Pernicious Anemia

An Archaic Name Comes Home to Roost

Breakfast Like an Emperor, my first multi-media digital book, is finally approaching publication.  One of the last tasks (I hope) is finishing up the glossary.

Today I came to a term entered in the glossary, but which I had ‘glossed’ over actually explaining.  And it’s turned out to be a big one.  Big enough that I decided it deserved a contemplation here.


Pernicious Anemia.  Many readers who were clients may wonder why I haven’t gotten to this one sooner—because it also turned out to be a significant aspect of your treatment.  Well, you’re not alone, and as I’m sure we’ve already discussed, I believe the presence of this autoimmune disorder, like so many others, is a growing reality in our midst.  This one, however, is far less known than, say, Hashimoto’s.

Here’s what I’ve written for the glossary in Breakfast Like and Emperor:

Pernicious anemia is a condition in which gastric parietal cells are eventually incapable of producing intrinsic factor.  Without intrinsic factor, we cannot absorb vitamin B12, one of the most important vitamins used by the body.  And without B12, we can’t produce sufficient red blood cells—hence the anemia.  Most commonly, this is an autoimmune disorder in which the immune system attacks either or both parietal cells and intrinsic factor.  Untreated, the lack of B12 can cause serious and irreversible damage and, ultimately, death.  This condition can be hereditary.

Common blood panels often suggest the presence of this process at play when high MCV (mean corpuscular volume) and normal MCHC (mean corpuscular hemoglobin concentration) are concurrent with symptomatology.  When I see this pattern, along with low gastrin (all of which I typically include in bloodwork), I then test for parietal cell antibodies and intrinsic factor antibodies.  For me, one or more positives on these tests confirm pernicious anemia.  The client is trained in self-administration of methylcobalamin (the preferred form of B12) via intramuscular injection, which immediately improves any number of symptoms.

Typically, this must continue for life.  Equally important, autoimmunity begets more autoimmunity, so treatment must focus on normalizing the errant immune system, as well as comprehensive monitoring, via lab work, of other antibodies which may develop, creating a cascade of declining health, and sometimes death.  Eliminating inflammatory factors is necessary, of course, but that’s just the first, obvious step.

Pernicious anemia has historically been likely to appear in blood type A individuals, who often exhibit weak digestion.  Over a period of twenty years, I watched type Os, who, also historically, have enjoyed excellent digestion, increasingly walk through my door exhibiting low hydrochloric acid and pernicious anemia.  

To me, the unavoidable conclusion is that the toll of toxins and lifestyle at the turn of the millennium has actually outcreated human constitution patterns that have existed for thousands of years preceding that shift.

Yes, that’s a glossary entry.




But many of you know, and more, still, suspect that there’s more to the conversation than this brief discussion.  Unsurprising to many of you, as well, is that this glossary term is found in a chapter on gluten—entitled Toast & Circus (a takeoff on ‘bread and circus’ which requires its own glossary entry…).

Here’s a taste from that chapter:

On the one hand, gluten issues are not that new, relative to the span of a typical human life.  

After decades of clinical success with mental patients, psychiatrists Dr. William Philpott and Dr. Dwight Kalita published, Brain Allergies, in 1980.  In this groundbreaking classic, these pioneers reveal the fact that 

“gluten is the most frequent and severe reactor of all foods.  As a result, gluten is the most likely food substance to evoke physical as well as mental symptoms.  However, it is important to keep in mind that many other foods, chemicals, and inhalants can also cause severe maladaptive reactions.”

Then follows the real bombshell:

“In addition to being the most reactive food substance in terms of immunologic and non-immunologic maladaptive reactions, gluten is the most addictive of all food substances.” [emphasis mine]

I’m assuming they’re including coffee, chocolate, and sugar…. Keep in mind, this was nearly forty years ago!

While not surprising to anyone who practices a functional form of medicine, this was truly astounding news at the time.  Yet even today, few clinicians, and even fewer media or consumers recognize this fact.

Mention it to a doctor of Oriental medicine who knows clinical success hinges on correcting the abysmal American diet, and you’ll see a lot of head nodding—or shaking.  It’s not rocket science to anyone who has broken the news to a client that they must eighty-six their toast—not to mention a couple hundred other fondnesses.  

To the client, it’s the end of the world, and they may respond with disbelief, deep resentment, overt animosity, or even dumbing down their doctor selection.

That gluten (as well as its cross-reactive buddies) is as addictive as heroin is still not recognized by clinicians or their clients today.  Philpott and Kalita again:

“Gluten is split in half during the first stage of digestion, which occurs in the stomach by a combination of hydrochloric acid with the enzyme pepsin.  This splitting of gluten produces an active narcotic called exorphin.  This narcotic becomes addictive when it is absorbed through the small intestine without further digestion by pancreatic enzymes, sodium, and potassium bicarbonate.”

This invites two more considerations:  

  1. Forty years ago, America’s food supply wasn’t as thoroughly inundated with wheat, gluten, soy, corn, and other additives as it is today.
  2. Nor was the health of America’s gut nearly as functionally inept as it now is.

Times have changed since the publication of Brain Allergies—and not for the better.  As perpetual consumers of food, we’re much further down the wrong road than we were then.

When I first began using the Ayurvedic interpretation of blood types as a reflection of constitutional type—about twenty years ago—the characterization of type O (the original, and most common blood type) was one of digestive strength.  Type A’s were the ones likely to show up with pernicious anemia and low hydrochloric acid.  That’s all changed now.  I routinely see new Type O clients whose stomachs are producing very little hydrochloric acid and who have multiple B vitamin deficiencies, including pernicious anemia.  

The type O constitution is no longer an indication of bombproof digestion—or even ‘good’ digestion.  Why?  From my perspective, it’s simply the toll taken by a combination of increased stressors and the continued consumption of a diet we can no longer tolerate.  I could write at least one book about a multitude of contributing factors as the twenty-first century begins.  But I truly believe these two are the most influential circumstances responsible for this phenomenon.

That’s a frightening contemplation on the nature of our diets and lifestyle predilections.  And yet, it’s a perfectly brilliant response to the most unapproachable dilemma of our time:  there are far too many humans on the planet.  Nature is no dummy.  It’s likely to find a way to eliminate as many of us, as effortlessly as possible, isn’t it?

The list of manifestations of insufficient B12 and other B vitamins is nearly endless.  Folic acid, too, is right up there at the top of increasingly more common B vitamin deficiencies.  Life can be quite miserable, if not untenable.  Muscle and neurological function are highly dependent on them.  

But I clearly can’t cover it all here, nor in the book.  After all, the book is about Breakfast Like an Emperor!

So, yes, I’m at the ‘P’s in the glossary.  There is a key animation and some videos that need to be finished.  The chapters are all—well, probably not ‘finished’, but—publishable.  The beauty of iBooks and e-books is that they can easily be updated, just like your software.

Soon, my friends, soon!