CONFERENCE The Role of Nutrition in Dementia Prevention and Management March 26 - 27, 2015

[Stavia]

Fascinating discussion.
What about a teeny bit of MCT oil every day? 150 calories (1T) might be enough with fasting exercise etc....what do you guys think?
I wont do coconut oil cos of the saturated fat.

[marthaNH]

I'm worried about MCT oil for same thing. Reports seem to differ about its safety for folks like us -- but I haven't really studied it. I saw something that scared me off. I may try it if and when I can finish tweaking what I'm tweaking.

[Julie G]

FWIW, the effect of MCT oil on E4 carrier's lipids has barely begun to be studied. Richard posted a very small trial examining this (the only one I've ever seen) and surprisingly coconut coconut oil fared better than MCT oil. Coconut oil is comprised of both medium and long chain triglycerides; much more of the former. Perhaps the combo has a slightly beneficial effect? One other consideration, MCT is an engineered/manufactured oil (just like canola.) Organic cold pressed coconut oil is much closer to whole food. THAT may provide an advantage.

For anyone deciding to trial pure MCT; go easy. A full TBS is a whopping dose especially if you also create mild ketones in other ways (i.e. LC, CR, exercise.) Many of us can't tolerate doses that high without negative side effects- way too much energy. FWIW, I've never had negative side effects with pure coconut oil probably because the long chain triglycerides slow down absorption.

I occasionally I use a few 1,000 mg capsules of MCT -a miniscule dose- that has a huge positive effect on me.

[AnneG]

A tale of MCT oil and my 81 year-old husband, who a couple of years ago was told he has mild-to moderate AD: 10 months ago, my husband's functional medicine doctor recommended that he take 2 tablespoons of MCT oil a day, with no advice about diet, although we've always eaten fairly low carb, low saturated fat, and high cruciferous and leafy vegetables, but did include eggs. The majority of his supplements during these 10 months were the same as those indicated by Dr. Bredesen in his study last September, although my husband hasn't been able to tolerate either COQ10 or curcumin. They also included 3600mg/day of red yeast rice as Choleast. 3 months ago, we started specifically aiming for a mild ketogenic diet. He's tall and skinny, so even with his excellent appetite maintaining weight was a daily concern. I eventually found this wonderful community, started reading, and slowly became alarmed about MCT oil and the fact that my husband was not being followed for changes in his lipids. Then I saw here that I could use Requestatest, and 10 days ago ordered an NMR. In September 2013, my husband's LDL-P was 1245, his LDL-C 126, his total cholesterol 202. They are now LDL-P 1565 (up 320 points), LDL-C 160, and total cholesterol 244. Needless to say, we stopped the MCT oil as soon as I saw the report a week ago. 10 months ago my husband was experiencing an episode of mild to moderate dizziness once every 3-6 months, with a specialist saying they could give no reason. Now it is a daily concern. My worry is that his cognitive decline has in some substantial part been vascular (dizziness a characteristic) rather than strictly AD (dizziness not a characteristic), and that the MCTs have pushed him down the road. In addition, he nearly passed out as we started off on our regular morning hike last week -- all ER studies subsequently "normal." That was a first. His energy has dropped off somewhat since quitting the oil, and it's yet unclear whether cessation has affected his long-experienced sense of "grogginess." Yesterday, we saw our doctor, who expressed surprise that MCTs had changed his lipids so markedly. He has recommended Bergamet Pro saying that drugs tend to have a higher incidence of side effects, but I saw Julie's caution about it, and I've subsequently emailed him asking that we follow Dr. Dayspring's recommendation here of using Pravastatin, for which we have yet to secure a prescription. We'd welcome any thoughts you might have.

[circular]

Wow AnneG, thank you for taking the time to post this story. I'm sorry you're having these challenges. Have you tried signing up for Dr. Bredesen's study?

[AnneG]

Yes, I submitted an application to Muses Labs last December and we were turned down. If there is another opportunity to apply, I may do so for myself as I learned last week that I too am 3/4. I've had memory problems since menopause almost 30 years ago, which I always thought came from having ME/CFS, with which memory issues are associated. Complicated stuff, isn't it?

[Julie G]

AnneG, I just typed you a long post...then lost it- ugh Good for you for testing the effect the MCT was having on your husband's lipids. If he carries an E4, I'm not surprised. Coconut and MCT oil is regularly prescribed for AD patients without regard for heart health.

That being said, I'm less convinced than you are that his recent increase in symptoms is due to vascular effects. A good cardio can help you quantify that to be sure... It's much more likely he's experiencing a precipitous drop in cerebral glucose metabolism. Two TBS of MCT daily was providing him with a serious dose of ketone bodies. By abruptly stopping that, his brain's fuel supply has been dramatically decreased.

There are no easy answers, my friend. I like the idea of trialing a low dose of a non-lipohilic statin while concurrently using the MCT. After a month or so, you could repeat lipids to gauge efficacy...

Another unorthodox avenue to explore is ketone esters. They create ketone bodies without affecting lipids. If you have a creative physician to guide you; you could look into that. KetoForce is a brand sold directly to consumers.

FWIW, I also initially had a hard time with curcumin. I had to try several brands before I settled on a bio-available brand called CuraMed. I tolerate it beautifully with noticeably positive effects.

You are an amazing partner. Your husband is lucky to have your loving care. Good energy to you both. Please keep us posted on his progress.

[Tincup]

In your shoes, I'd probably add the MCT oil back in and see what happens. If it helps cognition, I'd keep it. LDL-P issues are more likely to be long term - in my non-medical opinion. The cognitive issues are immediate. Assuming my opinion is correct, I'd trade immediate better cognitive function for a potential longer term heart problem. Unless the circulatory issues are actually in the brain, fixing heart issues is a lot easier than cognitive ones. Mary Newport MD http://www.coconutketones.com/biography.html said some who tried MCT/coconut oil thought there was no benefit till it was stopped. They realized the benefit when cognition dropped after the MCT's were dropped. She also found that MCT's and coconut oil created different serum ketone profiles over time. You'd need to verify from her site, but I think a 60% MCT/40% coconut oil mix provided the most even profile. To keep the brain fueled with ketones, you need to ingest the oil fairly frequently - at least 3x/day.

[AnneG]

Thank you Julie and George. I'm still skittish about adding the MCT back, but we'll see how he feels in the coming days. I would definitely feel better about it were he on a statin, and I appreciate your input there. I was insufficiently clear about the dizziness -- dizziness has been gradually increasing over the last 10 months while taking the MCT. He also had his near-syncope episode before we quit. In the first 3-4 days after stopping the MCT a week ago, I couldn't tell any difference at all, not in energy nor in cognition, and it's only as time passes that I wonder if his energy hasn't dropped overall, that he doesn't go up the hills as briskly. Hard to tell, as his energy has always varied. His father died of a heart attack at age 43, and his mother had a major stroke at age 70, so in comparison he's been fortunate. You may see why, with the gradual increase in dizziness, coincident with taking MCT, and with his parental history (no siblings) that my mind turns to vascular dementia as a component of what's happening. The ketone esters sound interesting, and I appreciate both your responses. The circa 20 Alzheimer Association support group members here have shown no interest in the Bredesen protocol, perhaps too overwhelmed with daily management, or simply resigned. That may happen with us in time, but despite the odds we're not giving up quite yet.

[pgf54]

Julie said

[quoteGeorge, fascinating to hear that niacin helps promote ketosis. That's new to me. Did either you or Ski catch that Dr. Dayspring was OPPOSED to niacin for our group? Does anyone understand his reasoning why? I haven't taken the time to look into any of this; other than note the discrepancy between his advice and Gundry's.
][/quote]

Julie he never actually said dont use it, but rather ...... it has too many metabolic side effects and should be used as a fourth line drug only , also worsening sterol absorption....

see below by Dr Lipid

Due to recent major clinical trial evidence, never use niacin except as a 4th line drug - way, way, way too many metabolic side effects. Unlike ezetimibe (Zetia) niacin worsens the absorption of sterols

Whilst other medications are aimed at lowering ldl and tc i think Niacin is the only one proven to increase hdl in addition