Pernicious anemia, in Aajonus's framework, is the gradual reduction in the numbers of blood cells because the bone marrow fails to produce mature red blood cells. This is a specific and more severe subtype within the broader category of anemia, which he defines as a low red blood cell level or weak red blood cells that cause oxygen deficiencies, resulting in carbon dioxide accumulations in cells, decreased blood and general body efficiency, general weakness, paleness, brittle nails, loss of appetite, fatigue, abdominal pain, and lower rates of bodily processes. If affecting the brain, anemia causes dizziness.

He makes an important distinction throughout his teachings: a person can have what appears to be a normal or even high red blood cell count and still be functionally anemic. This is because the red blood cells entering the bloodstream may be immature and incapable of performing their work. As he explains, immature blood cells do not transport oxygen and do not eliminate carbon dioxide and toxicity, they simply take up whatever nutrients are in the blood, making the person progressively weaker. This he calls a "secondary anemia." All the red blood cells in the world still result in anemia if the red blood cells are not mature. The bone marrow is where red and white blood cells are bred and matured, and the state of the bone marrow directly determines the health of those cells.

He also distinguishes anemia as a symptom and an experience rather than primarily a laboratory value. He explicitly says: "If you have anemia, and I don't mean anemia by the laboratory test, you've got low hemoglobin or low iron. Who cares as long as you don't have symptoms of anemia? Anemia is a symptom, not a blood test." This reframing is central to how he approaches pernicious anemia, the lived experience of weakness, low oxygenation, and fatigue is the condition, not the lab marker.

The bone marrow, because it is predominantly fat, 60% or better, like the brain, draws poisons to it. Those stored poisons contaminate the red and white blood cells being bred and matured there, weakening them before they ever enter the bloodstream. Even when they enter the bloodstream they may be so compromised that they cannot transport oxygen normally, perhaps at one-third to one-half of normal oxygen transport capacity, and this takes a severe toll on the body's energy level and function.

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Aajonus identifies the primary root cause of pernicious anemia in his written work as low blood sugar, usually because of the inability to digest or utilize cooked and processed sugars. The body, unable to properly process cooked and processed sugars for fuel, fails to sustain the blood sugar levels necessary to keep red blood cell production healthy and ongoing in the bone marrow.

Beyond this primary cause, he identifies several contributing and overlapping mechanisms:

Bone Marrow Toxicity: The bone marrow, being predominantly fat, accumulates industrial poisons, metals, iodine, aluminum, vegetable oils, crystals, and other contaminants, that directly impair its ability to breed and mature healthy red blood cells. When the bone marrow is toxic, the red and white blood cells produced will be weak and often immature. He observed cases where bone marrow was contaminated specifically with iodine and aluminum. Metal poisoning from sources such as photography chemicals, paint, and other industrial exposures can travel through the body to the brain and bone marrow, damaging the tissue responsible for blood cell production.

Protein Starvation During Sleep (Nocturnal Cannibalism): A major and repeatedly emphasized cause in his seminars is the complete bottoming out of protein levels in the blood after five hours without eating. When a person sleeps eight to ten hours without eating, the red blood cells, deprived of protein nourishment, become cannibalistic and eat each other. He states that 200 red blood cells, or sometimes as few as 50 red blood cells, will consume one red blood cell. Over eight to ten hours of sleep, a person can lose two to four tablespoons of red blood cells through this process. In some cases of heavier sleep or longer fasting he states a loss of up to five tablespoons. This produces a morning anemia, including pernicious anemia in its chronic form, that people then treat with caffeine, nicotine, theobromine, or other stimulants rather than with food.

Salt Consumption: He attributes significant blood cell destruction to salt. One tiny grain of salt, he explains, will kill one million red blood cells by drawing the ions out of the cell through the magnetism of the concentrated sodium ions. The cell shrivels like a grape to a raisin and can never eat again, dying. Two grains of salt can create enough clumping to destroy two million red blood cells. In addition to direct cell death, the explosions caused by sodium ions in the blood lead to cells receiving only 23 to 50 nutrients instead of the 93 to 117 nutrients normally available in a full blood meal, leaving every cell in the body malnourished. Chronic salt consumption thus contributes to progressive anemia.

Vegetarianism and Blood Type Diets: Aajonus repeatedly cites vegetarian diets as a profound cause of anemia, including pernicious anemia. He describes vegetarians as chronically cannibalistic, their blood is eating itself all the time because they do not consume adequate raw protein to feed the red blood cells. He gave the example of a neuroscientist who had been vegetarian for approximately 16 years and developed chronic fatigue with muscles ailing throughout the body. He also observed about 50 people with blood type A who came to him with severe anemia, including several with leukemia, after following blood type diet protocols that restricted or eliminated red meat. He states: "Every one of them needs red meat." He regards the blood type diet as "absolutely bogus."

Cooked and Processed Iron Supplements: He specifically addresses the iatrogenic contribution of iron supplements. Iron from rock or ground, the kind plants eat, is not appropriate for humans. When food is cooked or processed, ions and electrolytes are neutralized and often separated from minerals and nutrients, and many minerals including iron become free radicals, causing cellular destruction and degeneration, often resulting in infections. Iron supplements are never ionically or electrolyticaly appropriate. Many people who regularly consumed iron supplements developed iron deposits throughout their systems, appearing as rust spots in iridology. He cites the case of a one-year-old baby girl diagnosed with low iron and prescribed iron supplements, the infant was not growing, was about four months behind in development schedule, and the medical response was to give her ground-based iron rather than raw animal foods.

Spleen Metal Contamination: When the spleen, which holds a reserve of mature red blood cells of anywhere from a pint to two pints, is highly metal contaminated, the metal leaches into the blood cells stored within it. When those cells are released back into the bloodstream, they are already weakened and cannot transport oxygen well. This produces a secondary anemia even when the red blood cell count appears normal.

Over-Alkalinity: He notes that when a person's system is over-alkaline, they can present with anemia symptoms. He describes observing hands where the body is "over alkaline and anemic" with signs of anemia clearly visible.

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Pernicious anemia, in Aajonus's framework, spans multiple principles of his philosophical and practical teaching:

Root Cause / Terrain Theory: The fundamental mechanism, toxic bone marrow failing to produce mature red blood cells, the body's own blood cells cannibalizing each other from protein deprivation, salt destroying red blood cells from the inside, is entirely a terrain theory question. The body is not malfunctioning on its own; it has been poisoned, starved, and deprived of the raw nutrients it needs.

Cooked Food: Pernicious anemia most often develops from low blood sugar because of the inability to digest or utilize cooked and processed sugars. This places cooked food as a central etiological factor. Cooked iron supplements and cooked/processed foods that produce free-radical iron also directly contribute.

Raw Food / How to Eat: The reversal protocol is entirely dietary, raw meats, raw unripe fruit, unheated honey, raw fat, the Nut Formula, raw milk, raw eggs, eaten in small amounts every few hours rather than large meals. How to Eat is particularly relevant because the timing of eating (specifically during the night to prevent red blood cell cannibalism) is presented as essential to reversing pernicious anemia.

How to Live: The nocturnal eating protocol, setting alarms to eat during the night, having food at the bedside, never going more than five hours without protein, is a lifestyle practice central to addressing this condition.

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Aajonus lists the following symptoms for pernicious anemia: weakness, gastrointestinal problems, sore tongue, sallow skin, and tingling extremities. He also describes how, if exhausted all of the time, a person is usually anemic.

He reframes these symptoms through the lens of oxygen deprivation and red blood cell insufficiency or immaturity:

Weakness and fatigue: When red blood cells cannot transport enough oxygen, perhaps only a third to half of normal, the energy available to every cell in the body drops accordingly. Chronic fatigue results not because the body is diseased in the conventional sense but because it is protein-starved and producing immature or destroyed red blood cells.

Morning non-refreshment: If someone sleeps eight to ten hours and wakes not refreshed and still tired, Aajonus says flatly: "That's anemia." The blood has been eating itself for several hours. The person has lost two to four tablespoons of red blood cells overnight. They are waking into a state of anemia every single morning, not because of some mysterious disease process but because they have not eaten during the night.

Brain fog and cognitive decline: He explains that the brain will not work as well when oxygen transport is compromised. A person who is exhausted and cognitively slow is often anemic because their red blood cells are not transporting and utilizing oxygen properly.

Reduced stamina, shortness of breath: He describes someone with high hormonal activity, adrenaline, testosterone, active parathyroids, overactive lymph glands and thymus, who might not notice the anemia because of the artificial energy masking it. However, what they would notice is less stamina and being out of breath more quickly, because the oxygen is not being absorbed and utilized from the blood as well as it should be.

Cold extremities and pallor: The spleen's ability to dump red blood cells into the bloodstream to warm the blood when the body is cold is compromised in pernicious anemia. He frequently observes "signs of anemia, coldness all throughout the system" in iridology and hand readings, interpreting pallor and cold hands as direct indicators of anemia. Someone who is "very cold, white, with all the signs" is showing him anemia.

White splotches in the blood as seen in iridology/nail bed reading: He reads the nail beds and eyes to assess red blood cell health. White splotches in the nail bed mean more white blood cells than red, and the red blood cells are not transporting oxygen well. "The little white splotches show that the red blood cells are abundant but not transporting oxygen as well as they need to be." A completely red, even nail bed indicates high red blood cell count with good transport. He also notes this is a reading for that particular day and can change.

Using caffeine, nicotine, stimulants: He reframes the entire modern culture of morning caffeine as a symptom of chronic anemia. "Coffee, nicotine, caffeine, none of those drugs are a remedy for anemia." Starbucks skyrocketing around the world is, to him, a cultural expression of mass anemia from toxic food and failure to eat during the night. The stimulant gives an artificial high, a false energy, that masks the underlying protein starvation and blood cell destruction.

Dizziness: He states that anemia affecting the brain causes dizziness.

Hot flashes as a positive sign: He identifies hot flashes specifically as a sign that pernicious anemia has begun to reverse. This is a healing marker, not a worsening symptom. During hot flashes it is beneficial to consume unheated honey in good mineral water or in raw milk.

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Aajonus provides a detailed, multi-component protocol for reversing pernicious anemia, with specific foods, quantities, timing, and pairings:

Core Protocol Foods:

Raw Meat, especially beef: Eating raw meats is the central intervention. He specifies that raw meat, especially beef, should be eaten at least once daily. For those with strong signs of anemia, visible coldness, pallor, weakness, he recommends that 70–80% and sometimes up to 80–90% of meat consumed be red meat, particularly beef. He has observed that blood type A individuals with severe anemia from vegetarian or blood type diets recover their anemia "in a few weeks" when placed on lots of red meat. He recommends a minimum of a pound of red meat per day for those with significant anemia signs, asking: "Two steaks is about that, about a half a pound each."

For someone showing anemia signs who also has metal poisoning and bile throughout the system, he recommends blending oysters with a quarter pound of beef, adding an egg to the mixture for maximum benefit: "Half a dozen oysters with a quarter pound of beef... mix them. And then you have an egg with it, then you'll really be flying."

He also recommends steak tartare preparation: raw egg mixed with raw beef, chopped cilantro, red onion, and fresh hot pepper (black pepper can be used but fresh hot pepper is preferred).

Raw Unripe Fruit: He specifies "a little raw unripe fruit" as part of the pernicious anemia protocol. This provides specific nutrients without the high sugar content of ripe fruit. He emphasizes it must be raw and unripe, not cooked or processed.

Unheated Honey, minimum ½ cup daily: This is given as a firm minimum quantity. The honey supplies nutrients necessary to reverse pernicious anemia. During hot flashes, when pernicious anemia has begun to reverse, he specifically recommends consuming unheated honey in good mineral water, or in raw milk.

Raw Eggs: Eggs are mentioned as part of the nocturnal eating protocol and as part of meal combinations. "Wake in the night, eat an egg and a couple ounces of milk" or "a couple of eggs, golf ball size of meat." Raw eggs with raw beef and oysters are specified as particularly powerful for anemia with associated metal poisoning.

Raw Milk: Half a cup of milk at bedside for the nighttime eating protocol. A half-cup milkshake is also recommended. Raw milk provides protein that feeds the red blood cells through the night. He also specifies having milk before bed and during the night, never going five hours without eating.

Nut Formula: He specifies eating raw meat, especially beef, at least once daily with a Nut Formula or with a little cooked starch and plenty of raw fat.

Raw Fat, butter, cream, coconut cream: Eating fats with meats is essential. He repeatedly states "eat fats with your meats" and emphasizes this when people show anemia signs. Lots of cream, butter, and coconut cream are recommended. He also specifies a tablespoon of olive oil with the evening meat meal three days a week for those with signs of anemia and poor fat utilization. For someone with severe anemia signs and bile everywhere in place of fats, he recommends "eating lots of cream, butter, coconut cream."

Carbonated (naturally carbonated) water: For those not transporting oxygen well throughout the system, he specifically recommends drinking carbonated water rather than still water. Carbonated water helps with oxygen transport in a compromised system.

Juice of raw greens: For the broader context of pernicious anemia, he mentions juice of raw greens helps flush accumulated resins that are a major factor in the disease.

Specific juice formula for anemia with bile issues: 50–60% celery, 20–30% parsley. He explains: "You need all that vitamin E. You need the chlorophyll. When you get the chlorophyll into your system, you're going to start using the sun properly and you don't need as much red meat." However, he still recommends high amounts of red meat alongside the juice until the system normalizes.

Fish and fowl, initial phases: In the context of lethargy related to anemia (what he describes elsewhere as a precursor or related condition), he recommends eating a balanced raw diet with plenty of raw fish and/or raw fowl for 3–6 months to settle the condition and build protein levels. If after 6 months, when protein levels are built up or restored, lethargy continues, eating red meat like beef corrects the problem (anemia). This suggests a sequenced approach: white meats first to build the system, then red meat if needed for correction.

Tomato formula for associated weakness (3 days): 2 cups of tomatoes cut up and blended with 3 tablespoons of cow's cream, 1 tablespoon of butter, half a teaspoon of vinegar, quarter teaspoon of ginger juice, and 2 tablespoons of honey. This can be done every other day or every 3 days. More frequent use may make the person too acidic.

Pear and apricots (in season) for anemia with high hormonal activity: When anemia coexists with high hormonal activity where it might go unnoticed, pear is specified as good fruit, and apricots when in season.

Timing, Small Meals Every Few Hours:

This is presented as essential and non-negotiable. Since many other malfunctions are the result of pernicious anemia, eating small amounts of raw foods every few hours, instead of large meals, keeps the body freshly supplied with nutrients.

Nighttime Eating Protocol (detailed):

Do not go through the night without eating. After 5 hours, the protein level in the blood completely bottoms out. Red blood cells become cannibalistic and eat each other. If you sleep 8 to 10 hours without eating you lose 2 to 4 tablespoons of red blood cells. You will wake with anemia.

The remedy: Wake during the night and eat. Options he specifies: - An egg and a couple of ounces of milk - Half a cup of milk (at bedside) - Half a milkshake (half a cup) - A couple of eggs plus a golf-ball-sized piece of meat - Half a cup of milk plus a small amount of food

He says to have something at the bedside so you can eat, drink it, and go back to sleep. Most people need an alarm at first; after they get used to it, the body just wakes on its own.

For hyperactive, energetic people: Do not set the alarm for 5 hours. Set it for 3 hours. Wake, eat, then sleep 5 hours after that to get the full 8 hours. He notes he himself sleeps only about 3 to 3.5 hours at a time and takes a half-hour to 45-minute nap during the day.

For physically active people: They may set the alarm for 3 hours given their higher metabolic demand.

Ratio of red to white meat by condition severity:

• Normally for an athletically inclined person: 50/50 red to white meat
• Signs of anemia, coldness throughout the system: 70% red meat for perhaps 3–4 years, then reduce
• Strong anemia signs with bone marrow problems: 70–75%, even 80% at times, red meat (specifically beef)
• Severe anemia signs, very cold, very white, not utilizing sun properly: 80–90% red meat, at least a pound a day
• Person with a lot of toxic iron and compromised red blood cells: an ounce of red meat twice a meal by weight with the rest fish or chicken, just enough red meat to bring them out of it while managing toxic iron load

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Aajonus provides several recovery reference points:

Hot flashes as the first marker of reversal: When the body begins to have hot flashes, pernicious anemia has begun to reverse. This is explicitly stated as the initial positive sign that the protocol is working.

Red meat protocol for severe cases: "a few weeks": For blood type A individuals who came off vegetarian or blood type diets with severe anemia and were placed on lots of red meat, Aajonus reports they were over their anemia in a few weeks.

White meat initial phase: 3–6 months: For people with lethargy associated with the anemic-adjacent condition he describes, eating a balanced raw diet with plenty of raw fish and/or raw fowl for 3–6 months settles the condition and restores protein levels. If lethargy continues after 6 months, red meat corrects the remaining anemia.

Red meat high-ratio period: 3–4 years for bone marrow cases: For someone with lots of signs of anemia and coldness throughout the system (with bone marrow involvement), he recommends 70% red meat for perhaps 3 to 4 years, then reducing. This suggests deep bone marrow toxicity takes years to fully resolve.

Nighttime eating: immediate improvement: The simplest intervention, eating during the night, can produce immediate results. He describes the case of "John," a man who said he didn't get energy until 10 o'clock in the morning. Aajonus asked if he woke during the night to eat. He didn't. He did it the next night and woke in the morning with all the energy, "that simple little trick was all he needed to change a major focus in his life."

Bone marrow rebuilding red blood cells: 40–65 days per cycle: The bone marrow takes 40 to 65 days to breed and mature new red blood cells. After significant blood loss or destruction, replacing what was lost can take 60 to 90 days. In an ill person today, recovery from acute blood loss might take 6–10 hours via spleen reserve; in a caveman-healthy person it could happen within an hour.

Coconut cream for spleen health: When the spleen is contaminated with metals, coconut cream is referenced as supportive. The spleen, holding up to a quart of reserve blood in healthy individuals, needs proper fat support to function and to keep stored blood cells healthy.

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