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Why can whippets — canisters of nitrous oxide so commonly inhaled as recreational drugs — cause tingling in the fingers and toes, numbness or limpness in the hands and feet, weakness and wobbly legs, and other nerve damage? This party drug robs the body of vitamin B12, which the human body cannot make. Inactivated B12 puts the neurological system at risk, even when damage is not immediately apparent on tests. But these signs demand urgent medical attention.
How Nitrous Oxide Damages Vitamin B12
The human body cannot make vitamin B12, so it is an essential nutrient we must get from outside sources like diet. But nitrous oxide reacts chemically with the B12 molecule, oxidizing the cobalt in B12 and changing its shape.
This prevents B12 from doing its job. B12 is a cofactor for enzymes like methionine synthase, which help the body make the amino acid methionine.
The Warning Signs People Notice
Pains from weakened nerves or spinal cord tell you something is wrong. Look for these warning signs:
- Numbness, tingling, prickling in hands, feet, arms, legs
- Loss of ability to tell temperature or sharp from dull
- Electric shocks or pins and needles
- Unsteady walking, loss of balance
Nitrous oxide may harm the spine or nerves, or both. Nerve injury can be slow or fast.
How Doctors Figure It Out
Blood vitamin B12 may be normal even with nerve or spinal cord injury from nitrous oxide.
This makes diagnosis challenging. Doctors look at serum methylmalonic acid and homocysteine, which rise with B12 deficiency.
- Complete neurological physical examination of person
- Methylmalonic acid and homocysteine blood tests
- Magnetic resonant imaging of brain, spine or both
What treatment looks like
A doctor overseeing care will discuss the pros and cons of oral versus intramuscular B12, decide which to use, and weigh the evidence. Some case reports discuss prompt treatment success, but there's no standard care.
Why Prompt Care Matters
Neural injury might be reversible -- if it is treated quickly.
But delay could let nerve damage progress, potentially to permanent damage. Links have been shown between nitrous oxide, psychosis, pancytopenia, and subacute combined degeneration of spinal cord.
Whippets are not a temporary high that goes away lightly. Numbness, nerve pain, loss of strength, or nerve damage spreading through the body deserve urgent medical assessment and may need stopping nitrous oxide and vitamin B12 treatment.
This guide is general health information, not medical or legal advice. Talk to a doctor or pharmacist about your situation. In an emergency call 911.
