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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

I have a history of Sle Lupus and fibromyalgia

Even minor, everyday friction and pressure can be enough to trigger it

It's a coenzyme present in all living cells, central to metabolism, DNA repair, and countless other cellular processes

Furthermore, in MM, a subpopulation of regulatory T cells (Tregs) shows increased CD38 expression compared to T constitutive cells (Tcons), which enhances their immunosuppressive effect