10.1542/peds.2014-0646D 7
Common Risk Factors Include: Northern European descent Age over 50 years Autoimmune disorders (e.g., thyroid disease, type 1 diabetes) Long-term use of acid-suppressing medications Strict vegetarian or vegan diets History of gastric or intestinal surgery Pathophysiology of Pernicious Anemia The development of pernicious anemia follows a predictable sequence: Autoimmune destruction of gastric parietal cells Reduced or absent intrinsic factor production Failure to absorb vitamin B12 in the terminal ileum Impaired DNA synthesis in bone marrow Production of large, dysfunctional red blood cells Reduced oxygen-carrying capacity Over time, vitamin B12 deficiency also affects the nervous system , leading to neurological symptoms
How It Works: GH release increases IGF-1 production in the liver IGF-1 enhances muscle protein synthesis This process leads to greater muscle recovery and hypertrophy 2
(A landmark review covering selenium biology, deficiency, toxicity, selenoproteins, and global health implications.) Steinbrenner H, Speckmann B, Klotz LO
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