Does Nitrous Oxide Kill Brain Cells?

Despite many inhalants being well-documented for causing brain damage, a great deal of recreational nitrous oxide users believe laughing gas to be an exception to the rule.

But is this belief grounded in reality? Does nitrous oxide cause brain damage?

Please note that inhalation and recreational use of nitrous oxide can pose significant risks to your health. We strongly recommend you avoid using nitrous oxide without proper medical supervision or consultation with a licensed health professional.

Can Nitrous Oxide Inhalation Kill Brain Cells?

Research shows that unsafe inhalation of nitrous oxide can in fact kill brain cells.

Studies suggest that unsafe inhalation methods involving prolonged exposure to nitrous oxide are especially harmful to the brain, potentially leading to oxygen deprivation and brain cell death.

It’s important to note that the severity of the consequences of nitrous oxide abuse depends on the duration of oxygen deprivation and the user’s age.

Overall, evidence for the relationship between nitrous oxide inhalation and brain cell death is lacking.

However, research suggests that consuming laughing gas can kill brain cells in two key ways:

1. Apoptosis

Laughing gas inhalation can lead to apoptosis, a process by which cells die in a controlled and genetically regulated way.

It is believed that infants and the elderly are most at risk of this. However, it may also happen to those consuming nitrous oxide at high levels.

2. Oxygen Deprivation

Nitrous oxide inhalation may also kill brain cells through oxygen deprivation.

But how exactly can nitrous oxide use deprive your body of oxygen?

How Nitrous Oxide Inhalation Leads to Oxygen Deprivation

For use in medical procedures, practitioners dilute nitrous oxide with oxygen.

According to Drug Science, when nitrous oxide is inhaled in pure form (like in recreational use), the gas replaces the air within the lungs.

This temporarily stops oxygen from reaching the blood and hence, the brain. The short-term effects include a tingling or heavy sensation in the limbs and a rapid heart rate.

However, because nitrous oxide displaces oxygen in the lungs, this can result in oxygen starvation, which may lead to suffocation or lack of consciousness.

Evidence suggests that some inhalation methods are riskier than others, with the riskiest being:

• Inhaling the gas directly from the canister.
• Filling a room with nitrous oxide.
• Filling a bag with nitrous oxide and placing it over the head.
• Using a medical mask to inhale nitrous oxide recreationally.

So, why are these inhalation practices more harmful than others? Some researchers propose that breathing room air after inhalation reverses the hypoxic effects of nitrous oxide.

Therefore, the most harmful inhalation methods involve prolonged nitrous oxide exposure because they prevent the mediating effects of breathing in oxygen-rich air after nitrous oxide use.

It's important to note that, regardless of inhalation method, all forms of nitrous oxide use without medical supervision or consultation with a licensed health practitioner is considered unsafe and strongly discouraged.

Winek and colleagues outline one example of a fatality due to unsafe inhalation methods. A hospital worker died from asphyxia (deficient oxygen supply to the body) after inhaling nitrous oxide straight from the tank via a clear plastic face mask and hose.

Does Oxygen Deprivation Cause Brain Damage?

The simple answer to this is: Yes, but the answer likely depends on the length of time the brain has to function without oxygen as well as the user’s age.

Brain cells are highly sensitive. If hypoxia (oxygen deprivation) lasts a long time, this may result in an unconscious state, seizures, and potentially brain death, whereby there is no detectable brain activity, also known as a vegetative state.

Depriving the brain of oxygen, regardless of the exact duration of hypoxia, can be a risk to your health and something we actively discourage.

But with the obvious out of the way, how long roughly can the brain survive without oxygen? It can be tough to give exact times. Everyone’s biology is somewhat different and existing research can be a little unclear.

A very approximate breakdown would be:

• Brain cell death: when oxygen deprivation reaches 1 minute.
• Extensive neuron damage: oxygen deprivation lasting 3 minutes.
• Imminent death: 5 minutes of oxygen deprivation.
• Inevitable brain damage: 10 minutes of oxygen deprivation.
• Almost-certain death: 15 minutes of oxygen deprivation.

Evidence suggests that people under 25 may recover better from hypoxia, but again, this depends on the duration of oxygen deprivation.

Can Long-Term Nitrous Oxide Use Cause Brain Damage?

Many seek the ‘high’ that laughing gas provides; yet, the long-term neurological consequences of nitrous oxide abuse are no laughing matter.

Below are the common ways in which nitrous oxide can negatively affect the brain:

Depletion of Vitamin B12

One consequence of long-term nitrous oxide abuse is a depletion of vitamin B12, a component that’s vital for nervous system maintenance.

Regularly using nitrous oxide in large quantities can lead to nerve damage over time. Individuals typically experience this as a tingling sensation, numbness in their fingers and toes, and weakness in their legs and arms.

While you can treat some cases of B12 deficiency with B12 supplements, the damage is sometimes irreversible.

Anemia

Evidence suggests that severe nitrous oxide abuse can also cause anemia alongside vitamin B12 deficiency; this involves a reduction in red blood cells, the component responsible for transporting oxygen around the body. Severe anemia is associated with brain dysfunction.

Memory Loss

The Alcohol and Drug Foundation has also found that prolonged exposure to nitrous oxide may lead to memory loss.

It’s also been found that inhalation of 20% nitrous oxide led to the deactivation of the hippocampus, parahippocampus, posterior cingulate, and visual association cortices.

The hippocampus and parahippocampus play a key role in learning and memory, so deactivation of these particular brain areas may cause dysfunction.

Results from a recent 2020 study suggest that this finding may account for the cognitive impairments commonly associated with nitrous oxide misuse.

Summary

Nitrous oxide is beneficial for a myriad of medical tasks. However, when used recreationally, users can put themselves at significant risk.

Negative neurological implications are particularly likely when individuals are unable to experience the restorative effects of breathing in oxygen-rich air after nitrous oxide inhalation.

The neurological risks of long-term use include loss of consciousness, oxygen deprivation, brain cell death, and memory loss.