Alzheimer’s Update: Coconut oil and Etanercept
July 26, 2014
July 27, 2014
Jacob Schor, ND, FABNO
There are two potential new treatments for Alzheimer’s disease that we have noticed in the scientific press and in the health food store culture in recent weeks that both deserve mention.
The first, as it sounds more naturopathic, is eating coconut oil in significant quantities. Credit for the idea that this might be beneficial to Mary Newport MD who maintains a website: http://www.coconutketones.com/ promoting this idea. Her book “Alzheimer's Disease: What If There Was a Cure? Paperback “ published in April 15, 2013 has added to this idea. Her interest in Alzheimer’s is driven by her husband Steve who has Alzheimer’s himself.
There is a scarcity of research supporting her theory, unfortunately. There are some hints though that coconut oil may have a role in brain function. Ketogenic diets have been used since early last century to reduce epileptic symptoms especially in children. These are no carbohydrate and high fat diets, so severe that the system switched metabolism and produces ketones for energy. Ketones are the same chemicals that put a diabetic into ketoacidosis if they use too much insulin.
In the past these ketogenic diets used medium chain trigylcerides (MCTs) as a fat source. Recently parents of these children and researches tell us that coconut oil works as well and is less expensive. 
There is one study of interest that I have found to date cited in PubMed.org about Alzheimer’s and coconut (though my saying this will no doubt generate emails with further citations) published in 2013, “A ketone ester diet exhibits anxiolytic and cognition-sparing properties, and lessens amyloid and tau pathologies in a mouse model of Alzheimer’s disease” by Kashiwaya et al. In this study “… mice were fed a diet containing a physiological enantiomeric precursor of ketone bodies (KET) or an isocaloric carbohydrate diet. The results of behavioral tests performed at 4 and 7 months after diet initiation revealed that KET-fed mice exhibited significantly less anxiety in 2 different tests….. mice on the KET diet also exhibited significant, albeit relatively subtle, improvements in performance on learning and memory tests.” Fiftenn mice, not humans, were fed these “enantiomeric precursors”, whatever those are, (actually the are, “ketone ester [comprised of D-β-hydroxybutyrate and (R)-1,3-butanediol) (KET)”].
This is a long way from proof that coconut oil will make a difference in human Alzheimer’s disease. In this study, they didn’t just add these interesting fats to the diets of mice, they also stopped feeding them any carbohydrates.
Will this work in humans? We don’t know. Will it hurt to try? That’s not clear either. The University of Florida is currently recruiting subjects to hopefully answer these questions.  They are going to have patients consume a coconut oil containing drink, a trade marked product sold under the name, “Food for thought ™” three times per day. This is the only coconut and Alzheimer’s study currently listed on the website www.clinicaltrials.gov.
The second item worth paying attention in the world of Alzheimer’s research, and this is rather significant, though ever so tentative. Clive Holmes of the University of Southampton, UK, presented early data from a trial he is conducting to the Alzheimer’s Association International Conference in Copenhagen earlier in July. These early results suggest that a drug called etanercept used to treat arthritis may potentially stop Alzheimer’s progression. People with mild to moderate Alzheimer’s were given either etanercept or placebo for six months. Those receiving the drug had similar results on cognitive function testing at the end of the trial as at the start. Those receiving placebo continued to deteriorate
Etanercept is given via weekly injections to people with arthritis. It neutralizes a proteinc called TNF-alpha that sustains and increases inflammation caused by various diseases.
In 2010 Chou et al reported that people with Alzheimer’s and arthritis who were taking TNF-alpha drugs had half the risk of developing Alzheimer’s as people with arthritis not taking these kinds of drugs.
Back in April, Holmes and colleague Hugh Perry reported tht they had identified inflammatory molecules made by white blood cells that trigger brain cell death.
Thus we are seeing a steady progression of research supporting a theory of why etanercept could be a useful intervention. This was indeed a small pilot study though, 18 patients received the drug and 15 received the placebo. That’s a long way from proof. Larger and longer trials will be required to be sure. In the meantime, would it hurt to encourage patients with early Alzheimer’s and arthritis to look into this drug further?
It should be mentioned that a number of natural substrances inhibit TNF-alpha. Chief among them is curcumin, a natural supplement long investigated for it’s protective effects against Alzheimer’s.
Melatonin also inhibits TNF-alpha  and in fact a randomized placebo controlled clinical trial published last June using 2 mg of melatonin reported significant improvements in cognitive function in just 6 months.  While ethanercept sounds exciting from a drug sale perspective, melatonin certainly sounds cheaper, safer and easier to take.
A June paper reports that fish oil supplements appear to be protective on magnetic resonance brain images of people taking them. This was a fair sized study with 229 ‘normal’ older adults, 397 patients with mild cognitive impairment and 193 patients with Alzheimer’s disease.
Our old favorite has some interesting suggestions that it too may impact TNF alpha and be protective against Alzheimer’s disease but we are still lacking evidence in humans from a RCT.[10, 11] There was a mouse trial back in 2012 that berberine “ …..provides neuroprotective effects in …. mice ….. and that further investigation of the BBR [berberine] for therapeutic use in treating AD [Alzheimer’s disease] is warranted.”
Past newsletters related to Alzheimer’s disease from DenverNaturopathic.com:
Extra virgin olive oil, nuts and cognitive function June 2013
Alzheimer's Disease and Fish Oil
Alzheimer's Disease, Niacin and Statin Drugs
Alzheimer's Disease: walking and a good diet prevent 2004
Alzheimer's Disease: Juice protects against Sept 2006
Alzheimer's Disease and Curcumin Sept 2007
Alzheimer's Disease Update August 2008
Caregiving spouses at 6 times the risk Aug 2010
Grape Juice slows cognitive decline April 2010
Alzheimer's Disease: Protocol Update June 2010
Alzheimer's disease: green tea and l-theanine May 2011
Articles of Interest in the Natural Medicine Journal:
Will B Vitamins Prevent Alzheimer's Disease?
Amyloid B Protein of Alzheimers Disease: More than Just a Plaque
Antidepressants and Dementia: More Risk than Benefit?
Green Tea and L-Theanine in Mild Cognitive Impairment
Caloric Restriction and Fasting in Disease Prevention and Treatment
Emotions and Health: Laughter Really Is Good Medicine
3. Kashiwaya Y, Bergman C, Lee JH, Wan R, King MT, Mughal MR, Okun E, Clarke K, Mattson MP, Veech RL. A ketone ester diet exhibits anxiolytic and cognition-sparing properties, and lessens amyloid and tau pathologies in a mouse model of Alzheimer's disease. Neurobiol Aging. 2013 Jun;34(6):1530-9.