### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Good evening Dr, I have just found out that I have pernicious ananiema. i have had b12 injections but my count has not passes 230, i have had blood checked and within 2months it has dropped to 127. i don t feel any difference from having these injections. I have pins and needles in my toes so badly that it worries me. i feel exhausted when i wake up in the morning and my mood could be described as depressive to say the least. what should i be doing or who should i speak to other than my gp as nobody seems to take my condition serious. thank you

### output:

Hello, thanks for using Chat Doctor. Pernicious anemia is a type of anemia that results from a deficiency in nutritional supply of vitamin B12 or from an autoimmune disease that leads to destruction of a factor in the stomach that aids in absorption of it B12. Autoimmune causes could be hereditary and in this case could occur in other members of the family. Diphyllobothrium datum a fish tape worm is also known to cause It B12 deficiency. It B12 deficiency usually presents with large red blood cells. However, It B12 deficiency is not the only cause of large red blood cells. Deficiency in folic acid also is a cause and if your diagnosis of pernicious anemia was made based upon your full blood count or blood smear results, then it is likely you have a folic acid deficiency. Folic acid is richly found in leafy vegetables, liver, kidney, egg yolk etc. and is also found as a supplement.  You need to see a hematologist for a better evaluation and for further tests like bone marrow smear and autoantibodies if necessary. If you have more questions, please do not hesitate. Thanks.