Nitrous oxide: Nitrous oxide inactivates the cobalamin form of vitamin B12 by oxidation
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Kasliwal RR, Bansal M, Gupta R, et al
First, every puncture introduces a tiny amount of air, microbes, and surface contamination from the rubber stopper
This catecholamine surge increases alertness, suppresses appetite through stimulation of the hypothalamus, and elevates heart rate and blood pressure as secondary effects
For a 100kg individual, that translates to 22.5kg lost versus 2.4kg