In a new paper this month, doctors describe how a 32-year-old man’s habit of inhaling nitrous oxide via “whippits” left him partially paralyzed. Following treatment and the end of his nitrous oxide use, the man did eventually regain the function of his legs. But the medical tale is perhaps a timely reminder of why states like New York have recently decided to ban the sale of industrial-strength whipped cream chargers that contain the gas to teens.
The case study was published last week in the New England Journal of Medicine by doctors at Mount Sinai Hospital in New York and the Brigham and Women’s Hospital in Massachusetts.
According to the report, the man had visited a local emergency department six weeks after he began feeling a tingling sensation along his arms and two weeks after he lost the use of his legs. Two months before the symptoms started, he began inhaling nitrous oxide. Scans revealed nerve damage along the spinal cord and the telltale signs of a condition known as subacute combined degeneration (SCD).
SCD is caused by a deficiency of vitamin B12. Though it’s not entirely clear how the lack of B12 leads to SCD, B12 is known to be essential for the maintenance of myelin, the protective outer sleeve around our nerve cells in the brain and spinal cord. And it’s also known that long-term use of nitrous oxide can inactivate the body’s supply of B12. After ruling out other possible causes for the man’s illness, such as autoimmune disorders, the doctors determined that the nitrous oxide was to blame.
Nitrous oxide has many uses, including as a mild inhaled sedative in medicine. But it can also be used for the short-lasting euphoric effects that have led people to dub it laughing gas. Recreationally, people can inhale nitrous oxide through whippits, a reference to the whipped cream canisters from which it’s often sourced.
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In November 2021, New York banned the sale of industrial strength canisters to people under 21. But this summer, confusion surrounding the law and some poorly phrased news reports led people to believe that New York would be banning the sale of whipped cream cans in general to teens and children.
Misinterpreted as the law was, it is true that young people are the most likely to use nitrous oxide and other inhalants. Negative health effects vary depending on the substance being inhaled and how much of it is being used at once, but they include headaches, drowsiness, slurred speech, vomiting, and life-threatening complications like organ failure or a heart attack. Aside from SCD, long-term use of nitrous oxide can also cause memory loss and even psychosis.
The man in this case was given vitamin B12 shots, which restored his levels of the vitamin, and he reportedly stopped using nitrous oxide. And though SCD can lead to severe permanent neurological damage if untreated, doctors reported that the man was able to walk under his own power again four weeks later at a follow-up visit.
