Question - What is the mechanism for the myeloneuropathy that may occur in individuals who abuse nitrous oxide (N2O) or who may be exposed chronically to N2O from other sources?
Answer - The cited article notes “Nitrous oxide oxidizes the cobalt atom of vitamin B12, resulting in irreversible inhibition of methionine synthase. Consequences of this inhibition include bone marrow suppression and impaired myelin production that can result in megaloblastic anemia and subacute combined degeneration of the spinal cord respectively.” (Meyers LE and Judge BS. Myeloneuropathy in a dentist. 2008 Clin Tox 4:1095-1096)