Nitrous oxide is an anesthetic gas. It is used during dental work and with patients who are
not candidates for more commonly used
anesthetics during surgery.
Summary of
Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem
contradictory. For clarification, read the full article for details about the summarized
interactions.
May Be Beneficial:Depletion or
interference—The medication may deplete or interfere with the absorption or
function of the nutrient. Taking these nutrients may help replenish them.
Folic acid
Vitamin B12
May Be Beneficial:Side effect
reduction/prevention—Taking these supplements may help reduce the likelihood and/or
severity of a potential side effect caused by the medication.
Catechin*
Ginger*
Milk thistle*
Supportive interaction
None known
Reduced drug
absorption/bioavailability
None known
Adverse interaction
None known
An asterisk (*) next to an item in the summary indicates that the
interaction is supported only by weak, fragmentary, and/or contradictory scientific
evidence.
Interactions with Dietary Supplements
Folic acid and Vitamin B12
Nitrous oxide interferes with activity of vitamin B12, which further interferes with the
activity of folic acid, causing adverse actions.12 Administration of
folic acid or folinic acid (activated folic acid) has reversed nitrous oxide-induced bone
marrow changes.34 People with vitamin B12 deficiency may be especially
susceptible.5 People who will undergo nitrous oxide anesthesia for several hours
may benefit from vitamin B12 and folic acid supplementation.6 Some doctors
recommend 100 mcg of vitamin B12 and 1,000 mcg folic acid, starting one week before through
one week after prolonged exposure to nitrous oxide. People with normal vitamin B12 levels who
undergo short-duration nitrous oxide anesthesia (less than two hours) do not require
supplementation.
Catechin
Some general anesthetic drugs have infrequently caused liver damage. One animal study showed
that taking catechin (a bioflavonoid) prior to halothane exposure reduced the amount of liver
damage caused by the drug.7 Additional research is needed to determine whether this
protective effect occurs in humans and with other general anesthetics.
Interactions with Herbs
Ginger
(Zingiber officinale)
General anesthetics commonly cause nausea upon waking. In a double-blind study, taking 1 gram
of ginger one hour before surgery was as effective at reducing nausea and vomiting as the
anti-nausea drug metoclopramide.8
Individuals taking ginger in order to avoid side effects should disclose this to their doctor
prior to surgery, since the herb might affect blood clotting.
Milk
thistle(Silybum marianum)
Some general anesthetic drugs have infrequently caused liver damage. One animal study showed
that taking silybine, an active compound found in milk thistle, prior to halothane exposure
reduced the amount of liver damage caused by the drug.9 Though controlled research
in humans is necessary, some doctors of natural medicine currently suggest taking milk thistle
standardized to contain 140 mg of silymarin three times a day, beginning a week before surgery
and continuing for at least one week after surgery.
References (To view, roll mouse over the "References" heading; to hide, click on the heading)
1. Ermens AA, Refsum H, Rupreht J, et al. Monitoring cobalamin
inactivation during nitrous oxide anesthesia by determination of homocysteine and folate
plasma and urine. Clin Pharmacol Ther 1991;49:385–93.
2. Flippo TS, Holder WD Jr. Neurologic degeneration associated with
nitrous oxide anesthesia in patients with vitamin B12 deficiency. Arch Surg
1993;128:1391–5.
3. Nunn JF, Chanarin I, Tanner AG, Owen ER. Megaloblastic bone marrow
changes after repeated nitrous oxide anesthesia. Reversal with folic acid. Br J
Anaesth 1986;58:1469–70.
4. Amos RJ, Amess JA, Hinds CJ, Mollin DL. Investigations into the effect
of nitrous oxide anesthesia on folate metabolism in patient receiving intensive care.
Chemioterapia 1985;4:393–9.
5. Koblin DD, Tomerson BW, Waldman FM, et al. Effect of nitrous oxide on
folate and vitamin B12 metabolism in patients. Anesth Analg 1990;71:610–7.
6. Amos RJ, Amess JAL, Hinds CJ, Mollin DL. Incidence and pathogenesis of
acute megaloblastic bone-marrow change in patients receiving intensive care. Lancet
1982;ii:835–9.
7. Siegers CP, Fruhling A, Younes M. Influence of dithiocarb,
(+)-catechin and silybine on halothane hepatotoxicity in the hypoxic rat model. Acta
Pharmacol Toxicol (Copenh) 1983;53:125–9.
8. Phillips S, Ruggier R, Hutchinson SE. Zingiber officinale
(ginger)—an antiemetic for day case surgery. Anaesthesia
1993;48:715–7.
9. Siegers CP, Fruhling A, Younes M. Influence of dithiocarb,
(+)-catechin and silybine on halothane hepatotoxicity in the hypoxic rat model. Acta
Pharmacol Toxicol (Copenh) 1983;53:125–9.
The information presented in Aisle7 is for informational purposes only.
It is based on scientific studies (human, animal, or in vitro), clinical experience,
or traditional usage as cited in each article. The results reported may not necessarily occur
in all individuals. For many of the conditions discussed, treatment with prescription or over
the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist
for any health problem and before using any supplements or before making any changes in
prescribed medications.
