If you’ve followed my articles, then you’ve probably stumbled across a few regarding autoimmune diseases and plant-based diets. This article on pernicious anemia is a very unique topic as it applies to those suffering from the condition, but it can also be applied to strictly plant-based eaters that are having trouble getting enough B12 in their diet.
Let’s take a step back, what is an autoimmune disease?
They are conditions in which your “immune system mistakenly attacks your body” identifying certain body parts as foreign. The immune system is a crucial, necessary, and powerful weapon against bacteria and viruses, but when those fighter cells are deployed against healthy cells, the ramifications generally manifest as chronic inflammation and autoimmune disorders. Plus, autoimmune diseases are not uncommon affecting over 23.5 million Americans with around 80 diseases currently identified. Autoimmune diseases are also recognized as the “leading cause of death and disability.”
While some are incredibly rare, other autoimmune diseases are actually fairly common such as rheumatoid arthritis, psoriasis, multiple sclerosis, irritable bowel syndrome, and pernicious anemia.
What do all these diseases share in common? Inflammation.
Inflammation is a trigger word in the health world lately and for good reason. Normal inflammation is healthy, yet chronic inflammation — generally caused by diet or condition — has been linked to various serious health concerns including poor heart health, diabetes, cancer, and, as mentioned, autoimmune diseases.
If you’re seeking natural remedies, switching to a primarily plant-based diet may be a good step in the right direction. Plant-based foods are naturally rich in anti-inflammatory properties, antioxidants, vitamins, minerals, and fiber. All of these factors lend to not only a well-balanced healthy diet, but they also target and help reduce bodily inflammation naturally.
Getting to Know Pernicious Anemia

You may recognize the term anemia, which is a “medical condition in which the blood is low in normal red blood cells.” Many plant-based eaters struggle to avoid anemia as plant-based diets tend to be a bit lower in iron if you aren’t familiar with the best sources.
Pernicious anemia is a very specific form of anemia called macrocytic anemia in which the body lacks a protein that helps to absorb vitamin B-12 and therefore causes a deficiency in this vital vitamin. Vitamin B-12 essential part of your diet as it helps to prevent birth defects during pregnancy, supports bone and heart health, reduces the risk of macular degeneration, improves brain health, boosts energy, has been shown to improve symptoms of depression, is great for your skin, hair, and nails, and helps with red blood cell production. Without a sufficient amount of vitamin B-12, your body is unable to “make enough healthy red blood cells” and therefore anemia sets in.
When the body is unable to absorb enough vitamin B-12, it produces “abnormally large red blood cells called macrocytes,” which, due to their large size, are unable “to leave the bone marrow, where red blood cells are made, and enter the bloodstream.” This leads to common anemia symptoms from lack of oxygen-carrying red blood cells including fatigue and weakness.
If left untreated, pernicious anemia can be deadly.
Pernicious Anemia versus Vitamin B12 Deficiency
It’s important to note the difference between pernicious anemia and a vitamin B12 deficiency. You can have a vitamin B-12 deficiency due to poor diet, yet this does not mean you have pernicious anemia. When it comes to pernicious anemia, the body is lacking in a specific “protein called intrinsic factor (IF)” that is produced within the stomach and is necessary to absorb vitamin B-12.
Why is the body lacking this intrinsic factor protein?
This is where pernicious anemia gets its autoimmune disease categorization. For those suffering from pernicious anemia, the “body’s immune system attacks and destroys the cells that produce IF in the stomach.” Once destroyed, the “body can’t make IF and can’t absorb vitamin B-12 found in foods.”
Symptoms of Pernicious Anemia
An important aspect of pernicious anemia is that the symptoms progress fairly slowly. They start out on the milder side — such as general weakness, headaches, chest pain, and weight loss — then progress to more serious symptoms — such as spasticity (muscle stiffness), memory loss, spinal cord lesions, numbness in the arms and legs, and an unsteady gait. On top of that, pernicious anemia may be overlapped with vitamin B-12 symptoms including nausea, — sometimes accompanied by vomiting — confusion, depression, constipation, loss of appetite, and heartburn.
Managing Pernicious Anemia on a Plant-Based Diet
When it comes to managing pernicious anemia, you can actually follow some of the same guidelines as regular anemic diets. With that said, you’ll want to up your intake of anti-inflammatory foods along with anemia-friendly foods.
So, what do you eat to meet these demands? Lots of plants!
First off, focus on “foods rich in iron and other vitamins essential to hemoglobin and red blood cell production,” plus foods that “help your body absorb iron.” Plants and fortified foods offer nonheme iron, while meat products offer heme iron. It’s recommended in a normal diet to consume between 150 to 200 milligrams of iron every day, yet you’ll need to work with your doctor to determine a specific requirement based on your specific health status. Oftentimes, for those suffering from an anemic condition, including pernicious anemia, your doctor may suggest a supplement.
What type of plants? Leafy greens, beans, nuts, seeds, and fortified foods — such as orange juice, cereal, oatmeal, and rice — are all great sources of plant-based iron.
Foods to Avoid
When it comes to autoimmune diseases it’s often recommended to avoid meat and dairy products. It’s been found that these products can increase inflammatory responses and bodily inflammation. One of the main goals of diet for autoimmune disease sufferers is to focus on anti-inflammatory foods to reduce bodily inflammation. With that said, it’s incredibly important to talk with your doctor about all of your dietary needs.
Foods to Eat

As mentioned above, it’s important to up your intake of plant-based sources of iron including leafy greens, nuts and seeds, and beans. With that said, while you could choose the traditional route for each of these categories, that can grow old fast! Therefore, try a few of these more creative options to get your daily dose of nonheme iron!
Dandelion Greens

Dandelion Green Smoothie/One Green Planet
You may go directly for kale, spinach, or arugula at the grocery store in order to meet your leafy greens for the week, but what about trying your hand at dandelion greens? The dandelion plant is actually considered an herb and is completely edible providing a great source of not just iron, but also calcium and vitamins A, C, K, and B2. Medicinally, dandelion greens are used as a diuretic, but they are also great for reducing inflammation and boosting the health of the immune system. Get a full dose of greens with this Dandelion Green Smoothie or dress up your salads, dip your chips, or coat a burrito in this Dandelion Greens Dressing.
Black-Eyed Peas

Stewed Black-Eyed Peas/One Green Planet
You’ve probably got a can of green peas, kidney beans, or even chickpeas in your cabinet, but what about black-eyed peas? These are the often forgotten compatriots of the legume world, yet are just as resplendent in vitamins, minerals, and, for pernicious anemia, nonheme iron! Like other legumes, black-eyed peas truly shine when they’re a part of a larger recipe. Try a few of these re-heatable-friendly recipes: Smoky Black-Eyed Peas, Stewed Black-Eyed Peas, or this Black-Eyed Peas and Kale Chili.
Pine Nuts

Cauliflower Shwarma With Pomegranate, Tahini, and Pine Nuts/One Green Planet
When you think of nuts and seeds, your mind probably doesn’t go directly to pine nuts. These aromatic and savory little nuts are generally relegated to pesto recipes or sprinkled raw on top of salads. Yet, pine nuts can play a larger role in your diet, especially as they are a great source of nonheme iron, healthy fat, vitamins, and minerals. Create a veggie concoction — such as this Cauliflower Shwarma With Pomegranate, Tahini, and Pine Nuts, go traditional with this Fancy Pesto Potato Salad, or treat yourself with a pine nut-based dessert such as this Chocolate Fudge Pine Nut Cookies recipe.
Hemp Seeds

Raw Superfood Energy Bites/One Green Planet
Sunflower and pumpkin seeds have stolen the spotlight for many years, yet a not-so-newcomer is quickly absorbing that light. That is hemp seed. Hemp seeds are wonderfully nutty, yet not overwhelming. They are also incredibly rich in a variety of nutrients that are great for autoimmune disease diets including healthy fats — in particular, omega-3 fatty acids — nonheme iron, magnesium, folate, and calcium. Plus, they are incredibly versatile in the kitchen! Make your own DIY hemp-based milk — such as this Date Sweetened Hemp Milk, Two Ways — mix them with other powerful nuts and seeds for a boost in energy — such as these Raw Superfood Energy Bites — create a yummy mind-sharpening shake — such as this Memory Booster Chunk Monkey Shake — or even make your favorite dessert with a hemp seed twist — such as this classic Chocolate, Hazelnut, and Peanut Butter Cream Cake.
We also highly recommend downloading our Food Monster App, which is available for iPhone, and can also be found on Instagram and Facebook. The app has more than 15,000 plant-based, allergy-friendly recipes, and subscribers gain access to new recipes every day. Check it out!
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