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Blood Disorders and Systemic Effects The biochemical cascade triggered by nitrous oxides inactivation of vitamin B12 manifests primarily through severe hematologic and systemic complications

In white adipose tissue of obese, insulin-resistant and aged mammals, NNMT is dramatically upregulated and because it consumes both the universal methyl donor (SAM) and the NAD precursor (nicotinamide), its hyperactivity simultaneously depletes the cellular methylation reserve and the NAD-salvage pool [1,2]

Virologic outcomes during DOR use were not assessed for this study

Department of Health and Human Services, ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/