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.