One morning last month, Vrajlal Parmar got up, washed and dressed himself, and at 10am boarded the council minibus to a nearby leisure centre.
In the evening, the 67-year-old former production line worker from London took the bus home.
Nothing remarkable there — except that nearly a year earlier Mr Parmar had been diagnosed as being in the late stages of
Alzheimer’s.
Professor Kieran Clarke believes coconut oil and similar compounds might help by boosting the brain's energy supply
He’d
been given the standard pencil and paper test — called the Mini Mental
State Examination — that doctors use to diagnose Alzheimer’s and
measure how it’s progressing.
A healthy person would score 30.
The
letter Mr Parmar’s family got back from the Cognitive Disorders Clinic
at University College London stated that he was ‘too severely affected
to score anything at all’. Any drug treatment would be ineffective.
‘Dad
was so far gone he couldn’t do anything for himself,’ says his son Kal
Parmar, a filmmaker who together with Vrajlal’s wife, Taramati, looks
after
him at their home in London.
‘He
couldn’t wash himself, dress or go to the toilet without help. He had
to be watched all the time — the idea of him catching a bus, even a
special bus to a dementia centre, was out of the question.
'Often
at night he would become hyperactive. We were regularly woken up
because Dad was pulling pots and pans off shelves in the kitchen or
emptying the cupboards
What has made the difference, according to Kal, is a teaspoon of coconut oil twice a day mixed with his food, which Mr Parmar has been taking since July.
The
idea that a common vegetable oil — made from coconut meat and which you
can buy in supermarkets — could make a difference seems ludicrous, yet
in the U.S. there have been hundreds of similar anecdotes of dramatic
improvements.
Kal
Parmar first heard about coconut oil via a video on YouTube — it was
about a doctor in Florida whose husband’s Alzheimer’s had improved
amazingly with coconut oil.
Kal
says he would probably have dismissed this as one more bit of internet
hype if there hadn’t been a favourable comment about the oil from Kieran
Clarke, professor of physiological biochemistry at Oxford University
and head of the Cardiac Metabolism Research Group.
‘That made me think there must be something in it,’ he says. ‘So I called her up.’
SWITCHING THE BRAIN BACK ON
Professor
Clarke, an expert on the way the body makes and uses energy, believes
coconut oil and similar compounds might help by boosting the brain’s
energy supply.
Most
of the time our brains rely on glucose from carbohydrates, but if that
isn’t available — because we haven’t eaten anything for a while or
because we’re eating almost no carbohydrates — then our brain cells can
switch to using the energy from our fat stores.
This energy comes in the form of small molecules called ketones.
As
Professor Clarke explains: ‘Coconut oil contains a lot of a particular
sort of fat that our bodies can use to make more of the ketone “brain
food”.
'It’s known as MCT (medium chain triglycerides) and it’s not found in the fats most of us eat.’
One of the new ideas about Alzheimer's is that it is diabetes of the brain
There
is now a food supplement — available only in the U.S. — which largely
consists of MCT oil, and which might be a healthier source than coconut
oil, as we shall explain later.
But
why should ketones help people with Alzheimer’s? One of the new ideas
about the disease is that it is diabetes of the brain.
Just
as diabetics have problems with glucose and insulin, so Alzheimer’s
sufferers can’t get enough glucose into brain cells to give them the
energy they need to lay down new memories and think clearly.
If you have diabetes, you are three times more likely to develop Alzheimer’s.
As the New Scientist magazine
revealed last September, there is evidence that the brains of
Alzheimer’s sufferers become resistant to insulin. This is disastrous
because insulin regulates the brain chemicals that are crucial for
memory.
When
one U.S. researcher blocked insulin supplies in the brains of
laboratory animals, they developed all the plaques and tangles that are a
classic mark of Alzheimer’s.
CLEARING THE MEMORY FOG
The
doctor in Florida in the YouTube video is Dr Mary Newport, a
paediatrician who began using coconut oil to treat her husband, Harry,
four years ago.
He
had been suffering from early onset Alzheimer’s for eight years. She
claims the results after he started taking the oil were remarkable.
‘He began to get his short-term memory back,’ says Dr Newport.
‘His
depression lifted, he became more like his old self. The problem he’d
had with walking improved. An MRI scan showed his brain had stopped
shrinking.’
So what prompted her to use the oil in
the first place?
‘Some
years ago, I came across a small study suggesting that Alzheimer’s
patients had a problem using glucose in the brain and that ketones could
be an alternative source of fuel.
The
study suggested a patented drink that boosted ketone levels improved
memory and thinking skills in patients with mild to moderate
Alzheimer’s.’
A follow-up paper on this was published in the journal BMC Neuroscience in 2008. Dr Newport
found out the patented drink contained MCT oil extracted from coconuts.
‘The patented product still wasn’t on the market, so I thought it would be worth trying coconut oil itself,’ she says.
Her
accounts of Harry’s improvement, illustrated with videos on YouTube,
prompted hundreds of people to share their positive experience of the
oil (traditionally used in the tropics for everything from cooking to
protecting wood).
One carer of a
man with dementia reported: ‘His ability to speak and recall words is better, but not his ability to make good decisions.’
The
carer of another man who’d had dementia for ten years said: ‘His
reaction to the oil was very gradual, but his mood is so much better.’
Dr
Newport recently added MCT oil to her husband’s regime because the
combination gives a more steady supply of ketones, she says.
While MCT supplies more ketones, most
are gone from the body in three hours. Coconut oil provides fewer ketones, but they last up to eight hours.
Let us be clear, coconut oil doesn’t appear to be a cure. Furthermore, none of these accounts prove anything scientifically.
They
are just anecdotes and until there is a proper controlled trial against
a placebo, few medical professionals will feel the case for coconut oil
has been made.
THE TROUBLE WITH DEMENTIA DRUGS
These stories, however, do suggest pure coconut oil — and the MCT oil that can be extracted from it — is worth investigating.
Currently,
the only type of drug available for Alzheimer’s patients, known as a
cholinesterase inhibitor, works by boosting the amount of a brain
chemical they are lacking.
It slows memory decline in about a third of patients for between six months and a year.
Currently, the
only type of drug available for Alzheimer's patients works by boosting
the amount of a brain chemical they are lacking
Last
year, the NHS spent more than £70 million on the most widely used
brand, Aricept. Its potential side-effects include nausea, diarrhoea and
slow heart rhythms, which can lead to
fainting.
Hundreds
of millions of pounds have been spent trying to develop drugs to clear
the plaques of damaged protein in the brain that are the classic sign of
Alzheimer’s, but all have failed to get a licence.
So could tackling the energy supply to the brain be another option?
One expert who thinks it’s
worth investigating is Professor Rudy Tanzi, director of the Genetics
and Ageing Research Unit at Massachusetts General Hospital and
professor of neurology at Harvard Medical School.
In a recent article for the Cure Alzheimer’s Fund, he explained why coconut oil might work.
‘Virgin
coconut oil contains the fats that can be converted into ketone bodies,
which can serve as an alternate energy source for the brain.
'The ketone bodies could potentially provide energy to the glucose-deprived brains of Alzheimer’s patients.’
ARE THERE ANY DRAWBACKS?
He stressed that, as yet, there was no evidence —– and warned that coconut oil itself has its own down-side.
‘The
fats (found in coconut oil) can be potentially harmful to the heart, so
it would be wise to regularly monitor cholesterol and triglyceride
levels if you are taking it.’
Anyone
interested in boosting their ketone supply in this way has three options — at least in the U.S.
As
well as coconut oil there is MCT oil, which can be bought over the
counter and has been used by some athletes for years (ketones also power
muscles), and the patented food supplement drink that triggered Dr
Newport’s original experiment.
The
more expensive patented supplement is called Axona, and has a licence
from the U.S. Food and Drug Administration for use as a medical food for
patients with mild to moderate Alzheimer’s who are taking a drug such
as Aricept. It’s not available in the UK.
‘The
attraction of Axona for doctors is that it provides a well-studied,
pure and concentrated dose of the ketone-producing properties found in
coconut oil, while eliminating the multitude of triglyceride-elevating
components it can contain,’ says Dr Richard S. Isaacson, associate
professor of clinical neurology at the University of Miami Miller School
of Medicine.
Food
company Nestle recently bought a stake in the manufacturer, Acera, and
is planning the sort of large, expensive clinical trial that, if
successful, could get Axona a drug licence.
‘This
would encourage more doctors to use it and insurance companies would
pay for it — at the moment most don’t,’ says James Galvin, a professor
of neurology and psychiatry at New York University.
Professor
Galvin is the author of an article in the June edition of
Neurodegenerative Disease Management that recommends taking Axona in
combination with the Aricept-type drugs. (He, like Dr Isaacson, is a
consultant for the manufacturer Acera).
‘It’s a rational approach that may result in
maximum preservation of cognitive function,’ he says.
‘The
ketone-boosting approach to Alzheimer’s seems to work in about half the
patients. I’d recommend coconut oil as well if there was some good
trial evidence for it.’
This
evidence could soon be coming from the first coconut trial now being
set up by Dave Morgan, professor of molecular pharmacology and
physiology and head of the USF Health Byrd Alzheimer’s Institute in
Florida.
‘I
was very impressed by the anecdotal evidence gathered by Dr Newport,’
he says. ‘Patients want to know if it works and who is going to benefit,
but our physicians have no scientific basis to advise them.
‘It
will be a placebo-controlled trial on patients with mild to moderate
Alzheimer’s. I don’t expect it to slow the progression of the disease,
but it does seem to improve some of the symptoms.’
WHAT ABOUT SCIENTIFIC PROOF?
Here in
the UK most experts are, perhaps understandably, sceptical of the coconut oil claims.
‘There
is a huge placebo response in Alzheimer’s,’ warns Professor Robert
Howard, professor of old age psychiatry and psychopathology at the South
London and Maudsley NHS Foundation Trust.
‘It’s a remitting and relapsing disease, so there are often times when things seem to be getting better.
‘It
is important to protect patients from false hope
and not expose them to quackery. I’m not sure there is a problem with
glucose getting into brain cells but if I were to follow that line I
think an existing diabetes drug like metformin would be a better bet
than coconut oil.
‘All
sorts of things can help patients feel better — music, massage, having a
kitten. If people believe coconut oil improves symptoms it probably
won’t do any harm.’
However, in some people large amounts can cause diarrhoea.
The
charity Alzheimer’s UK, which has just had its funding boosted by the
Government, says while it ‘wouldn’t discourage anyone from taking
it . . . there is not enough evidence to suggest that coconut oil or
ketones have benefits for people with Alzheimer’s, so we would not
consider funding research into it’.
However,
David Smith, professor of pharmacology at the Physiology Institute at
Oxford University and director of Optima (Oxford Project to Investigate
Memory and Ageing), insists this is a mistake.
‘We
have no way of knowing if coconut oil
is truly effective, but given the scale of the Alzheimer’s crisis
facing us, and that there’s a rational mechanism for why it could work,
it’s obviously crying out for a proper trial.’
And people are hungry for information on anything that might help with Alzheimer’s.
When Kal Parmar talked to a local newspaper about his father’s improvement, he received more than 150 emails asking for help.
So
far about a dozen people in the UK
have come back to him saying they had someone in their family on
coconut oil, in some cases with impressive results following Dr
Newport’s reports.
Recently, following Dr Newport’s example, Kal has added a teaspoon of MCT oil twice a day to his father’s regimen.
Mr Parmar says: ‘Before we
started him on coconut oil, Dad’s speech was gone and he couldn’t
remember his name or his date of birth.
'Now you can have a simple
conversation with him. We go for walks.
'He even remembers his national insurance number. We’re so happy.
No comments:
Post a Comment