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It requires selenium as a cofactor and contains a selenocysteine amino acid residue in the active site of each monomer that participates in the actual mechanism of the enzyme

Nitrous oxide, a commonly used anesthetic, oxidizes and inactivates vitamin B 12 , thus inhibiting both of the vitamin B 12 -dependent enzymes, and can produce many of the clinical features of vitamin B 12 deficiency, such as megaloblastic anemia and neuropathy

Medically reviewed by Alan Lucks | MD , Alan Lucks MDPC Private Practice - New York on December 17th, 2025