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100 Years On: Pernicious Anaemia – from Raw Liver to Today’s Still‑Troubling Reality

In 1926, the treatment was brutal but effective. In 2026, treatment exists—but accessing it can be brutal... Despite advances in diagnostics, B12 therapy, and clinical understanding, today’s Pernicious Anaemia patients still endure experiences that many would argue are equally horrendous—just in a different guise. Modern PA patients frequently report: Late or missed diagnosis — often after years of worsening symptoms. Undertreatment, especially long intervals between B12 injections or inadequate dosing even though research and published guidelines advocate otherwise. Dismissal of symptoms, attributed to stress, ageing, or unrelated causes. Fragmented care, with inconsistent primary…

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 One History of Pernicious Anaemia

In the late 1920s and early 1930s, doctors started treating people diagnosed with Pernicious Anaemia with raw liver, often liquidised and eaten in large quantities. The disease was no longer fatal if treated. In yet another published paper by a William, this time William Thomas Wilkins, he refers to the efficacy of treatment of PA with raw liver. He mentions that periods of hospitalisation and stomach tube feedings seemed to result in difficulties in getting the patient to continue with their treatment (I wonder why!) so he tasked Clara Schroeder of Ohio, a woman ‘gifted in the culinary art’, to prepare an edible liver cocktail. Apparently, this dish proved acceptable and even enjoyable for some

 Vitamin B12 deficiency: what is pernicious anaemia, and why can it be so dangerous?

While some B12 deficiencies are caused by diet, the most common reason for low B12 levels worldwide is an autoimmune disorder called pernicious anaemia. This is a chronic form of low B12 that can have serious consequences on health if left untreated long-term. However, because symptoms of the condition typically look like other common conditions, it’s often misdiagnosed as depression or anxiety. Not only does the condition cause physical distress, the stigma of living with this chronic condition can also cause serious psychological harm, as I’ve shown in my research.

Articles of Interest

More than you wanted to know about pernicious anemia, vitamin B12, folic acid, and rheumatoid arthritis

Vitamin B12 works in concert with folic acid in several critical steps of blood manufacture and nerve repair. Adequate doses of folic acid can mask a deficiency of vitamin B12 in the blood while the nervous system deteriorates irreversibly. I‘ve seen a few cases of advanced B12 deficiency and they weren’t pretty. Once B12 injections were started the progression stopped but every single one was left with permanent neurologic damage, some looking like multiple sclerosis and some looking like Alzheimer’s.

A three-pack of vitamin deficiencies

Vitamin B12 comes only from animals or things resembling animals; human beings don’t make it and have to ingest it. Most people in the US get enough B12 from eating meat, eggs, and milk. Strict vegetarians (such as Hindus) in third world countries get enough insect contamination in their grains to fulfill their B12 needs.

Always Tired? Why Pernicious Anemia Blocks Your B12 + Medically Approved Next Steps

Pernicious anemia is an autoimmune condition where the immune system attacks stomach cells that produce intrinsic factor, blocking vitamin B12 absorption. This causes persistent fatigue, brain fog, and tingling — even with a healthy diet or supplements. It's serious but highly treatable, and early diagnosis is key to preventing permanent nerve damage. Medically recommended next steps: ask your clinician for a CBC, vitamin B12 and MMA levels, and intrinsic factor antibodies. Treatment usually involves lifelong B12 injections (or supervised high-dose oral B12), along with routine monitoring and awareness of urgent red flags.

Megaloblastic (Pernicious) Anemia in Children

There are many causes of megaloblastic anemia, but the most common source in children occurs from a vitamin deficiency of folic acid or vitamin B12.

Pernicious Anaemia (2nd edition)

The parietal cells of the stomach produce a protein called intrinsic factor. Intrinsic factor is essential for the absorption of vitamin B12 in the distal ileum. In pernicious anaemia, autoantibodies target either the parietal cells or intrinsic factor, resulting in a lack of intrinsic factor and a lack of absorption of vitamin B12.

Pernicious anaemia and B12 deficiency

Vitamin B12 is present in meat and animal protein foods. Absorption occurs in the terminal ileum and requires intrinsic factor (IF), a secretion of gastric mucosal (parietal) cells, for transport across the intestinal mucosa. In pernicious anaemia, IF production is deficient. It is believed to be an autoimmune disease. Helicobacter pylori infection has been mooted to be an initiating factor, with subsequent autoimmune changes affecting the gastric mucosa.

Receiving a Diagnosis of Pernicious Anemia: Exploring Experiences of Relationships With Health Professionals

Pernicious anemia (PA) is a chronic condition that stems from an inability to absorb and use vitamin B12. The condition is prevalent in 0.1% of the general population and is more frequently diagnosed in older adults (1.9%). Common symptoms of PA are fatigue, memory loss, and difficulty maintaining concentration.

Severe Pernicious Anemia: A Case Report

Pernicious anemia is an infrequent condition and a recognized cause of vitamin B12 deficiency. It is an autoimmune disease that impairs the absorption of vitamin B12, leading to a significant reduction in its uptake. Clinical manifestations are often subtle and non-specific, yet potentially debilitating, which may delay diagnosis. However, with early recognition in primary care and appropriate replacement therapy, patients can recover their quality of life. Fatigue and asthenia are common complaints in primary care, highlighting the importance of careful clinical evaluation in the presence of nonspecific symptoms. Timely laboratory investigations are essential for the early detection of the disease and the prevention of serious complications.

Resources

Pernicious Anaemia Society

The original objects of the society still remain the core of our activity – namely providing information help and support not only to sufferers of Pernicious Anaemia but also their families and friends.

Life With Pernicious Anemia- Discover, Cope, Live

Blog about my life with pernicious anemia as a 20 year-old including the ups, downs, details, and coping methods. From pre-discovery to my present daily life, this is my story. I strive to keep a positive outlook on my condition and my life and encourage others to do the same. Hoping to connect with others who have Pernicious Anemia and also find those who share this condition at a young age. *I am not a doctor and I do not have any medical training or background.

Living with Fibromyalgia and Pernicious Anemia

I often wonder how two such disorders could make someone feel as I do? I have been tested for all sorts of things and it always goes back to fibromyalgia and pernicious anemia.

David Darling

People can develop low levels of this important vitamin in three main ways: • From the lack of a protein in the stomach that helps the body absorb vitamin B12. The protein is called intrinsic factor. Intrinsic factor is made by special cells in the lining of the stomach. In some people, these cells are destroyed by the body's immune system or as a result of stomach surgery. When this happens, intrinsic factor is not produced and vitamin B12 cannot be absorbed. This is the most common cause of vitamin B12 deficiency. •From not getting enough vitamin B12 in the diet. This can be the result of eating a strict vegetarian diet or a poor diet due to factors such as aging or alcoholism. •From certain intestinal disorders that interfere with the absorption of vitamin B12, such as Crohn's disease and intestinal infections.

MayoClinic

Vitamin deficiency anemia can occur if you don't eat enough folate, vitamin B-12 or vitamin C. Or vitamin deficiency anemia can occur if your body has trouble absorbing or processing these vitamins.

MedicineNet

The most common cause of pernicious anemia is the loss of stomach cells that make intrinsic factor. Intrinsic factor helps the body absorb vitamin B12 in the intestine. The loss of parietal cells may be due to destruction by the body's own immune system. Pernicious anemia can cause permanent damage to nerves and other organs if it goes on for a long time without being treated. It also raises the risk for developing stomach cancer.

StatPearls

Pernicious anemia is a relatively rare autoimmune disorder that causes diminishment in dietary vitamin B12 absorption, resulting in B12 deficiency and subsequent megaloblastic anemia. It affects people of all ages worldwide, particularly those over 60. Despite the advances in understanding, making the diagnosis can be challenging for clinicians due to its complexity, broad spectrum of clinical presentation, and limitations of the currently available diagnostic tests. Once diagnosed, prompt treatment with B12 supplementation commonly reverses the patient's anemia; however, they will require lifelong supplementation and monitoring.