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The blood abnormalities characteristic of pernicious anemia can be corrected by folic acid, but a simultaneous deficiency of vitamin B12 causes this disease to be accompanied by an irreversible degeneration of the spinal cord. An individual lacking vitamin B12 or one with untreated pernicious anemia develops a shuffling gait, loses the sense of position of his feet, and can become completely paralyzed. If the fatigue caused by the anemia is prevented by folic acid, a patient may fail to consult his physician during the early stages of the disease, and permanent crippling can result. For this reason, folic acid is presently sold on prescription, though supplements should supply both vitamin B12 and folic acid.
Vitamin B12 can only be absorbed with the aid of an enzyme known as the intrinsic factor, normally produced by glands in the stomach. In pernicious anemia, the stomach has become so unhealthy that it can no longer secrete either this enzyme or hydrochloric acid. An injection of 0.1 milligram of vitamin B12 each month can prevent the degenerative changes in the spinal cord, but this amount given daily by mouth is ineffective.G2 Some vitamin B12 can be absorbed when huge quantities are taken orally, but the cost of such doses is usually prohibitive.
pernicious anemia giant band and metamyelocyte
When the stomach is removed because of cancer or ulcers, hence no intrinsic factor is available to assure the absorption of vitamin B12, four or five years can pass before pernicious anemia develops. A person who still has his stomach thus has years in which he can improve his health before pernicious anemia sets in. The same B vitamins that stimulate hydrochloric-acid production appear to be essential for the secretion of the intrinsic factor; therefore if the diet were adequate during this five-year period, pernicious anemia would be prevented. Because of the assumption that the intrinsic factor can never again be produced after pernicious anemia once develops, persons with this disease rarely make a serious attempt to improve their diets. Before folic acid and vitamin B12 were isolated, Miss Amy Tapping of Plainfield, New Jersey, consulted me because of severe pernicious anemia. At that time her work kept her traveling constantly and, like a sailor with a girl in every port, she had a physician in nearly every major city in the United States. Injections of liver extract were costing her an average of 140 dollars each month. After staying on an adequate diet containing large amounts of liver, yeast, and wheat germ for some time, however, her stomach secretions became normal and all liver shots were discontinued. She has had not the slightest return of anemia and now, almost 30 years later, is still in remarkable good health.
The structure of cyanocobalamin is depicted. The cyanide (Cn) is in green. Other forms of cobalamin (Cbl) include hydroxocobalamin (OHCbl), methylcobalamin (MeCbl), and deoxyadenosylcobalamin (AdoCbl). In these forms, the beta-group is substituted for Cn. The corrin ring with a central cobalt atom is shown in red and the benzimidazole unit in blue. The corrin ring has 4 pyrroles, which bind to the cobalt atom. The fifth substituent is a derivative of dimethylbenzimidazole. The sixth substituent can be Cn, CC3, hydroxycorticosteroid (OH), or deoxyadenosyl.
Through the years several persons with pernicious anemia who have consulted me have had equally good results. Physicians examining such individuals, however, have invariably concluded that the original diagnoses were wrong. This conclusion has perhaps been true in some cases, but it is improbable that a dozen or more physicians would all be wrong concerning Miss Tapping's diagnosis. It seems to me. therefore, that a person with pernicious anemia should make every attempt to stimulate normal stomach secretions. Vitamins B6 and C increase the absorption of vitamin B12. and adequate protein prevents this vitamin from being lost in the urine, whereas diets low in protein accelerate its loss. Provided iron and vitamin C are obtained with hydrochloric acid, they stimulate the production of the intrinsic factor sufficiently so that persons with mild pernicious anemia can take smaller doses of vitamin B12. Although many persons have died from this disease, it has not yet been proved to be incurable. If individuals with pernicious anemia who take hydrochloric acid with each meal to assure the absorption of nutrients were to adhere to a completely adequate diet containing generous amounts of the anti-stress factors, pantothenic acid, and all the natural sources of B vitamins, the reverse could probably be shown.
Cobalamin (Cbl) is freed from meat in the acidic milieu of the stomach where it binds R factors in competition with intrinsic factor (IF). Cbl is freed from R factors in the duodenum by proteolytic digestion of the R factors by pancreatic enzymes. The IF-Cbl complex transits to the ileum where it is bound to ileal receptors. The IF-Cbl enters the ileal absorptive cell, and the Cbl is released and enters the plasma. In the plasma, the Cbl is bound to transcobalamin II (TC II), which delivers the complex to nonintestinal cells. In these cells, Cbl is freed from the transport protein.
Vitamin B12 is almost exclusively associated with animal proteins such as liver (by far the richest source), kidney, muscle meats. milk, eggs, cheese, and fish. Vegetarians are particularly subject to pernicious anemia unless they eat generous amounts of milk and eggs. Because a vegetarian diet is rich in folic acid, however, the blood remains normal, and irreparable nerve damage can easily occur before the vitamin- B12 deficiency is discovered.
Of all vegetable foods, only yeast, wheat germ, and soybeans contain traces of vitamin B12. People who have followed a vegetarian diet without eggs or milk for five years or longer often develop sore mouths and tongues, menstrual disturbances, and a variety of nervous symptoms including a "needles and pins" feeling in hands and feet, neuritis, pain and stiffness in the spine, and difficulty in walking. All of these symptoms, which are danger signals, dramatically clear up provided vitamin B12 is obtained. To prevent permanent damage, persons adhering to a strict vegetarian diet should probably take 50 micrograms, or 1 tablet, of vitamin B12 each week while their stomach secretions are still normal. Although vitamin B12 is synthesized by intestinal bacteria, human absorption from this source is doubtful. The intrinsic factor is produced only in the stomach whereas the B vitamins are mostly released in the large bowel almost thirty feet away.
The Price Paid
Except for the occurrence of pernicious anemia in strict vegetarians, all other varieties are part of the price paid for being consumers of refined foods. If natural foods grown on rich soils could be eaten by everyone, most anemia would probably be only of historical interest.
About The Author
David Crawford is the CEO and owner of a male sexual health company known as Male Enhancement Group which is dedicated to researching and comparing male enhancement products in order to determine which male enhancement product is safer and more effective than other products on the market. Copyright 2010 David Crawford of sex stamina pills This article may be freely distributed if this resource box stays attached.
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