Pernicious anemia is not the same as B12 malabsorption illness.
Pernicious anemia is a lack of intrinsic factor in the gastrointestinal system and that means that if a person with pernicious anemia eats the same foods containing B12 as a person who does not have pernicous anemia, the person with pernicious anemia will not get the benefit of the B12.
Our bodies need intrinsic factor in order to get benefit from the B12 we ingest. We can eat eggs and not use the B12 in them without intrinsic factor.
Hence the brilliance of sublinguals which bypass the gastrointestinal system.
Anemia is a medical word indicating a change in the blood,
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Originally Posted by "American Heritage Dictinary"
a·ne·mi·a also a·nae·mi·a n. A pathological deficiency in the oxygen-carrying component of the blood, measured in unit volume concentrations of hemoglobin, red blood cell volume, or red blood cell number. [New Latin, from Greek anaimia : an-, without; see A-1 + haima, blood.]
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The fact is that not everyone with low B12 has anemia, but many do.
So it is as harmful to people to say anemia must be a feature of a B12 deficiency, as it is to say that it is not a feature of B12 deficiency.
If someone has enlarged blood cells, and those cells are not carrying enough oxygen, and the person is feeling abnormally tired, then the person deserves to have their blood looked at both for signs of anemia and low B12.