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Nitrous oxide can change how your body processes vitamin B12

It also reduces hepatic fat accumulation, which independently worsens insulin sensitivity a relevant secondary benefit given that non-alcoholic fatty liver disease is significantly more prevalent in women with PCOS

Many energy drinks, protein bars, and meal replacement shakes contain high doses of B12 (sometimes 2,000 to 5,000% of the Daily Value per serving)

This strong start helps quickly fill up B12 stores and ease symptoms

Whether this is three per year or a course of three or three in a lifetime is not at all clear and left to individual clinicians judgement and experience