5 essential supplements you need if you have pernicious anaemia, including the most effective form of B12:

What do you think of when you hear the word ‘anaemia’? Anaemia is a condition where the body doesn’t have enough healthy red blood cells. Most people equate it with iron deficiency-anaemia: pretty common, mainly affects women, and easily remedied by taking an iron supplement. But in fact, there are several types of anaemia and some are more serious than others. Pernicious anaemia is one of them.

This type of anaemia occurs when your body stops being able to absorb vitamin B12. Doctors started calling it ‘pernicious’ anaemia in the 1800s, because it was almost always fatal. This changed in 1926 when it was discovered that a special raw liver diet helped improve outcomes. Raw liver isn’t prescribed as treatment now – all the veggies and vegans can breathe a sigh of relief! But pernicious anaemia remains a serious condition that can cause irreversible damage to the nervous system if it isn’t treated quickly enough. This can lead to everything from muscle weakness, to numbness or tingling in your hands and feet, memory loss, and dementia.

It’s crucial to recognise the signs of pernicious anaemia and get effective treatment fast if you want to avoid complications. So what should you be looking out for?

What are the symptoms?

Feeling very tired, diarrhoea, tingling in your limbs, and brain fog are all signs you might have pernicious anaemia. You could also develop a swollen and red tongue, keep forgetting things, and experience mood swings.

Symptoms are often mistaken for other conditions. Diarrhoea gets misdiagnosed as IBS, feeling tired put down to having a busy lifestyle… It’s no wonder getting a diagnosis of pernicious anaemia sometimes takes time. Research by the Pernicious Anaemia Society shows that 14% of their members experienced symptoms for a jaw-dropping 10 years before being diagnosed!

As with all conditions, it’s important to pay attention to how you feel each day. If you’re experiencing some of the symptoms above, make an appointment with your doctor and ask for a blood test. Many GPs will just run a full blood count test, but this can miss B12 deficiency. It’s a good idea to also ask them to include a Serum B12 test. And one for Serum Holotranscobalamin, which will determine how much ‘Active’ B12 you have. This is a relatively new test that’s far more effective at picking up if you’re lacking in B12.

What causes pernicious anaemia?

Pernicious anaemia is an autoimmune disease that comes about when your immune system attacks cells in your stomach that produce ‘the intrinsic factor’. It might sound like something straight out of a science fiction blockbuster, but ‘the intrinsic factor’ is actually a protein crucial for absorbing B12. When everything is working as it should, vitamin B12 and the intrinsic factor combine and the B12 is absorbed into your gut.

If you have pernicious anaemia, you can’t make enough of the intrinsic factor, which means your body is unable to absorb vitamin B12 (or cyanocobalamin to give it its posh chemical name). Vitamin B12 deficiency affects your red blood cells, leaving them underdeveloped and larger than normal. This means they can’t transport oxygen as efficiently as they should. Not getting enough B12 also has a negative impact on the development of the myelin sheath (the protective covering) of the nerves. This can cause everything from tingling and numbness to Alzheimer’s Disease.

What is the best treatment for pernicious anaemia?

Once you get a diagnosis of pernicious anaemia, it will usually be treated by supplementing with B12. Either by having it injected, or taking a supplement. It’s very difficult to treat pernicious anaemia by changing your diet. If you don’t have enough of the intrinsic factor you could eat a truckload of meat, eggs, and salmon, but very little of the B12 will be absorbed by your body.

What’s the best way to top up your B12?

B12 injections are considered the gold standard to treat pernicious anaemia. Regular injections are generally very effective and recommended within NICE guidelines.

Most people living with PA will need injections every 2-3 months to feel their best. Some GPs are happy to prescribe this, but others are not. If you can’t get the injections as often as you’d like, you can have B12 injected privately. But this can get expensive very quickly. Properly regulated clinics will charge around £40 per injection, which soon adds up. Or what about if you just don’t like injections!? It’s estimated – 1 in 10 people in the UK have a phobia of needles…

There’s no point in taking oral tablets, because if you have pernicious anaemia your gut is unable to absorb B12. B12 mouth sprays are another option, but they don’t work for everyone.

If this is you, B12 patches are an excellent alternative. Transdermal delivery means the B12 goes directly into the bloodstream via the skin, completely avoiding your gut. What’s more, patches deliver the B12 gradually throughout the 8 hours you wear them. This is much easier for your body to absorb and utilise, rather than the mega dose you get from mouth sprays. Many of our customers with pernicious anaemia swear by the B12 Plus Patch and have seen marked improvements in blood tests. You can read some of their reviews here.

What other supplements are helpful if you have pernicious anaemia?

It’s not just B12 that can give you a boost if you have pernicious anaemia. Give these 4 supplements a try too:

1. Magnesium:

Magnesium promotes the normal function of the nervous system and can help reduce some of the symptoms of PA like tingling hands and feet, or leg pain. It also helps to stimulate your metabolism, lift your energy levels and reduce the tiredness and fatigue associated with pernicious anaemia. Even better, B12 and magnesium don’t compete for absorption, so there’s nothing to stop you from wearing a B12 patch and a magnesium patch together. Our bestselling Tri Magnesium patch is here.

2. Iron:

If you’ve got pernicious anaemia, unfortunately, you’ve also got a high chance of developing iron-deficiency anaemia too – sigh. Research has shown that 50% of PA patients are also iron deficient. Taking an iron supplement like our Iron Plus patch can help to replenish your body’s iron stores and support the formation of red blood cells. Topping up your iron with a patch will also help you avoid all the pesky digestive side effects oral iron tablets can trigger. Don’t forget that iron can interfere with how your body absorbs other minerals and vitamins, so it’s best to use iron at least 2 hours apart from your other supplements.

3. Vitamin D:

Aaand it’s not just iron you might be lacking if you have pernicious anaemia… Vitamin D deficiency often goes hand-in-hand with not having enough B12. In fact, it could even be part of the reason you got PA in the first place! Not getting enough vitamin D can damage the mucosal lining of the gut and prevent the reabsorption of B12 and folate. So if you’re topping up your B12, it’s also a wise move to up your daily D levels, to get all your essential nutrients back on track. You can read our blog about vitamin D deficiency here, and get your hands on the super-effective D3/K2 patch here.

4. Vitamin C:

Last but not least, vitamin C is another must-have if you’re living with pernicious anaemia. Doctors aren’t sure why, but low C levels are often found in PA patients, so it’s a good idea to add vitamin C to your supplement shopping list too. And this is one supplement that’s ok to take alongside iron because vitamin C actually increases iron absorption and utilisation. It’s also great for immune system function and a powerful antioxidant – hurrah!