Here’s a checklist of all signs and symptoms of pernicious anemia. However, keep in mind that severity and frequency vary among individuals. Some people show just a few signs, others may have the entire spectrum. As a rule, the more pernicious anemia symptoms you have, the more likely you are to have a positive PA diagnosis.
Pernicious Anemia Symptoms Checklist
Look out for these signs, symptoms and clinical manifestations:
- Shortness of breath. Are you easily out of breath? In other words, do you often gasp for air, or feel the need to stop and take a deep breath?
- Extreme fatigue. Do you feel a strong sense of tiredness that constantly haunts you? Do you wake up feeling tired in the morning?
- Skin problems. I.e. psoriasis, eczema, acne. Can you spot any dry skin, white patches (vitiligo) or red skin around your nose or cheeks (rosacea)?
- Brain fogs. Find it hard to focus? Do you often feel fuzzy or confused? All in all, think dementia-like symptoms. Do you tend to forget simple things, like the names of common objects, or leave items in the wrong place?
- Clumsiness. Do you fall down or tend to bump into things? Do you feel as if your coordination is impaired (also known as ataxia)?
- Brittle, flaky nails. Are your nails frail or flaky?
Neurological Symptoms of Pernicious Anemia
- Tingling. Feel any pins and needles (most common in the hands or feet)? Likewise, do you feel a sensation as if a spider crawls on top of your face?
- Numbness. Do parts of your body tend to get numb sometimes?
- Impaired balance. Feeling unsteady? Having problems putting on your underpants? Do you bump into walls with your shoulder? Got problems trying to stand up straight when it’s dark or with eyes closed? Do you have to hold on to something when you’re taking a shower? Is there a sense of vertigo when you are high up or in a wide open space, and the only way to cope is to look at the floor?
- Dizziness. Do you often feel as if you’re about to faint?
- Hyperreflexia. Do you seem to have exaggerated reflexes?
- Loss of senses. Are your smell, touch, taste and/or vision senses impaired?
- Burning legs and/or aching feet. Burning feet syndrome / Grierson-Gopalan syndrome.
- Widespread pain. Do you experience fibromyalgia or neuropathic pain? For the most part, the pain only affects one side of the body.
- Ringing in the ears (tinnitus). The ringing may also sound like clicking, hissing, or roaring. However, this is very common in the general population as well. But it could also be the result of nerve damage in the brain due to pernicious anemia.
Other Signs of Pernicious Anemia
- Cracked or swollen tongue. Is your tongue cracked? Do you have the infamous pernicious anemia tongue, that is – is it swollen and beefy?
- Mouth ulcers. Do you have ulcers, especially on the inside of your cheeks?
- Bleeding gums. This is another oral symptom of pernicious anemia. However, it is often seen in the general public as well.
- Diarrhea. Sudden and explosive in particular. Also, does it tend to surprise you after having constipation or flatulence for some time?
- Loss of appetite. Did you lose your appetite, and as a result some of your weight?
- Digestion issues. Do you feel anything unusual in your gastrointestinal tract? Do you see anything atypical, such as ‘floating poop’?
- Incontinence. Unable to control urination and defecation even if you try?
- Irritability. Impatient and frustrated? Do you often seek to isolate yourself for peace, to escape the overwhelmingness of noise or people?
- Irregular heartbeat. Does your heart beat too fast or slow? Also known as arrhythmia.
- Depression. In general, do you feel as if there’s a cloud of sadness that never leaves?
- Sudden, unusual mood swings. Do you experience any changes of mood that are undeniably out of your character?
- Sleep issues. Can’t fall asleep at night even though you’re exhausted? Do you often have to sleep for hours during the day?
- Sexual problems. Any loss of libido in general? Infertility is reported, in both sexes. Women may also experience menstrual issues.
- Hair loss. Are you losing hair? Is it greying prematurely? Hair loss is one of the most daunting symptoms of pernicious anemia.
- Thyroid issues. Do you have hyper or hypo thyroidism? Thyroid symptoms affect almost only women.
Don’t Forget Comorbidities
Pernicious anemia is rarely an exclusive disease. It often comes with other co-existing morbidities. The impairment of the methylation cycle, for example, leaves PA patients with hyperhomocysteinemia (very high, harmful levels of homocysteine).
This is why we recommend methylcobalamin shots as the ultimate pernicious anemia treatment. Methylcobalamin offers methyl donors to eliminate the excessive homocysteine, addressing both diseases in a single treatment.
Pernicious anemia is an autoimmune disease, where the body produces antibodies and tries to destroy itself. Sadly, autoimmune diseases tend to often coexist (which is why an autoimmune friendly diet may help), and many PA patients will also have:
- Multiple sclerosis (MS).
- Type 1 diabetes.
- Rheumatoid arthritis.
- Psoriatic arthritis.
- Celiac disease.
- Myasthenia gravis (weak muscles making it hard to swallow, chew or open eyes).
- Grave’s disease (over-active thyroid, also known as hyperthyroidism).
- Hashimoto’s thyroiditis (under-active thyroid, also known as hypothyroidism).
Many of the symptoms overlap. This is why misdiagnosis or late diagnosis are so common among PA patients. In our eyes, that is nothing short of a tragedy.
Pernicious Anemia Symptoms In Children
Although PA normally strikes at older ages, there’s a rare congenital form of it where babies are born being unable to produce intrinsic factor. Normally the signs are clear, and as early as a few months into the baby’s life. Those signs include:
- General sense of weakness.
- Inability to sleep.
- Digestive problems.
- Lack of appetite, often profound.
- Failure to develop and thrive.
- Pale complexion.
- Rapid heartbeat.
- Yellow tone to the skin.
- Mental retardation.
- Blood protein present in the urine.
Do PA Symptoms Ever Go Away?
Remember, the cause of pernicious anemia is the body being unable to absorb B12 through the stomach. As a result, your symptoms will get more and more severe until you start injecting to correct the B12 deficiency. If caught early, symptoms may disappear. But most patients are diagnosed late, and symptoms tend to persist to some degree.
By injecting the right form of B12, you are doing your best to stop deteriorating and start improving. The earlier you start, the more likely the symptoms are to disappear. Risk of overdose does not exist, because B12 is water-soluble. That means any excess is flushed out through the urine. If you show symptoms – especially neurological, which mean a severe B12 deficiency – waiting for diagnosis could make things much worse.
Did you know?
B12 is crucial to the formation of myelin, a protective sheath guarding your nerves. When a B12 deficiency is severe, you start having neurological symptoms as the sheath gets stripped off. Myelin damage is often irreversible, but with injections you can at least stop it from getting worse.
Signs and symptoms of pernicious anemia in adults grow slowly and subtly over years. If and when they afflict you, you’ll tend to blame ‘aging’. As a result, you may never mention a word to your doctor. This is dangerous. If you are having any pernicious anemia symptoms, begin diagnosis right away. Don’t wait a second.
Also, we advise not to use this page as a definitive pernicious anemia symptoms list for self-diagnosis. If you think you may have PA, go and do the correct tests.
This is the only way you will know for sure.