By Michael Rafii, MD, PhD
Director, Memory Disorders Clinic
Associate Medical Core Director
Alzheimer’s Disease Cooperative Study
UC San Diego
I always suggest that when considering whether or not to start a supplement for AD, it is best to consult with your doctor to ensure that there are no medication interactions, or any untoward effects of the supplement given one’s own personal medical history. In addition, it is important to consider whether the data supporting the supplement is anecdotal or supported by results from a randomized, double-blind, placebo controlled trial. This is the best evidence, and the kind of evidence required by the FDA, for any substance to be prescribed for an indication.
With that said, I would like to discuss the recent attention on coconut oil in the treatment of AD. Coconut oil has medium chain triglycerides, which are a good source of energy, in the form of ketone bodies. Ketones are byproducts of the breakdown of fats in the body; small amounts are normally produced. However, ketone levels rise when you fast (which can lead to a state called ketosis), in response to low glucose intake.
Another way to boost ketones in the body is to consume fats called medium-chain triglycerides (MCTs), of which coconut oil is a good source. MCTs are converted in the liver into ketones, which can be used by the brain as fuel; they are a more immediate source of energy than other fats and are not as readily stored as body fat.
Ketones can provide energy to cells without the need for insulin, the hormone the body relies on to get glucose from the blood into cells. The theory behind coconut oil’s potential use in AD is that ketones might provide an alternative energy source for brain cells that have lost their ability to use glucose as a result of Alzheimer’s disease pathology.
However, there are no studies yet to support this.
In addition, it should be kept in mind that coconut oil is quite high in calories — 115 calories per tablespoon. That can add up when doses are 4 to 8 tablespoons or more a day. Large amounts can also cause diarrhea and other gastrointestinal problems.
Unfortunately, there just isn’t enough data to support the idea of using coconut oil to treat AD. It is impossible for us to know whether coconut oil has any beneficial effect in Alzheimer’s disease until a randomized, double blind clinical trial is conducted.
