What Are the Symptoms of Pernicious Anemia?
Because the body has large stores of vitamin B-12, a deficiency takes many years to establish so symptoms only develop after years of poor absorption of dietary vitamin B-12.
Symptoms relating to the effects of vitamin B-12 deficiency on the nervous system may appear before symptoms related to the anemia. These symptoms may be vague and nonspecific, especially at the outset. Feelings of numbness, tingling, weakness, lack of coordination, clumsiness, impaired memory, and personality changes may be apparent. The legs are typically more affected than the arms, and usually both sides of the body are affected. When the deficiency is severe, symptoms can worsen, leading to severe weakness, spasticity, paraplegia, and fecal and urinary incontinence.
Importantly, not all people who have vitamin B-12 deficiency and neurological symptoms will have anemia. However, when anemia is present, the typical symptoms of anemia may occur. When red blood cell numbers are reduced from anemia, the heart has to work harder to pump blood to get enough oxygen to the body's tissues. This stress on the heart can cause heart murmurs (an extra or unusual sound heard during the heartbeat), fast or irregular heartbeats, an enlarged heart, or even heart failure. Shortness of breath, fatigue, dizziness, and pale skin are other symptoms of anemia.
A deficiency of vitamin B-12 can also alter the surface of the tongue, making it appear shiny or smooth.
In some cases, pernicious anemia may be present and not cause any symptoms. In this situation, it is usually found incidentally when blood tests are ordered for another reason.