Alzheimers Disease – Therapeutic management with Exogenous Ketones, MCT Oils and Fasting
Alzheimers Disease is the most common type of dementia, accounting for60 to 80 percent of cases of dementia in the United States. In 2013, 6.8 million people in the U.S. had been diagnosed with dementia. Of these, 5 million had a diagnosis of Alzheimer’s. By 2050, the numbers are expected to double.
What causes Alzheimers Disease ?
Scientists at the Mayo Clinic believe that for most people, Alzheimer’s disease is caused by a combination of genetic, lifestyle and environmental factors that affect the brain over time.
Less than 5 percent of the time, Alzheimer’s is caused by specific genetic changes (APOE4) that virtually guarantee a person will develop the disease.
With there being no pharmaceutical ‘cure’ available to treat Alzheimer’s, the scientific community cannot agree on what is the real cause.
The Mayo Clinic… go on to say
Although the causes of Alzheimer’s aren’t yet fully understood, its effect on the brain is clear.
Alzheimer’s disease damages and kills brain cells
A brain affected by Alzheimer’s disease has many fewer cells and many fewer connections among surviving cells than does a healthy brain.
As more and more brain cells die, Alzheimer’s leads to significant brain shrinkage. When doctors examine Alzheimer’s brain tissue under the microscope, they see two types of abnormalities that are considered hallmarks of the disease: Plaques and Tangles.
The question is …
Are Plaques and Tangles what is causing the disease or
Are they in place because of other processes that are occurring?
- Plaques are clumps of a protein called beta-amyloid that may damage and destroy brain cells in several ways, including interfering with cell-to-cell communication. Although the ultimate cause of brain-cell death in Alzheimer’s isn’t known, the collection of beta-amyloid on the outside of brain cells is a prime suspect.
- Tangles. Brain cells depend on an internal support and transport system to carry nutrients and other essential materials throughout their long extensions. This system requires the normal structure and functioning of a protein called tau.
Pre-Clinical Diagnosis Of Alzheimers Disease
Some evidence indicates the neuropathological changes of AD begin years before the appearance of any neuropsychiatric symptoms. Cognitively normal elderly individuals, without complaints or evidence of cognitive decline, may have neuropathological changes in the brain consistent with the diagnosis of AD, indicating that there is a preclinical stage of the disease. Some researches have said that the first signs can be 20 years before a clinical diagnosis is made.
Ricardo Nintrinin in his article Preclinical diagnosis of Alzheimer’s disease: Prevention or prediction? states the diagnosis of Alzheimer’s disease for cases with dementia may be too late to allow effective treatment.
Do you want to know if you have an increased risk of Alzheimers if there is no cure?
With that in mind the focus of this article is what you can do to protect yourself from Alzheimers Disease and what you can do if you or a loved one is either showing signs of Mild cognitive impairment or has been diagnosed with Alzheimers from a NUTRITIONAL point of view. There are lots of things to do in terms of activity to keep the mind and body active that will help.
You may be genetically pre-disposed to alzheimers but how you love your life can have a massive effect whether the genes are actually activated.
Your genes load the gun but your ‘environment’ pulls the trigger.
Before we give up hope though there is another theory of Alzheimers Disease development that is starting to attract research dollars and the first implications of this stem back to work carried out over 50 years ago, work that would not be given ethical approval now.
George Cahill 50 years ago in his paper from 1967 Brain Metabolism during Fasting” discovered that…
‘Patients undergoing 5-6 wk of starvation demonstrated that β-hydroxybutyrate (BHB) and acetoacetate replaced glucose as the predominant fuel for brain metabolism’.
In a review article that documents the discoveries through Cahills life published in 2006 it states…
Due to its use by brain, D-β-hydroxybutyric (BHB) acid not only has permitted man to survive prolonged starvation, but also may have therapeutic potential owing to its greater efficiency in providing cellular energy in ischemic states such as stroke, myocardial insufficiency, neonatal stress, genetic mitochondrial problems, and physical fatigue.
More about ketones later let’s look at glucose and the role of Insulin.
The role of Glucose and Insulin Resistance in Alzheimer’s
Is TYPE 3 DIABETES Really a thing?
It’s no secret that the rate of type 2 diabetes is increasing in the general population, it’s also been documented that T2 diabetics have an increased risk of developing Alzheimers Disease. This is why there is increased concern about finding ways to manage and ‘reverse’/cure Alzheimers Disease as it’s going to be a health care crisis.
Dr Jason Fung discusses the term Type 3 Diabetes in his book the Diabetes Code as an alternative name for AD that implicates the role of insulin resistance in the death of brain cells. In other words, the cells in the brain lose the ability to take up and metabolise glucose to fuel them, without a fuel source they perform poorly and start to die.
What if there was another fuel source
that the brain could run on
Could the alternative fuel source help restore function or slow the progression of Alzheimer’s disease, the answer appears to be a resounding yes.
Ketones have been linked with fasting as this is usually the switch that is flicked that initiates the body to start producing them, when we fast, our carbohydrate stores are depleted and the body starts breaking down fat and producing ketones.
Mark Mattson is a professor of neuroscience in the Johns Hopkins School of Medicine and also serves as chief of the Laboratory of Neurosciences at the National Institute on Aging and is a proponent of FASTING. In the review article ‘Are There Any Proven Benefits to Fasting the author says.
‘You probably know that too many calories aren’t good for your waistline, but as it turns out, they aren’t good for your brain either.
According to research conducted by neuroscientist Mark Mattson and others, cutting your energy intake by fasting several days a week might help your brain ward off neurodegenerative diseases like Alzheimer’s and Parkinson’s while at the same time improving memory and mood.
Mattson’s studies have built on decades-old research establishing a connection between caloric intake and brain function. In laboratory experiments, Mattson and his colleagues have found that intermittent fasting—limiting caloric intake at least two days a week—can help improve neural connections in the hippocampus while protecting neurons against the accumulation of amyloid plaques, a protein prevalent in people with Alzheimer’s disease. “Fasting is a challenge to your brain, and we think that your brain reacts by activating adaptive stress responses that help it cope with disease,” says Mattson. “From an evolutionary perspective, it makes sense your brain should be functioning well when you haven’t been able to obtain food for a while.”
Other anecdotal evidence from World War II prisoners in Japanese Prisoner Camp in the film Unbroken described the amazing clarity of thought that often accompanies starvation.
Mark Mattson’s Ted Talk
It’s not only Alzheimers disease that has decreased glucose uptake as one of the factors involved, other diseases include.
Diseases With Decreased Glucose Uptake into Brain/Nerve Cells
- Parkinson’s disease
- Multiple sclerosis
- Huntington’s chorea
- ALS/Lou Gehrig’s disease
- Duchene muscular dystrophy
- Some forms of autism
- Down’s syndrome – develop Alzheimer’s in middle age
- Traumatic and acute hypoxic brain injury
- Type I and Type II diabetes
- Certain rare enzyme deficiencies
When we look back at the history of medicine many times there have been defining trigger points, we think of Flemings mould growing accidentally on bacterial cultures for the discovery of penicillin
A key person in the study and treatment for Alzheimers Disease will have Dr Mary Newport playing a major role in the history of the disease.
Dr Mary Newport Story
Dr. Newport’s husband Steven was diagnosed with early onset Alzheimer’s aged 58, a qualified neo-natologist she explored routine treatment options, but when his symptoms became so severe she looked to enrol Steve in clinical trials.
One of the tests to assess the level of Alzheimers progression is to draw a clock.
Below is Steve’s attempt before starting coconut oil. At this stage he was not eligible to participate in the initial trial his score was too low.
Exasperated Dr Newport returned home and found a press release about a new compound AC-1202 that was pursuing FDA approval as medical food, AC1202 proved to be coconut oil, she calculated that 35g that would provide 20 grams of MCTs.
The following day Steve was being assessed for inclusion into another trial, ‘amazingly’ he scored 14 day before coconut oil and 18 four hours after first dose on the MMSE test battery of tests just a day after.
Delighted they decided to keep on using the coconut oil as well as the drug in the trial, this was lucky as it turned out that Steve was on the placebo arm of the trial.
Steve reported the “light switch came back on.”
During the first few days more alert, less confused, personality and his sense of humour returned.
- Gait normalized and could run
- Visual disturbance resolved and was able to read again
- Resumed yard and housework
- Initiated conversation and made sense
- More animation in face
- Personality and sense of humour returned
- Recognized family members
- No longer looked “lost”
- Facial tremor resolved
- Intention tremor occasional
Dr Newport started talking about this and was invited to many conferences to present her findings many people in the scientific community viewed her as the ‘lone nut’ however the testimonials and anecdotal reports starting stacking up
Dr Mary Newport has presented the information at a Ted Talk in 2013 and also wrote a book telling the story and providing advice.
As there was and is little that can be done for Alzheimers patients many who found out about her work tried out coconut oil as a therapy, you can find out more about her at her website
or grab a copy of her book…
Alzheimers disease…What if there was a cure?
What is special about Coconut Oil
Coconut oil is a saturated fat that is solid at room temperature. For many years saturated fat has been vilified, however most progressive people now know that this information was based on ’flawed science’. I conducted an interview with UK Cardiologist Dr Aseem Malhotra who is an advocate of eating healthy fats and states that there is no link between dietary cholesterol and heart disease, so we won’t discuss that claim here.
Saturated Fat is GOOD.
The 2 components of Coconut Oil that are of most interest are the Medium Chain Triglycerides (diagram from Wikipedia)
C8 Caprillyc Acid
C 10 Capric Acid
C8 and C10 make up 15% of coconut oil, C12 is also classed as an MCT but it does not get converted into ketones in the liver. The name C8 is because of the chemical structure (8 Black carbon atoms in the diagram below)
What is special about how the MCT’s C8 and C10 and how they work?
Because of the size of C8 and C10 they are rapidly transported directly to the liver, they do not go through ‘normal’ digestion and emulsification through the gut. In the Liver they are rapidly oxidised and turned into fuel for use by the muscles, organ and brain. MCT’s are not stored as fat which has to be a bonus.
The fuel that MCT’s are RAPIDLY
converted into is KETONES
Ketones are a more efficient fuel than glucose when used by the brain and body tissues, this means that less oxygen is required in the production of cellular energy (ATP).
Side effects of MCT’s
MCT’s need to be consumed in moderation, too large a dose can lead to gastric distress and diarrhoea, so when starting out using MCT’s it is best to start off slow to test your tolerance rather than be ‘gung ho’ and end up with ‘disaster pants’. With the recent commercial availability of exogenous ketones, it is less of an issue as more people will use exogenous ketones to raise their ketone levels higher.
There are 3 Ketones that the liver produces
Beta Hydroxy Butyrate
It is BHB that is the most important because it is the only one that is used directly as a source of fuel by the body.
Dr Stephen Cunnane is a Canadian based researcher that has developed a positron emission tomography (PET) scan, it’s an imaging test widely used for detecting the presence of cancer tumours. Glucose is labelled and given to the patient to drink, tumour cells use more glucose than surrounding tissues so the tumours show up on the PET scan.
He published an article where MCT’s were used to increase brain ketone levels Can Ketones Help Rescue Brain Fuel Supply in Later Life? Implications for Cognitive Health during Aging and the Treatment of Alzheimer’s Disease (MCT’s were used instead of exogenous ketones as ketones were not commercially available at that time).
The next phase of work will be to undertake experiments to demonstrate how Exogenous ketones may assist with brain activity in the alzheimers brain, as there are no side effects many people with neurological conditions are drinking ketones and feeling significant beenfits.
This lecture is a bit sciency… worth a watch/listen though.
There’s a link to a PDF to the slides of a Presentation Dr Cunnane delivered in Aug 2018 in Paris here. The title of the presentation was
Brain metabolic rescue with ketones:
Implications for cognitive function during aging
Exogenous Ketones enter the mix
So far we have discussed 3 methods of introducing ketones into the body.
1 Prolonged Fasting (> 36 hours)
2 Ketogenic Diet (Very Low Carb Diet)
3 Supplementing with MCT Oils (Coconut Oil, MCT Oil, MCT Powder)
In 2015 Exogenous Ketone salts became commercially available, this has accelerated the interest in this therapeutic area as there are increasing amounts of people with a wide range of Neurological conditions using ketones and sharing many positive stories.
Ketones have no side effects compared to the pharmaceutical treatments available for people suffering with Alzheimers Disease. Ketones are not available on prescription so mainstream Dr’s won’t prescribe them and as there is no ‘proven’ clinical research that indicates conclusively ketones or MCT’s actually work.
Conclusive research may take 10, 20 even 50 years to emerge, most people with a diagnosis don’t have the luxury of that amount of time. What we do know is this..
Ketones are an alternative fuel source for the brain
We know that when carbohydrates are limited the brain can function on ketones in the form of BHB and acetoacetate. Ketones can provide between 70% -80% of the energy requirements of the brain that’s enough of an indicator for most people to try ketones. Many neurological conditions are caused due to a lack of glucose avaialability to the brain, so being able to supple
Using Ketones as a therapy for ALZHEIMER’s Disease
We have to use the usual disclaimer that you should talk to your medical care practitioner before doing anything different.
Don’t be surprised if your Dr has not heard of Ketones or MCT’s even. Having been in this situation and had these conversations they will stay there is no conclusive proof etc, some will say ‘there is no harm in giving them a go’, as a patient what you want them to say or agree to is.
I’m planning on adding Ketones or MCT’s into my diet I just wanted to check that they are not going to interfere with my current medications as long as they agree to that then go for it.
Some patients will have the attitude….unless my Dr says without hesitation that it’s woirthwhile I’m not going to do it, every patient or carer has that right.
no prescription needed
No contra indicati
STRATEGIES to Protect Against Cognitive Decline and Alzheimers Disease
Add MCT’s where possible
As a salad in dressings
Intermittent Fast Daily
Use Coconut Oil as a fat for cooking
What I would do if I or a close family member was diagnosed with Alzheimers Disease.
Ideal Prolonged Fast 7 to 21 Days
Start Drinking Exogenous Ketones
Use MCT Oil and Powder
High Fat Low Carb Diet / Keto
Intermittent Fasting (Skip Breakfast or Evening Meal)