Nitrous oxide can occasionally cause significant vitamin B
deficiency especially in people who are already borderline deficient in the vitamin (total vegetarians, for example) or those who are frequently exposed to the gas such as dentists and anesthesiologists.
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Ermens AA, Refsum H, Rupreht J, et al. Monitoring cobalamin inactivation during nitrous oxide anesthesia by determination of homocysteine and folate plasma and urine.
Clin Pharmacol Ther
49: 385–393, 1991.
Flippo TS and Holder WD Jr. Neurologic degeneration associated with nitrous oxide anesthesia in patients with vitamin B
128: 1391–1395, 1993.
Amos RJ, Amess JAL, Hinds CJ, and Mollin DL. Incidence and pathogenesis of acute megaloblastic bone-marrow change in patients receiving intensive care.
2: 835–839, 1982.
Shils M, et al. (eds.). Modern nutrition in health and disease, 9th ed. Baltimore: Williams and Wilkins, 1999: 1635.
Nunn JF, Chanarin I, Tanner AG, and Owen ER. Megaloblastic bone marrow changes after repeated nitrous oxide anesthesia. Reversal with folic acid.
Br J Anaesth
58: 1469–1470, 1986.
Amos RJ, Amess JA, Hinds CJ, and Mollin DL. Investigations into the effect of nitrous oxide anesthesia on folate metabolism in patient receiving intensive care.
4: 393–399, 1985.
Koblin DD, Tomerson BW, Waldman FM, et al. Effect of nitrous oxide on folate and vitamin B
metabolism in patients.
71: 610–617, 1990.