Nitrous Oxide–Induced Vitamin B12 Deficiency
The title of this post, is the same as that of this peer-reviewed paper on the National Library of Medicine.
This is the abstract.
Nitrous oxide is a gas that is odorless, colorless, and has a sweet taste at room temperature. Nitrous oxide has several uses, including in surgery and dentistry (referred to as “laughing gas”), in automotive racing, and in aerosol spray propellants. The aerosol spray propellants that typically use nitrous oxide are whipped cream canisters and cooking sprays. Unfortunately, these over-the-counter household items are a source of nitrous oxide that can be used for recreational use. The most popular is the use of industrial-grade canisters having the slang term “whippets.” The nitrous oxide can be extracted by pushing the nozzle down slightly to the side and catching the released gas with a balloon. The contents of the balloon can then be directly inhaled, giving an instant feeling of euphoria. This is not a benign means to achieve a euphoric state but can cause severe nitrous oxide–induced B12 deficiency, which is presented in this case report.
An estimated 800,000 young adults abuse inhalants every year, and almost 11% of high school seniors report using inhalants at least once in their lifetime . Heavy inhalant abuse can result in a variety of side effects, including cardiac arrhythmias, hypoxia, metabolic acidosis, and neurologic deficits. Of all inhalants, nitrous oxide is particularly toxic due to its conversion of the active monovalent form of vitamin B12 to its inactive bivalent form. We present a case of subacute combined degeneration of the spinal cord due to nitrous oxide–induced vitamin B12 deficiency.
Basically, don’t inhale nitrous oxide, unless it’s being administered by a anaesthetist or a dentist.
Interestingly, because I was an undiagnosed coeliac my vitamin B12 was running on empty for much of the first fifty years of my life.
As my B12 was so low and didn’t really respond to regular injections, I was sent off to Addenbrooke’s, where they quickly diagnosed coeliac disease.
I wonder what would happen to an undiagnosed coeliac, who was low in B12, who got addicted to nitrous oxide.
The abstract implies that inhalants can cause cardiac arrhythmias, which has this Wikipedia entry, where this section talks about atrial fibrillation.
Arrhythmia affects millions of people. In Europe and North America, as of 2014, atrial fibrillation affects about 2% to 3% of the population. Atrial fibrillation and atrial flutter resulted in 112,000 deaths in 2013, up from 29,000 in 1990. However, in most recent cases concerning the SARS-CoV‑2 pandemic, cardiac arrhythmias are commonly developed and associated with high morbidity and mortality among patients hospitalized with the COVID-19 infection, due to the infection’s ability to cause myocardial injury. Sudden cardiac death is the cause of about half of deaths due to cardiovascular disease and about 15% of all deaths globally. About 80% of sudden cardiac death is the result of ventricular arrhythmias. Arrhythmias may occur at any age but are more common among older people. Arrhythmias may also occur in children; however, the normal range for the heart rate varies with age.
Doctors tell me, that my stroke was caused by atrial fibrillation.
Hospital Pioneers Cancer Service For Over 70s That Saves Lives And Money
The title of this post, is the same as that of this article in The Times.
This is the sub-heading.
Treatment is adapted to take into account age-related illnesses, such as heart disease, diabetes and dementia.
These three paragraphs outline, what the Christie Hospital is doing.
The Christie Hospital in Manchester is pioneering a specialist cancer service for elderly patients under plans to tackle a “silver tsunami” of cases.
More than 200 patients have been treated by the new team, which was set up to meet the more complex care needs of an ageing population.
The service has nearly halved the number of unplanned hospital admissions among older cancer patients, improving survival and quality of life.
But it’s the graph that follows that I find interesting.
It shows the cancer incidence rate (per 100,000 population) in 2020 by gender and age at diagnosis.
I am a control engineer and statistician and one of the most interesting things in a graph like this is the rate of increase or in this graph’s case the rate of decrease, as the graph effectively has the present at the top.
I have used an old trick and looked at the difference between the groups and the difference between the difference.
Note.
- It seems that the rate of increase of cancer diagnosis with age seems to increase with ages of 60-64 and 25-29.
- This would seem to correspond to those born before 1960 and those born before 1995.
- As a coeliac, I know that the first test for coeliac disease, which used endoscopy was introduced around 1960.
- The modern genetic test for coeliac disease was developed in the 1990s.
Is it coincidence, that the rate of increase of cancer diagnosis with age seems to increase, when a better diagnosis for coeliac disease was introduced?
These are my thoughts!
Coeliac Disease And Me
I am coeliac and I was born in 1947. I wasn’t diagnosed as coeliac until 1997.
I was an unhealthy child, with all sorts of avenues being chased, so in the end they just took my tonsils out.
- It should be remembered, that there was no test for coeliac disease in children until 1960.
- I’ve also only met one coeliac older than me and both her parents were GPs and she was diagnosed by food elimination.
- In fact, I never met a coeliac until I was about 25. He was the two-year-old son of one of C’s friends.
At fifty, an elderly locum gave me a present of a blood test to clear up my long-term health problems. The results showed that my body had very little Vitamin B12. Injections didn’t improve the level, so my GP sent me to Addenbrooke’s.
It was a Monday and all the consultant did was ask a nurse to take several vials of blood. He didn’t ask me any relevant questions or even touch me.
On the Wednesday morning, I got a letter from the hospital saying I was probably coeliac and it would be confirmed by endoscopy.
I must have been one of the first to have been diagnosed by a genetic test on a sample of blood.
Coeliac Disease And My Youngest Son
My youngest son was born in 1972 and after my diagnosis, my late wife felt he was coeliac, as physically he was so like me. But neither him nor our other two sons would get themselves tested.
I am now sure he was coeliac, as his daughter was born with a congenital hernia of the diaphragm and Swedish research says can happen with coeliac fathers. Luckily, she was born in the Royal London Hospital and thanks to heroic surgery at a few days old, she survived and is now in her first year at Southampton University.
Sadly my youngest son died of pancreatic cancer in 2011.
Coeliac Disease And Cancer
Nottingham University have shown that if you are coeliac and stick to a gluten-free diet, you are twenty-five percent less likely to suffer from cancer.
Cancer in the Over Sixties
The following is an extract from A Thought On Deaths Of The Elderly From Covid-19, which I wrote in April 2020.
How many undiagnosed coeliacs are there in those over seventy, who because they are coeliacs, have a compromised immune system?
I would be undiagnosed but for that elderly locum!
How many other coeliacs are there in the UK population?
- Age UK has a figure of twelve million who are over 65 in the UK.
- If 1-in-100, as stated by Coeliac UK, in the UK are coeliac, that is 120,000 coeliacs over 65, who are too old to have been diagnosed as a child, because no test existed.
Note that as of today 177,388 have been diagnosed with Covid-19.
Could the drop in the cancer rate of those born before 1960 be because of the availability of a test for coeliac disease, so that if they were a sickly child like me, they would be diagnosed? As I said earlier diagnosed coeliacs have a lower cancer rate than the general population.
Cancer in the Under Thirties
I was diagnosed in 1997 by a genetic blood test and there is no doubt that I have coeliac disease.
As the test is so simple, I wonder what proportion of coeliacs born since the Millennium have been diagnosed.
And how does this contribute to the drop in cancer cases?
More Research Needs To Be Done
It is obvious to me, that research needs to be done into the link between undiagnosed coeliacs and cancer.
It might be prudent to test every cancer patient for coeliac disease. My GP told me, that the test is not expensive and generally gives the right result.
Heat And The City
As I do on many Saturdays, I took the bus to Moorgate to have a late breakfast and do some food shopping in the Marks & Spencer department store.
To say it was hot would be an understatement and it must have been over thirty, so I retreated into an air-conditioned restaurant for my brunch, with my son and a friend.
I know that area well and although, I’m normally there on a weekday, I’ve never seen so much display of female flesh, with bare shoulders, cleavage and tummies everywhere. At least some were wearing white, which surely was prudent, but others were suffering in black and other darker colours.
After eating, I did my shopping.
I didn’t need much, but I did need some beer. As I’d miscalculated my consumption in the hot weather, it was a priority.
At home, I generally drink Adnams 0.5% alcohol Ghost Ship, which my body attests to be gluten-free. Normally, the store stocks it, but I couldn’t find any, so I asked an assistant, who was restocking the shelves. She said that they didn’t have any, but they did have the Adnams-brewed M & S own-brand, of which I’ve drunk dozens of bottles and my body also attests is gluten-free. So a couple of bottles, went into my shopping basket.
Interestingly, the assistant was rearranging shelves and it appeared, she was moving zero-alcohol bottles from the floor into the refrigerated end of a large display.
Could the heat be creating a high demand for customers needing to drink something to cool down? And many felt that zero-alcohol beer was acceptable in the heat of the City.
On Monday, I went back to take this picture of the display.
Note the Marks & Spencer own label brewed by Adnams in the middle!
And this was the price label for the beer.
No Alcohol – No Gluten – £1.90 a bottle – What more can a coeliac, who’s on Warfarin after a stroke need?
Biarritz And My Family
I am coeliac and I am fairly sure, my father was too, as he had all the wind, I had at fifty, which was something that led to my being diagnosed as coeliac.
But as my father was born in 1904, there was not really any tests for the disease.
I was one of many, who were diagnosed at Addenbrooke’s Hospital in the 1990s, where I am certain, they were testing out, the genetic test for the disease.
How else could I go in on a Monday and have a very short chat and give some blood for testing and then get a letter on the Wednesday saying I was probably coeliac and it would be confirmed by endoscopy.
I never met my paternal grandfather, as he died in 1929 at around fifty.
My father told me a lot about his father. He had been very affected by his father’s heavy drinking and alcoholism. I suspect, it was part of his plan to make sure, that I didn’t go the way of his father.
In fact now at 76, I am virtually teetotal, although I do drink a lot of bottles of 0.5 % alcohol real ale. But this doesn’t affect my gut or my INR.
I know little about my grandfather’s health, but he did suffer from asthma and that was what killed him.
Was he coeliac? From my father’s descriptions of his father, it was highly likely.
My grandfather had a profitable printing business, which even in the 1920s had around a hundred employees according to what my father told me.
My father also remembered going to see Spurs at White Hart Lane in a pony and trap. That at least showed a certain status.
My paternal grandparents also used to go to Biarritz for at least part of the winter.
My father did say a couple of times, that it did improve my grandfather’s health.
But when I went to Biarritz ten years ago, it certainly made me feel better.
I wrote Would I Go Back To Biarritz Again?.
Gluten-Free Afternoon Tea On Oxford Street
I spitted this sign outside Marks & Spencer on Oxford Street.
I wonder, if this is going to be offered in all the larger stores.
A Walk Over Wandsworth Bridge – 25th July 2023
This article on the BBC is entitled Wandsworth Bridge Closes For 10 Weeks Of Repairs.
This is the sub-heading.
A 10-week closure of Wandsworth Bridge for “essential safety repairs” has begun, Wandsworth Council says.
These are the first three paragraphs.
The authority added that the work was needed “to safeguard the long-term future of this key river crossing”.
Transport for London (TfL) has warned passengers that bus services which use Wandsworth Bridge will be diverted or stop short of normal destinations.
It added that the bridge would remain open for pedestrians, while cyclists can cross if they dismount.
So I went to have a look, starting at Wandsworth Town station.
It is a station, that needs a single lift and perhaps a small amount of refurbishment.
I walked from the station and over Wandsworth Bridge and along Wandsworth Bridge Road.
Note.
- There were several restaurants and cafes.
- It was a level walk.
- It looks like the Council was taking the chance to resurface the bridge.
- Along Wandsworth Bridge Road, drivers were not keeping to the 20 mph speed limit.
Some cyclists were still cycling on the bridge.
Il Pagliaccio Restaurant
I had lunch in the Il Pagliaccio Restaurant.
It was a typical friendly Italian restaurant, that served gluten-free food.
Asbestos In M&S Killed My Wife — Gove’s Ruling Is A Disgrace
The title of this post, is the same as that of this article in The Sunday Times.
It is in a section of the paper, which is entitled Act Now In Asbestos, where the paper has a campaign.
These are the first three paragraphs.
Janice Allen met and fell in love with her husband, Stuart, when they worked together at Marks & Spencer’s flagship store in London’s Marble Arch.
The shop would end up killing her.
Janice died of mesothelioma, a cancer she got from exposure to asbestos. The M&S store was constructed using the toxic building material and it was found in several locations where she worked. The department store would award her substantial damages before she died at a hospice in Kent in June 2018.
I have only worked with asbestos once.
This picture shows my father’s printing works in Station Road, Wood Green.
They were not the most salubrious of premises and my father was always making improvements.
My father was a very good practical carpenter and an accomplished painter and decorator.
The back wall of the building was covered on the inside with damp and mould, which even in the 1950s, he thought could be a health hazard, so he decided to do something about it.
- Above a certain height he cleaned the wall and painted it with a standard magnolia paint.
- About two metres above the ground, he fixed a two-by-two batten piece of wood to the wall.
- He also fixed another one to the wall, perhaps halfway up.
- To cover all the damp and mould, he then fixed corrugated asbestos cement sheeting to the two battens with galvanised roofing nails.
- To finish it off he screwed a piece of slatting to the top batten, which he painted a fetching blue colour.
The damp and mould was now out of sight and out of mind.
I remember how this construction was done, as I was my father’s ten-year-old assistant.
Although we’d used asbestos cement sheeting, I don’t think either my father or myself inhaled any asbestos dust, although we weren’t wearing masks, as no-one did in those days.
ICI And Asbestos
My next encounter with asbestos was at ICI in the late 1960s.
- A lot of chemical plants, built before the Second World War were riddled with it.
- But ICI, knew of the problems, and I was given strong warnings about asbestos.
- As I was only putting instruments on plants, with experienced plant fitters, I didn’t have an real encounters with it.
But why if ICI were so anti, were builders still using it and otherwise sensible companies not removing it from their buildings?
This is the large paragraph in The Times article.
An M&S spokesman said: “Like many older buildings, Marble Arch dates back to the interwar era when asbestos was commonly used in construction, and sadly our former colleague Janice Allen worked in the store over 40 years ago, before the consequences of asbestos use were known. Today we rigorously manage asbestos where it is present and ensure the store is safe for every colleague and customer.”
If ICI were worried about asbestos in the late 1960s, why weren’t Marks & Spencer worried about asbestos in the late 1970s.
A Barn In Suffolk
In the 1980s, I put up a new barn, where we lived.
Often, in those days, asbestos was still used for roofing, but I was recommended to use a new British Steel product, where steel was covered in a coloured weatherproof coating.
I Sneeze A Lot
These days, I sneeze a lot, but I didn’t sneeze this much before I was diagnosed as coeliac and went gluten-free.
Could it be that my immune system is so much stronger and when there is something in the air, it is only giving it a good kicking?
I’ve been sneezing a lot for the past few days, as the Council removed a dead tree from outside my house.
But we do know, that Nottingham University have shown, coeliacs on a gluten-free diet have a 25 % lower cancer rate than the general population.
Could this be due to a stronger immune system?
My Coeliac Son Died From Cancer
I believe my youngest son was an undiagnosed coeliac and he lived the rock-n-roll lifestyle on a diet of ciggies, cannabis and Subways, as he was a sound engineer in the music business. He died virtually out of the blue of pancreatic cancer at just thirty-seven.
So on the one hand being a diagnosed coeliac on a gluten-free diet gives you a certain immunity to cancer and other diseases and on the other hand undiagnosed coeliacs are prey to all the nasties we have to live with.
To return to the tragic story in The Times, which gives Stuart’s age as 62, so that places him as being born around 1960 and his late wife; Janice looks about the same age.
I think it is true to say, that in the 1960s, medicine started to change dramatically.
- Serious heart operations and kidney transplants became commonplace.
- The first heart transplant was performed in 1967.
- Drugs were improving.
- Vaccination was stopping polio and other diseases.
- The first test for coeliac disease in children was developed. Sadly, it wasn’t used on me.
But we had little inkling of the role of genes in diseases.
Incidentally, I didn’t come across my first coeliac, until 1972, when a neighbour had a coeliac baby son called Nicholas.
So was the poor lady in The Times story, in some ways a victim of her time?
- Asbestos was wrongly ignored by Marks & Spencer.
- Medicine hadn’t advanced enough to be able to identify, those susceptible to cancer.
- I have heard so many stories of bad use of asbestos.
Sadly, the dangers of asbestos are still ignored by many companies and organisations today and that includes the NHS.
One of my colleagues at ICI in 1968 will be livid at how we are ignoring asbestos.
Is This A Possible Scenario?
Consider.
- Someone is born coeliac and they are not diagnosed.
- If they were born before 1960, there was no test for coeliac disease in children.
- The simple genetic blood test came in around the turn of the century.
- They work with asbestos in their twenties.
- Their immune system is not good enough to protect them.
Just like my son, will they get a serious cancer?
Coeliac Disease And Covid-19
In Risk Of COVID-19 In Celiac Disease Patients, I look at a pier-reviewed paper from the University of Padua.
This sentence, sums up the study.
In this analysis we report a real life “snapshot” of a cohort of CeD patients during the SARS-CoV-2 outbreak in Italy, all followed in one tertiary centre in a red area of Northern Italy. Our data show, in accordance with Emmi et al., the absolute absence of COVID-19 diagnosis in our population, although 18 subjects experienced flu-like symptoms with only one having undergone naso-pharyngeal swab.
There were 138 coeliac disease subjects in the study and they had been gluten-free for an average of 6.6 years.
The downside of this, is how many undiagnosed coeliacs, suffered a severe dose of Covid-19.
Conclusion
Given the pain coeliac disease has inflicted on my family over the years, I believe that all children should be tested for coeliac disease.
I would also recommend, that anybody thinking of working with asbestos or taking a job with a high cancer risk, should get themselves tested for coeliac disease.
Being found to suffer from coeliac disease will not in itself kill you, and with the right diet, it might even prolong your life.
Lunch On The Pier In Cleethorpes
I took these pictures as I walked along the sea front, where I had lunch at a restaurant called Papas.
Note.
- As you can see, I had some excellent gluten-free fish and chips, which I washed down with a zero-alcohol beer.
- The service was good, friendly and fast.
- I needed it fast, as I had a train to catch and if I missed it, it would be a two-hour wait.
Strangely, I don’t think, I’ve ever eaten a proper meal on a pier.
This Google Map shows the location of the pier with respect to the station.
Note.
- The station is in the North-West corner of the map.
- The pier and restaurant is in the South-East corner of the map.
It is a very easy level walk from the station to the restaurant.
Gluten-Free Fish And Chips In Old Fashioned Seaside Towns
This is the third time in recent years, when I’ve had excellent gluten-free fish and chips in an old-fashioned seaside town.
The other two places were Lowestoft and Skegness.
Incidentally, from what I remember of the taste of ordinary fish and chips, I prefer the taste of the gluten-free version, which I’ve had perhaps a dozen times in the last twenty0five years.
But then some gluten-free versions taste better than the ordinary version. Egg sandwiches are one.
British Five-Year-Olds Up To 7cm Shorter Than Western Peers
The title of this post, is the same as that of this article in The Times.
This is the sub-heading.
Poor diet and health service cuts blamed for ‘pretty startling’ trend
These are the first two paragraphs.
Five-year-olds in Britain are on average up to seven centimetres shorter than their peers in other wealthy nations, in a trend described as “pretty startling”.
A poor national diet has been highlighted as a major culprit in Britain’s fall down international rankings of child height.
I am coeliac and am only 170 cm.
During the pandemic, I did some statistical research on coeliac disease and the covids for my own interest.
I found a peer-reviewed Indian medical paper entitled Coeliac Disease: Can We Avert The Impending Epidemic In India? The author felt that modern high-gluten wheats, were increasing the rate of the disease.
The author also said this about introduction gluten to babies in Sweden.
The time of first exposure to wheat influences the development of celiac disease. In countries such as Finland, Estonia, and Denmark, characterized by low gluten consumption in infancy, celiac disease prevalence is much lower than in Sweden where gluten consumption is high in infancy. A natural experiment occurred in Sweden about two decades ago when national recommendations were made to introduce wheat into the diet after cessation of breast feeding at six months. This change was coupled with increased wheat gluten consumption through infant feeds. Together these measures resulted in a two-fold increase in incidence of celiac disease in Sweden, which was attributed to introduction of wheat into the diet after cessation of breast feeding. In 1996 this recommendation was changed to introduce gluten in gradually increasing amounts while the infant was still being breast fed. This led to a dramatic decrease in celiac disease incidence.
It is interesting to look at heights of five-year-olds given in the Times article for the four countries.
- Denmark – 117.4 – 118.1
- Estonia – 116.9 – 115.7
- Finland – 116.3 – 114.5
- Sweden – 115.1 – 115.1
Note that all heights are in centimetres, with boys first.
As according to the graphs in the article the UK and the US have shown the biggest declines in height, is gluten-rich junk food, the major cause of this decline?
More research needs to be done!
Bonus For GPs If Patients Join Drug Trials In Plan To Lure Firms To NHS
The title of this post, is the same as that of this article on The Times.
This is the sub-heading.
£650m boost for medical research after number of participants slumps
These three paragraphs outline what is to be done.
Tens of thousands more patients will be signed up for clinical trials as ministers promise drug companies better access to the NHS to expand the economy and develop cutting-edge treatments.
Jeremy Hunt, the chancellor, is promising a £650 million package to boost life sciences as he attempts to lure pharmaceutical giants to Britain.
GPs will be offered financial incentives to recruit patients into trials of new treatments and hospitals will be given research targets under plans to reverse a slump in clinical testing while the NHS struggles with the backlog from Covid-19.
It all sounds good to me.
I have been involved in several trials and medical research projects.
- As part of my coeliac disease diagnosis, one endoscopy was performed by Rebecca Fitzgerald at Cambridge, as she was taking samples of bile fluids for her research into Barrett’s esophagus.
- After the death of my wife, I was interviewed by PhD students in the Psychology Department at Liverpool University for their research into widowhood.
- Oxford University interviewed me on diet for their coeliac disease research.
- After my stroke, I spent an entertaining afternoon at the University of East London doing balance tests by computer. Their aim was to develop a reliable balance test for stroke and other patients, that could be carried out by physiotherapists quickly, than by more expensive doctors.
- I have also been on a drug trial at Queen Mary University, but that drug was useless and had no good or bad affects, so the trial was halted. However, it did lead to other enjoyable activities in the field of patient relations with treatment and research.
As a confirmed coward, I should note that with the exception of the drug trial, all of the other projects were low risk.
I should say, that I also sponsor pancreatic cancer research at Liverpool University, in memory of my son, who died from the disease. I wrote about the first Liverpool project in There’s More To Liverpool Than Football And The Beatles!.
A Database Of Projects Open For Volunteers
I believe that this is needed, so that those like me, who like to contribute to research can volunteer.
Perhaps some of the £650 million, that has been promised by Jeremy Hunt, could be used to create the database.
I also believe the database could be used for other non-medical research.
The Anonymous Widower 