What are the Neurological Symptoms of Pernicious Anemia and How are they Managed?

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Pernicious anemia is categorized as a blood disease in which there is a deficiency of the intrinsic factor needed to absorb vitamin B-12 from foods. When the body is deficient in vitamin B-12, its cells are unable to get adequate oxygen and the body does not produce adequate amounts of red blood cells. In patients with this blood disease, certain antibodies block intrinsic factor action or the body destroys parietal cells, a type of cell located in the stomach that creates intrinsic factor.

Common Symptoms

This blood disorder can cause a variety of symptoms such as fatigue, lightheadedness, paleness of the skin, constipation or diarrhea, weight loss, nausea and stomach upset, shortness of breath, fast heartbeat, cold extremities, trouble concentrating, bleeding gums, and a sore, red tongue. Patients who have a mild form of this blood disorder may experience no symptoms at all. As the deficiency gets worse, patients are at risk for potentially severe neurological symptoms of pernicious anemia.

Neurological Symptoms

The neurological symptoms of pernicious anemia most often arise when the body has been running on low levels of vitamin B-12 for a prolonged period of time. Low vitamin B-12 levels for a prolonged period of time can lead to nerve cell damage in turn producing neurological symptoms. The most common neurological symptoms of this blood disease include tingling and numbness in the patient’s toes and fingers, anxiety, burning sensations (arms, hands, legs, feet), ringing in the ears, muscle coordination loss, dizziness, muscle weakness, erratic or slowed reflexes, confusion, irritability, depression, poor balance and in severe cases, dementia. Dementia is a condition in which the patient steadily loses their mental and cognitive abilities.


Treating this blood disorder is necessary to prevent the neurological symptoms. Most patients will first be given a series of regular vitamin B-12 injections. These injections are administered into a muscle and many patients get them five days a week for the first week and then once a week for the next month. Once this is complete they will get them once a month and can often administer them by themselves at home once they get to this stage of treatment. Once the patient’s vitamin B-12 levels are where they should be, most patients can take pills everyday to keep their levels normal. Patients with this blood disorder that wish to avoid the neurological symptoms will most likely need to have vitamin B-12 shots or pills administered for the rest of their lives.


WebMD. (2008). Vitamin B-12 Deficiency. Retrieved on October 6, 2009 from Website: https://www.webmd.com/a-to-z-guides/vitamin-b12-deficiency-anemia-topic-overview