Who should receive nitrous oxide?

Nitrous Oxide (NO2) -- commonly referred to as "laughing gas" - was used for years in the practice of dentistry. It is used currently as part of general anesthesia, and recently has been gaining popularity as a "recreational drug." An article in Popular Science in the late 1940s demonstrates how easy it is to make NO2 with an at "home laboratory."

The methylation pathway I refer to above is a fundamental biochemical pathway occurring billions of times per second in the human body. It's like the dollar bill of our economy -- it keeps things moving. Methylation plays a key role in the building up and breaking down of molecules.

The methylation pathways work well when we get enough B12 in our diet (vegans are very vulnerable to B12 deficiencies), enough folic acid (spinach, kale, Swiss chard), and B6. Additionally selenium (nuts), vitamin B2 (riboflavin), magnesium (Brazil nuts and almonds), and some amino acids (methionine, cysteine, serine, glycine, taurine) are needed to keep the methylation cycle running smoothly.

So here is the punch line:

Laughing gas (N02) -- nitrous oxide -- stops the methylation pathway in its tracks by deactivating B12, and stopping the activity of a certain enzyme for days to weeks. When someone is already deficient in B12/folate (e.g. due to diet, medications such as proton pump inhibitors or metformin), or has genes that are not functioning properly, the B12 deficiency is suddenly worsened, and weeks later neurological and psychiatric problems develop. They can be subtle (e.g. trouble with balance) or they can be severe (cognitive problems); any psychiatric syndrome (e.g. panic, depression) can develop. It is unlikely that anyone will make a correlation of cause and effect between the NO2 and the symptoms, because of the delayed toxicity, and the fact that not everyone is affected. Symptoms can be subtle.

NO2 is a very serious danger to your health. The risk is unappreciated by college students who are using NO2 as a recreational drug, and the risk needs to be assessed before use of anesthesia (by testing homocysteine and methionine in the blood, looking for risk factors for B12 deficiency such as a vegan diet or the use of certain medications, as well as the genetic MTHFR test) when possible. Please raise people's awareness of this risk by passing this information along.

Nitrous oxide is intended to be administered by healthcare professionals to people who have little to moderate anxiety when having dental work performed. The anxiolytic (anti-anxiety) properties of nitrous oxide can be very effective in making the procedure much easier to tolerate.

Nitrous oxide is safe enough to give to people of all ages, including children. It's used to help nervous patients relax during dental procedures.

Nitrous oxide is very helpful for kids who are terrified of going to the dentist, or whose gag reflex makes treatment very hard to do otherwise.

Continue Learning about Nitrous Oxide

Is the use of nitrous oxide safe for pregnant women?
The use of nitrous oxide in pregnant women is controversial, and it is preferable pregnant women not...
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What happens if I miss a dose of nitrous oxide?
Stacy Wiegman, PharmDStacy Wiegman, PharmD
It is unlikely that you will miss a dose of nitrous oxide because it will be administered by tra...
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What is nitrous oxide?
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At room temperature, nitrous oxide is a colorless, odorless, tasteless gas used for general anes...
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How soon after taking nitrous oxide will I feel its effects?
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When nitrous oxide gas is administered, you will feel the effects within one to two minutes. The...
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.