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A Case Study by Dr. Mary Newport - page 2 / 4

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and ALS9 have a similar defect in utilizing glucose but in different areas of the brain or spinal cord.

MCT oil is digested differently by the body than other fats. Instead of storing all MCTs as fat, the liver converts them directly to ketone bodies, which are then available for use as energy. Oral and intravenous administration of MCT oil produc- es hyperketonemia, 10 or circulating ketone bodies, which are then available to the brain for energy, in the absence of glucose19 and even in the presence of glucose.22 In addition, hyperketonemia results in a substantial (39%) increase in cerebral blood flow,

and appears to reduce cognitive dysfunction as- sociated with systemic hypoglycemia in normal humans. 18 19

About 2 months ago, we took Steve to the Johnny B. Byrd, Jr. Alzheimer’s Institute at Uni- versity of South Florida (USF) in Tampa, Florida for an annual evaluation and screening for a vac- cine study (Elan.) He was fasting for blood work and had an MMSE of 12, much too low to qualify for the vaccine study – a minimum score of 16 was required. We were very disappointed, but were ad- vised that we could come back another time to try again, since he met all of the other criteria.

We made an appointment in mid-May 2008 in St. Petersburg, Florida to screen Steve for an Eli Lilly gamma-secretase inhibitor and made another appointment for Steve to be screened for entry into the Elan study at USF the following day. The evening before the first screening in St. Pete, I re- searched the two drugs to help us decide which drug to choose, should he qualify for both studies. I came across another drug, Ketasyn, or AC-1202, that was also recruiting healthy older people to test the tolerability of three different formulations. Investigating further, I learned that this treatment brought about significant improvement over a 90- day period in about half of the subjects who had a certain genetic profile (APOE2 or APOE3.) The APOE4 group remained about the same, whereas the controls (people taking the placebo) contin- ued to show decline. The results were even more impressive for people who were already taking certain Alzheimer’s medications. In a pilot study, some people improved on memory testing with the very first dose. Upon doing an internet search for Ketasyn, I found a January 2008 patent application (see www.freepatentsonline.com ,)10 a continuation of a 2000 application, 75 pages long, with a well- written and thorough description of the science of Alzheimer’s disease and description of the “inven- tion,” including these study results and numerous potential formulations in combination with other substances that may enhance its effect.

I learned that the promising “ingredient” in Ketasyn is simply MCT oil, and that a dose of 20 grams (about 20 ml or 4 teaspoons) was used to produce these results. The MCT oil that these re- searchers used was obtained from Stepan Compa- ny and consists of primarily 6 and 8 carbon chains, however they state that MCT of any combination of medium chains (6 to 12 carbon chains are medium chain) would also be effective. Just once in this ap- plication, the author mentions that MCT oil is de- rived from coconut or palm oil (this is incorrect, the author should have stated palm kernel oil.)

I didn’t know at that point that I could easily purchase MCT oil online, so I researched coconut oil and found out that coconut oil is about 60% me-

dium chain fatty acids (MCFA), contains no cho- lesterol and also contains omega-6 fatty acids and some other short and long chain fatty acids of up to 18 carbon chains. 11 Coconut oil can be found in many health food stores and even some grocery stores. Wal-Mart sells a non-hydrogenated (no transfat) brand of coconut oil in a one-liter size (almost 32 ounce containers) for about $7 in our area of Florida. It can be purchased in quantities as small as a pint and up to five gallons online. It is important to use coconut oil that is non-hydroge- nated and contains no transfat. There is a widely held misconception that coconut oil is the “artery clogging oil,” a term coined in the mid-1900’s by the president of Proctor and Gamble, the manufac- turer of Crisco and other hydrogenated vegetable oils. The early studies in animals used hydrogenat- ed coconut oil, which we now know produces the notorious trans-fats, and the essential fatty acids were excluded from the diet. 13

The largest producer of coconut oil is the Phil- ippines, where coconut and its oil are food staples, and it is also produced in India, Thailand and other parts of Southeast Asia, the Caribbean islands and even in south Florida. The Philippines has one of the lowest incidences of cardiovascular disease in the world. Studies have shown that total cholester- ol to HDL ratio improves with non-hydrogenated coconut oil.14, 15, 16, 17 The people in this part of the world also eat fish regularly, providing them with omega-3 fatty acids, which probably contributes as well to the lack of cardiovascular disease. My nurse friends from the Philippines tell me that many of their relatives back home cook everything in coco- nut oil and have coconut in one form or another at nearly every meal.

I have also learned that after coconut and palm kernel oil, the food that medium chain triglycerides are most concentrated in is human breast milk. 12 It is also found in smaller concentrations in goat and cow’s milk, as well as the butters from these milks. In fact, we used to add MCT oil 20-25 years ago to premature formulas to add calories, and MCT, co- conut and palm oils are currently added to prema- ture and full term infant formulas, along with ARA and DHA to mimic breast milk.

Back to Steve, it was too late to find coconut oil before the first screening. On the way, I remind- ed him repeatedly that we were in St. Petersburg, in Pinellas County. On the MMSE, he remembered the city but not the county, and he couldn’t remem- ber the season, the month or day of the week, much less the date, even though he had to initial and date numerous pages of consent forms be- fore the MMSE. He had to be reminded on every single page where to initial and what the date was and even how to write out the date. He scored a 14, too low for entry into the study. Dr. Margarita Nunez spent considerable time with us and asked Steve to draw a clock (see clock #1), which she said was a specific test for Alzheimer’s. She took me aside and told me that his “clock” indicated he was leaning more towards severe than moderate AD, a devastating, but not surprising revelation to me, considering that I am his wife of 36 years and now his caretaker.

Thinking, what have we got to lose, we stopped at a health food store on the way home and picked up a quart of 100% “virgin” coconut oil. I calculated that in order to provide 20 gm of MCT, he would

need to take 35 grams or just over two table- spoons (about 35 ml or 7 level teaspoons) of coconut oil. The following morning, around 9 A.M., I made oatmeal for breakfast and stirred two tablespoons, plus more for “good luck,” into his portion. I had some as well, since I cannot expect him to eat something that I won’t eat.

On the way to the 1:00 P.M. screening, I tried to prepare Steve by asking him the season, the month, the day of the week, re- minding him that we were going to Tampa, in Hillsborough county. He couldn’t remem- ber the word “spring,” came up with April instead of May for the month every time I asked him and he couldn’t remember it was Wednesday. During the hour-long drive, we went through these facts at least 10 times, but he still couldn’t remember. Shortly after we arrived he was whisked away for the test, about 4 ½ hours after consuming the coconut oil. When he returned, he was very unhappy about his performance. Laura, the research coordinator, returned shortly thereafter and began to take his vital signs and blood pres- sure, and, suspecting that we were continu- ing with the screening process, I asked her if she could share his score with us. She said, “Didn’t he tell you? He scored an 18!” more than he needed to qualify for the vac- cine study. He remembered it was spring, it was May, it was Wednesday, that he was in Tampa, in Hillsborough county and that we were at the Byrd Institute, all points that he missed on the previous attempt at USF. As a result of the screening, we learned that he is positive for APOE4, but do not know at this time if he has one or two copies.

According to the Ketasyn studies, Steve should not have improved, but rather he should have stayed about the same. Since then he has retested for the Eli Lilly study drug, now available closer to home and scored an MMSE of 17 - he even remembered the date of July 2, 2008 this time. We have decided, af- ter looking at the potential side effects of the vaccine for APOE4+ people, to go with the Eli Lilly drug.

At the time of this writing it has been 60 days since he started taking coconut oil (May 21, 2008.) He walks into the kitchen every morning alert and happy, talkative, making jokes. His gait is still a little weird. His tremor is no longer very noticeable. He is able to concentrate on things that he wants to do around the house and in the yard and stay on task, whereas before coconut oil he was easily distractible and rarely accomplished anything unless I supervised him directly, a source of some contention between us!

After about two weeks, and again at 37 days, after starting the coconut oil, I asked him to draw a clock (see Clocks #2 and #3.) There is an obvious marked improvement. I promise that I did not help him. He tells me that he could not even picture a clock at the St. Pete screening, but with the last two at- tempts, he was very concerned that the 6 was opposite the 12 and the 9 opposite the 3 on the face of the clock. He drew “spokes” to

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