
• oranges
• romaine lettuce
• spinach
• liver
• rice
• barley
• sprouts
• wheat germ
• soy beans
• green, leafy vegetables
• beans
• peanuts
• broccoli
• asparagus
• peas
• lentils
• wheat germ
• chick peas (garbanzo beans)

Foods that are rich in folic acid and vitamin B12include the following:

• eggs
• meat
• poultry
• milk
• shellfish
• fortified cereals