On the website of the Pernicious Anaemia Society (PSA) they write:

Co-existing Conditions

Pernicious Anaemia is an Autoimmune Disease. Autoimmune Diseases are characterised by the body somehow attempting to destroy itself. In the case of Pernicious Anaemia, the body produces an antibody that attacks the protein responsible for extracting vitamin B12 from food (any animal product). Doctors don’t know why this happens nor do they know with any certainty why patients with one autoimmune disease will frequently have other autoimmune condition. Many unlucky patients will have more than one other condition and some will have several.

Here is a list of the most common autoimmune conditions that patients with Pernicious Anaemia will also have:

  • Diabetes (Type 1)
  • Graves’ Disease (Hyperthyroidism)
  • Hashimoto’s Thyroiditis (Hypothyroidism)
  • Multiple Sclerosis
  • Psoriasis
  • Vitiligo

This is a classic idiopathic statement ‘doctors don’t know why this happens, nor do they know why patients have other autoimmune conditions as well’. If you have followed this series of articles you can all advise Doctors why this happens, although I suspect you will get thrown out of the clinic for being too smart. To use the word luck, has no scientific basis, and as we have learnt, the body expresses conditions and adapts to situations based on intelligence and logic.  You can visit the PSA website to view the symptoms from the link below:

Let us look at this autoimmune condition in more detail.

The biovavailability of Vitamin B12 I

As you can see from Diagram below the production of Vitamin B12 is by far the most complex Vitamin in terms of its bioavailability and absorption. When dietary B12 is first ingested in the mouth, the salivary glands secrete a substance called Haptocorrin ( also know as R-Binder or Transcobalamin 1 ) which is used to protect the Vitamin B12 from the stomach acid that can destroy it. Protein foods that contain B12, like meat, dairy or fish are then transported from the esophagus into the stomach for digestion. The Chief cells of the stomach wall secrete a precursor substance Pepsinogen, and when released and mixed with Hydrochloric acid secreted by the Parietal cells, they produce a protease substance called Pepsin which is used to digest food, and in this case, also liberates the Vitamin B12 from the food. The liberated B12 binds with the Transcobalamin 1 transport and is shipped to the entry of the intestine, the Duodenum where the Pancreas releases several enzymes including Protease ( for protein breakdown ) and liberates the B12 again from the Transcobalamin 1. The parietal cells of the stomach wall, in addition to the hydrochloric acid secretion also produce a glycoprotein ( protein with a sugar attached ) called ‘Intrinsic Factor’ (IF) which is used to bind the second B12 liberation from transcobalamin 1.

The biovavailability of Vitamin B12 II

Once the Intrinsic factor and the B12 are bound the ‘pair make their way to the end of the intestine, the Ileum, where Ileum cells reside that contain Intrinsic factor receptors. Once the IF/B12 bound combo reaches the IF receptors on the Ileum cells, the cell attaches the IF and liberates the B12 for the third and last time where it travels through to the Portal vein that transports it via a plasma transport called Transcobalamin 2 to its final destination, to the Liver for storage. Approx 50% of the B12 is stored in the liver and can last for 3-5 years without replenishment since B12 is secreted in the bile of the Gallbladder and recycled. Approximately 20% of the B12 is transported to the tissue but the lion’s share goes to the liver. Within a few hours approx 1.5 micrograms is absorbed. Depletion depends on the balance between 1. How much is ingested from the diet, 2. How much is secreted ( normally only 0.1% of the total B12 absorbed is expelled from the body), 3.How much is absorbed.

Vitamin B12 Circulation

The amount of B12 that circulates around the body is somewhat of a mystery since there are 23 bacterial genera that synthesize this vitamin and most of them reside in the colon, and medical science claim that any manufactured B12 in the colon will end up in the stool since it is beyond the absorption site in the Ileum of the small intestine. So this is where it becomes somewhat of an enigma. There are many articles and scientific papers that state that any B12 manufactured by the bodies bacterial colonies is beyond absorption, since no B12 producing bacteria live inside the small intestine. However, I believe this not to be true, because there is absorption capability in the bowel ( how is water reabsorbed?).. A lifetime’s supply of Vitamin B12 is extremely small, some estimate it to be no more than a 40mg; equivalent to a speck of red crystal, and around one seventh the size of an average aspirin tablet. When B12 is excreted in the bile the amount is between 1-10 micrograms/day which is then reabsorbed.

Vitamin B12 malabsorption

Even vegetarians and vegans should have normal B12 levels because of this efficient re absorption process .  So, if vegetarians and vegans and for anybody for that matter have a healthy gut flora, a healthy pancreas, adequate stomach acid, good digestion, and an efficiently functioning liver than I see no reason why they don’t absorb B12 from our bacteria.. Vitamin B12 deficiency is generally not due to inadequate dietary intake, it is because the B12 manufacturing and absorption mechanism is under attack by the immune system caused by gut dysbiosis which will affect any of the steps needed to successfully metabolise B12.

Pernicious Anemia is an AD variant

Conventional medicine call this Pernicious anemia, whose discovery was attributed to George Whipple ( 1878-1976) who found that giving liver to anemic dogs reversed their condition. Pernicious anemia is interesting which is why I have included a more detail discussion supported by a Diagram. I have written some detailed articles on the Microbiome and dis-ease concerning unbalanced microbiota or gut dysfunction ( dysbiosis ) which if occurs can trigger autoimmune conditions like Crohn’s disease, Celiac disease, Psoriasis, Hashimotos, Graves disease, Autism. I can’t tell you how frustrated I become when I read that Pernicious anemia is genetic and people ( like my Mother and sister, and I might add my sister inherited an unhealthy gut not Pernicious anemia ) have to have B12 ( passive absorption) injections for the rest of their lives. Because the body needs so little of this crucial vitamin and that the body possesses such an efficient re absorption mechanism it might take 20 years for this condition to show up, and even if the absorption mechanism fails it still would take around 3 more years for pernicious anemia to occur because of the efficient recycling mechanism. 

Vitamin B12 Absorption

According to Dr Vetrano of New Jersey, plants foods like Nori seaweed ( as in sushi ‘paper’), sprouts, aloe vera, nuts and seeds contain Vitamin B12 coenzyme which they absorb from algae and soil bacteria, but are they bio available to humans is still an unanswered question, although Dr Vetrano claims he has answered it. Dan Reeter at Bio systems Colorado claims that plants grown in organic soil produce B12 and wild fruit also contain it. Furthermore, the 1999 version of the book ‘Human Anatomy and Physiology by Marieb states that small intestinal B12 producing bacteria do exist and they synthesis B12 for the human host. My take is as always a referral to the intelligence of the body and to believe that a crucial Vitamin like B12, like all the other B vitamin family and K2, are designed for us to absorb in times of dietary scarcity and must be bioavailable to the host..  As I pointed out in an earlier article, for all the natural B Vitamins and K2 that are synthesised by our own bacteria, and then only for it to be excreted through our stool makes no biological sense. Indeed Dr Klaper believes that the B12 coenzymes are present in the bacteria in our mouths and tonsils, but that is yet to be proven.

You may read of the various forms of Cobalamin (B12) which are :

Methylcobalamin Natural occurring enzymatically active cofactor for B12, this form works with Methylfolate for methylation

Hydroxocobalamin Bacterial produce B12 from single cell Prokaryotes and Archea

Cyanocobalamin Synthetic form made from Hydroxocobalamin ( best to avoid )

5-Deoxyadenosylcobalamin Natural occurring enzymatically active cofactor for B12

Vitamin B12 is used for methylation, protection of DNA/RNA synthesis, red blood cell production and Lipid synthesis ( for myelin sheath nerve insulation).

How does Pernicious anemia occur in the body

Most people who are diagnosed with pernicious anemia will have antibodies to gastric parietal cells in the blood suggesting that the immune system is regarding the host’s own parietal cells as a target for attack.  As in all autoimmune conditions a dysbiotic gut, and thus a compromised immune system is acting inappropriately attacking the host’s healthy cells. Since the parietal cells are the target, they become compromised and fail to produce the crucial intrinsic factor.  In fact, the body also produces antibodies against the intrinsic factor so it’s a disaster all round. The actual tests that are performed by conventional medicine can distinguish between parietal cell antibody production and B12 malabsorption, but they must occur together so what’s the point.  What is to be expected is the elevated levels of the peptide hormone Gastrin which is used to stimulate the parietal cells to produce gastric acid (HCl or hydrochloric acid). Since the parietal cells are being attacked, their gastric acid production is severely impaired, so gastrin is being released excessively because the stomach acid is low.  This is similar to insulin secretion within an excessive glucose environment, and the insulin is still requesting the cells to take up the extra glucose in the blood despite the cells refusing more sugar since they contain enough, thus resisting (or ignoring ) the insulin signal which is why Diabetes type II is also referred to as Insulin resistance. 

As we discussed above, the final B12 stage of absorption that occurs within the Ilium of the small intestine cannot happen since the cell receptors are intrinsic factor receptors not B12 receptors.  As a result B12 is not cleaved from the Intrinsic factor and thus not absorbed. Thankfully conventional medicine have a non toxic treatment to intravenously introduce the B12 into the bloodstream, by passing the absorption pathway, and transported to the liver which is B12’s natural storage house.  If the gut was healthy the B12 (Hydroxocobalamin) produced by the colon dwelling bacteria ( the colon is capable of nutrient absorption) would be absorbed but gut dysbiosis impairs this process as well. As I stated before an imbalance in the microbiota affects the whole bacterial ecosystem.

The causal source of Pernicious Anaemia – Gut review

Gut composition

The composition of the gut flora consists of Beneficial vs opportunistic or commensal bacteria. The opportunistic gut flora can exist as either beneficial or opportunistic gut flora, dependent upon the healthy state of the beneficial bacteria since healthy gut flora keep the opportunistic flora in check. In some instances our beneficial flora innoculate or neutralize pathogens that populate the commensal flora colony. These ‘micro-creatures protect us, the host. Beneficial bacteria are micro-factories producing antibiotic, anti-viral, anti-fungal substances to maintain health and balance in the gut.

Host protection

The central command areas, the ‘Peyer’s patches’ that are attached to the epithelium, launch immune system responses recruiting T and B Lymphocyte cells, Macrophages and Dendrites. It is the beneficial bacteria species Bifidobacteria that activate the the T & B Lymphocyte cells using a secreted substance Muramyl Dipeptide. Furthermore, our gut flora assist in our protection by destroying potential harmful bacterial species, where some species of E.Coli produce protein based Bacteriocins to kill off competing species, thus controlling the growth of enterohemorrhagic E.Coli. The gut flora act as balancing agents for TH1 and TH2 responses preventing spurious allergic reactions that can happen any time in a person’s life if imbalance occurs


The purpose of our digestive system and its function is to digest/absorb food and nutrients, but it can only do so if the microbiota is functioning efficiently and the various microbial colonies are happy and fed well with nutritional food. Efficient digestion and absorption is performed by our epithelial cells the enterocytes that our bacteria help to orchestrate functionally. If we have consumed insoluble fibers from plant sources, i.e lignans or some other indigestible fibre than our colonic bacteria will break it down by fermentation, producing Short Chain Fatty Acids (SCFA) such as propionate, acetate and butyrate which are then ingested by other microbial species to achieve optimal energy for the host.

Nutrient production

Nature in its infinite intelligence has provided for us certain beneficial bacterial strains that produce Vitamins K2,B1,B2,B6,B12 and others that synthesize nutrients such as Vitamins K2, B5,B1,B2,B3 B6,B12 and folic well as antibiotic substances called Colicins within the colon. Even if food and nutrients are scarce and the gut is functioning our bodies will still be nourished with essential nutrients internally. However, if the gut is not functioning these nutrients are not synthesised, causing nutrient deficiency and Individuals can look pale and pasty which are obvious signs of anemia because they are B12 deficient.

Nutrient absorption

The only way that nutrients can pass the gut barrier is by the epithelial cells ( enterocytes ) that take the nutrients into the cells, examined and released into the bloodstream. However, with gut dysbiosis, pathogenic bacteria can break the tight junctions by chemically dissolving the zonulin proteins thus destroying the enterocyte security and all substances like bacteria,undigested food particles pass through unheeded straight into the bloodstream ( this is labeled Leaky gut syndrome – I don’t know why this is called ‘syndrome’..we know what it is, and we know what causes it but I suppose allopathic medicine are still looking for the gene that causes it. The enterocytes themselves become damaged, the microvilli or brush border becomes damaged and they are unable to break down food substances because the enzymes that sit on the brush border become inactive. When undigested food particles leak through into the bloodstream it is attacked by the immune system causing autoimmune conditions, allergies and food intolerances.


The intelligence of our own immune system becomes skewed when the gut is dysbiotic and the immune system becomes confused and non-functional. This situation coupled with a breach in the gut barrier causes the host to begin attacking its own tissues because the amino acid sequence of the unprocessed substances in the bloodstream could be similar to the amino acid sequence on a body tissue, a condition called ‘molecular mimicry’. This is referred to as an ‘Autoimmune condition’. The body can also attack the amino acid sequence for Collagen ( as we discussed in the article concerning Fibromyalgia), the substance that our tissue and skin are made of, because some toxins prefer to attach themselves to the Collagen substance and as a consequence changes the molecular structure. The immune system does not recognise our collagen anymore since the toxins have distorted their composition, and considers it a foreign invader and launches an attack, resulting in arthritic pain that can occur any way in the body. The body heals the inflammatory response and the pain disappears only for the pain to appear somewhere else. I can again refer to the great medical profession that are expert in labeling disease but very little else. This condition is called Migratory Neuralgia (fibroneuralgia) .The result of the toxic load, undigested food particles, non-recycled neurotransmitters, toxic substances crossing the BBB and their accumulation in the brain creates a myriad of Psychological and Physiological disorders. A partial list is shown below which are all caused by Gut dysbiosis ((Imbalanced microbiome ) :

Allergy, Asthma, Skin conditions: Eczema, Psoriasis, leaky gut syndrome, liver dysfunction, multiple sclerosis, Type 1 Diabetes, Hashimoto’s Thyroiditis, Hepatitis, Systemic lupus erythematosus, Thyroiditis, Rheumatoid arthritis, Scleroderma, Celiac disease, Graves Disease, Sjogren’s syndrome, Addison’s disease, Fibromyalgia, Crohn’s disease, Dyslexia, Dyspraxia, Depression, Autism,Schizophrenia, Epilepsy, Dementia, Alzheimers. Obsessive compulsive disorder, Bipolar disorder.

“ Can you imagine how many people could live happily ever after, and the huge amounts of money that could be saved that is being doused on worthless medical treatments when all it needs is to tell the patients to go home and change their diet and lifestyle….selling sickness that’s all it is”.

‘Medicine’, is a science which hath been…more professed than laboured, and yet more laboured than advanced; the labour having been, in my judgment, rather in a circle than in progression’. Unless medicine were refounded upon a purified register of natural fact and a proper philosophy of nature, we could never hope for the effective treatment of disease or the prolongation of life: ‘ the science of medicine, if it be destituted and forsaken by natural philosophy, it is not much better than an empirical practice’.! Medical practice lacked both evidential discipline and philosophical system. But were it to achieve discipline and system, what benefits might humankind expect ? The ‘prolongation of life’.

Francis Bacon (1561-1926)


If you don’y fix this problem naturally, you will need to receive B12 injections for the rest of your life and ensure that your stomach acid is maintained at the correct PH, and not too alkaline, which means HCL supplementation and/or taking Apple cider vinegar.  Better still keep your gut in good health so you can prevent this problem.   In the final parts, we will gather all of the information from previous articles on healing the gut  with a discussion on Pre/Probiotics and Synbiotics.

Check out the previous articles in this series :

Autoimmune Disease I

Autoimmune Disease II (Gut Flora Balance, Gut Symbiosis)

Autoimmune Disease III (Thymic recruits, Immune system Battlemap,Th1/Th2 balance)

Autoimmune Disease IV (Inflammatory mediators)

Autoimmune Disease V ((Asthma, Gut Epithelium, Chronic cystitis)

Autoimmune Disease VI (Fibromyalgia,Rheumatoid Arthritis,Allergies)

Autoimmune Disease VII ((Attack on the thyroid Hashimotos and Graves)

Autoimmune Disease VIII ((Celiac disease)

Autoimmune Disease IX ((crohns-disease-ulcerative-colitis-inflammatory-bowel-disease

Autoimmune Disease X ((Psoriasis, Vitiligo)

References/Acknowledgments :

  1. Pernicious Anaemia Society (PSA)
  2. 90 essential nutrients article Part 3 Eric Malouin Dr Berg’s website owner guide for humans
  3. Microbiome Eric Malouin Dr Berg’s website owner guide for humans

My name is Eric Malouin

In terms of my heritage I am not a thoroughbred, I am half English from England and half French Canadian from Quebec. Having spent the last 10 years in Medical research I thought that it was time to share my passion for true health to anybody interested in maintaining health without using conventional medicine. Once in the distant past I lived off conventional grocery shelves until you visit the man in the white coat and then a light shines through the darkness that you had not realized you were in… I was in..the twilight zone….I cured my own problems using natural methods, although they were not a big deal since I have always exercised..jogging every morning and tennis 12 hours/week, swimming but I was eating a lot of devil food that was causing my body to become easy fix..reprogrammed my taste buds and gave the food back to the devil…lol

I hope you enjoy the articles……



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