Friday, February 5, 2010


The brain uses mainly glucose for its fuel, but works far better when fed ketones. Ketogenic diets have been used in medicine since 1924 initially to prevent seizures, and recently to treat degenerative neurologic diseases such as Multiple Sclerosis, ALS, Strokes, and Dementia. Thirty years ago, Medium Chain Triglycerides were found to be metabolized into ketones by the liver. No longer did one have to eat the very stringent ketogenic diet, which was 70% fat 25% protein and only 5% carbs. A person could ingest a given amount of MCTs and produce their own ketones. The ketones do supply cerebral energy metabolism (provide alternative fuel), protect cerebral function, suppress cerebral edema and reduce the extent of cerebral infarction in brain injury.

The presence of ketone in circulation, even at low levels, increases cerebral blood flow by as much as 40%. Ketones also prevent diseases involving free radical damage such as occurs in coronary reperfusion, diabetic small blood vessel disease, inflammatory bowel disease, and pancreatitis. MCTs do not behave like the more common long chain fats. Because of their shorter structure, they are metabolized directly in the liver into ketones, rather than going into storage in fat cells. They are used as an alternative source of energy when glucose stores are exhausted.
Two years ago a drug company applied for and received a patent to bring this out as a prescriptive functional medical food. The Acerra Company brought out Axona® to treat Alzheimers disease.

The neurons work 30% better using ketones rather than the usual glucose. It is like putting high-test gas in an old high compression engine, it runs much better without the "pings". In a review article on Alzheimers in this week New England Journal of Medicine, the metabolism of the brain cell was detailed as "Type 3 Diabetes" in which the glucose receptors were blunted and could not transport the sugar into the brain cell to produce ATP, for cellular energy. Not only could the cell take in the ketone, but more efficiently made ATP (energy) from it. MCTs have been medically used in the past for feeding premature infants, recovering surgical patients and for malnutrition. Off label it has been used for liver support, antimicrobial therapy, enhancing the immune system and to increase athletic performance. Contrary to popular opinion these tropical saturate fatty acids inhibit atherosclerosis instead of producing it. They also decrease appetite and help people lose weight much like the ketoses of Atkins diet. Also there is not a tendency for diabetics to have problems of "diabetic coma", keto-acidosis with MCTs.

Coconut oil, which is a misnomer, in that it is solid at room temperature contains over 60% MCTs. Not only is this a healthy cooking oil in that it has a high smoke point, but it has a pleasant taste. It can be used in baking, oatmeal, spreads and salad dressings. Costing $8 for 14 oz for organic and $5 for the regular it is almost a best buy for this cooking oil that doesn't smoke unless the temperature exceeds 280 degrees. Butter smokes/burns at a much lower temperature producing free radicals that rust our body. Research at NIH by Richard Veech, MD. indicates that ketones which are made from coconut oil and MCTs work better since a higher dose is more easily achieved. However, they are not yet available.
To treat Alzheimers today and give that high of a dose of MCTs (20 grams per meal), you need to combine 16 oz. of MCT oil with 12 oz. of coconut oil and use 7 teaspoons at a time. It should be stored at room temperature, and increased gradually from 2 teaspoon per meal up to 7 teaspoons. Given too much at a time initially will cause abdominal cramps and diarrhea.

Although costing twice as much, one can use Axona® which may be paid by some insurances and for sure by flex plans. It has a pleasant coconut taste when used as a cold drink with a meal. There are no omegas 3s in this mixture, therefore I recommend some fish or fish oil during the day because this compliments the MCTs for improved brain function. Several varieties of Alzheimers and the APOE negative types respond better to this therapy. Since the brain starts developing defects in glucose metabolism decades before the development of the disease, those who have a strong family history, or memory problems earlier in life might consider doing this treatment now!

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