Earlier this summer I mentioned that I had been diagnosed with Autoimmune Pernicious Anemia (APA) in addition to my Acute Iron Deficiency. I briefly went into the symptoms and reasons for the diagnosis but haven't truly revisited the subject since then. Partially because life was just busy and because, well, I truly needed to educate myself on all of the aspects possible.
My beautiful grandmother, Alice, or more appropriately "Nannie", passed away from Alzheimer's disease along with her mother and it seems as if her mother also. Hearing the doctor state that APA has traits that mimic or can be linked to Alzheimer's is beyond comprehension and a statement that I will likely never forget.
First of all, let's remind ourselves what APA is: It a potentially fatal nutritional deficiency caused by the body's inability to absorb vitamin B-12, which is essential to the body's production of red blood cells. APA is caused by the absence of intrinsic factor, a substance secreted by the stomach. Intrinsic factor facilitates the absorption of vitamin B-12.
Knowing this, and that three generations of women in my family were affected by dementia, I sat, listening to the words the doctor said, swirl around like a tornado in a china shop. Immediately I blamed APA for their illnesses although I will be honest that they were never screened for APA so linking them together is difficult. However, because APA is a hereditary disease, it is likely that they too carried the traits for APA.
So how can APA be overlooked in blood tests? Because the body stores B-12 very efficiently, it takes years for pernicious anemia to develop and for symptoms to begin to show.
What are the symptoms of APA? A tingling numbness in the feet and hands ("boot and glove" numbness) is a common symptom of pernicious anemia. It occurs because of nerve damage caused by the B-12 deficiency.
Another frequent symptom is memory loss--not a momentary forgetfulness, but actual "erasures" or "holes" in the memory. Left untreated, this symptom can develop into a secondary dementia, which resembles such primary dementia's as Alzheimer's disease. Unlike primary dementia's, however, secondary dementia's can be treated and usually reversed if proper diagnosis of the cause of the dementia leads to appropriate treatment.
Like other anemias, APA is associated with fatigue and a lack of energy, but in the absence of other characteristic symptoms, fatigue alone is unlikely to suggest a diagnosis of pernicious anemia.
Similarly, other symptoms associated with APA may also suggest other conditions, unless accompanied by symptoms more obviously characteristic of pernicious anemia, or unless pernicious anemia has already been diagnosed by means of a blood test. Such symptoms may include weakness, loss of appetite, unexplained weight loss, pallor (paleness) or jaundice (yellowish skin tone), a red or inflamed tongue, gastrointestinal distress, and nervous disturbances.
In other words, APA, is VERY difficult to diagnose because it mimics so many other diseases. And the ultimate question -
Can APA be cured? There is no cure for APA, but it can be successfully treated with intramuscular injections of vitamin B-12.
Left untreated, pernicious anemia will cause progressive and eventually permanent nerve damage, memory loss (potentially leading to fully developed dementia), and ultimately death. With timely diagnosis and treatment, however, existing nerve damage can be partially or completely reversed, as can the secondary dementia caused by the disease.
Do I still wonder if three generations in my family had APA and just went undiagnosed? Absolutely. Am I concerned that my long-term prognosis is dementia? Absolutely? Am I concerned that this will affect my daughter? my mother? my sister? You better believe I worry about it.
This is just another reason to fight for blood donors for clean blood transfusions, I continue to live today because of them and I will continue to fight for each day with all my heart, my passion, and my mind.
