Unconventional But Effective Therapy for Alzheimer's Treatment: Dr. Mary T. Newport at TEDxUSF
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When Dr. Newport's husband Steven was diagnosed with early onset Alzheimer's, as a Doctor herself, she explored routine treatment options. But when his symptoms became so severe that he was not able to participate in clinical trials, her scientific deductions led to coconut oil, which has led to amazing results.
Mary T. Newport, M.D. grew up in Cincinnati, Ohio, and was educated at Xavier University and University of Cincinnati College of Medicine. She is board certified in pediatrics and neonatology, training at Children's Hospital Medical Center in Cincinnati, and Medical University Hospital in Charleston, SC. She is founding director of the newborn intensive care unit at Spring Hill Regional Hospital, practicing full-time through All Children's Specialty Physicians and volunteer clinical faculty at University of South Florida. She was also founding director of the neonatal intensive Care unit at Mease Hospital Dunedin.
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The speaker argues that Alzheimer's disease involves type 3 diabetes of the brain—insulin resistance and insulin deficiency—which can be bypassed by providing ketone bodies as an alternative fuel through medium-chain triglycerides and ketogenic diet, offering a treatment path that has shown clinical promise in her husband's case and should be investigated further through clinical trials.
- Brown University researchers demonstrated insulin resistance and insulin deficiency in Alzheimer's brains, coining 'type 3 diabetes'
- Medium-chain triglycerides convert to ketones in the liver and can serve as alternative brain fuel, bypassing insulin-dependent glucose uptake
- Her husband showed dramatic cognitive improvement on coconut oil (60% MCT) within days, improving from 12 to 20 on the 30-point mental status exam within two months
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A recent NIH study by Dr. Richard Beach used ketone ester beta-hydroxybutyrate in a mouse model of Alzheimer's disease and found reduced amyloid plaques and neurofibrillary tangles (two hallmarks of Alzheimer's pathology) in the mice's brains, along with improved memory and learning.
“there was a recent study that was published from the NIH by Dr Richard beach again and this time they used Ketone Esther beta hydroxy butyrate in an Mouse model of Alzheimer's disease and they found that there was reduced plaque and Tangle which are two Hallmarks of the disease in the brain and these mice and also improved memory and learning”
Medium-chain triglycerides are absorbed directly from the intestine into the liver, where they are partially converted to ketone bodies that are released into circulation, cross the blood-brain barrier, and are readily taken up by brain cells to provide energy.
“what happens with medium chain triglycerides is when you consume foods that contain these they're taken up directly from the intestine into the liver and part of it is converted to ketones and ketones are released into the circulation they cross the blood brain barrier and they're eagly eagerly taken up by brain cells um and provide you know the cells with um energy”
The University of South Florida's Bird Alzheimer's Institute is beginning a study of coconut oil and MCT oil in people with mild cognitive impairment to determine if it will alleviate symptoms and prevent progression to Alzheimer's disease.
“the University of South Florida the bird Alzheimer Institute is beginning a study very soon of coconut oil and MCT oil and people with mild cognitive impairment to see if it will help relieve symptoms and also prevent progression to Alzheimer's disease”
Most people in a typical American diet consuming fat-free milk receive virtually no medium-chain triglycerides from their diet.
“if you're eating a typical American diet and you're consuming fat-free milk you're getting virtually no medium chain triglyceride in your diet”
Formula manufacturers began adding medium-chain triglycerides to infant formulas because they were attempting to mimic human breast milk, which contains 10 to 17% of its fats as medium-chain triglycerides.
“then the formula manufacturers began adding it to their infant formulas because they were trying to mimic human breast milk which has 10 to 177% of the fats as medium chain triglycerides”
Other researchers have reported that the type 3 diabetes pathology in Alzheimer's disease may occur 10 to 20 years before symptoms appear in individuals at risk for the disease.
“other researchers have reported that uh this may occur 10 to 20 years before symptoms even begin to appear and someone who is at risk for this disease”
The brain can use ketone bodies as an alternative fuel source when glucose is unavailable, which occurs during starvation after 36-48 hours when stored glucose is depleted and the liver converts fat to ketone bodies that cross the blood-brain barrier.
“but glucose is not the only fuel that the brain can use when we go into starvation within 36 or 48 hours we use up the glucose that is stored in our body and we begin to break down fat and part of that fat is converted to Ketone bodies in the liver and Ketone bodies can serve as an alternative fuel for brain cells and for other organs”
Using alternative fuel sources like ketone bodies could bypass the problem of insulin resistance and insulin deficiency in the Alzheimer's brain by providing energy to brain cells without requiring insulin-dependent glucose uptake.
“here is an idea that use of an alternative fuel could bypass the problem of insulin resistance and Insulin deficiency in the old time or brain”
Dr. Samuel Henderson had the insight that mild ketosis from consuming medium-chain triglycerides might be sufficient to improve cognition in people with Alzheimer's disease, leading him to file a patent application for AC122, which is medium-chain triglyceride oil.
“Dr Samuel Henderson had the brilliant Insight that another way of getting ketosis mild ketosis from consuming medium chain triglycerides might be enough to improve cognition in people with Alzheimer's disease and so he filed a patent application for ac122 which is simply medium chain triglyceride oil”
Brown University researchers reported in 2008 that insulin resistance and insulin deficiency in Alzheimer's brains occurs in the early stages of disease and becomes progressively more severe and widespread with each subsequent disease stage until it is present throughout the brain.
“they further reported in 2008 that this happened in the earli stages of the disease and it became more severe and more widespread with each subsequent stage of the disease until it was throughout the brain”
Brown University researchers in 2005 found that brains of people who died with Alzheimer's disease (without type 1 or type 2 diabetes) showed insulin resistance and insulin deficiency, leading them to coin the term 'type 3 diabetes' to describe this condition.
“a group at Brown University in 2005 reported that when they looked at the brains of people who had died with Alzheimer's that did not have type 1 or type 2 diabetes that they found insulin resistance and Insulin deficiency in all of these brains and they coined the term type 3 diabetes to indicate Alzheimer's dis disease”
AC122 (medium-chain triglyceride oil) had completed Phase 2 clinical trials showing that both a single dose and prolonged use improved cognition and memory in nearly half the people with Alzheimer's who took it, and was approved by the FDA as a prescription medical food in spring 2009.
“ac122 had completed Phase 2 clinical trials and they found that just with a single dose of MCT oil and also with prolonged use of MCT oil that there was improved cognition and memory in nearly half the people with Alzheimer's that took it and so it was approved by the FDA it's a prescription medical food in the spring of 2009”
Some children with drug-resistant epilepsy who had hundreds of seizures per day have experienced complete seizure cessation after starting the ketogenic diet.
“it has um actually some of these children have no seizures at all after having hundreds of seizures a day after starting this diet”
The speaker is a neonatologist who specializes in the care of sick and premature newborns, and her husband Steve developed early-onset Alzheimer's disease, which motivated her to investigate alternative treatments for the condition.
“I am a neonatologist which is a physician that takes care of sick and premature newborns but I'm talking about Alzheimer's disease tonight because my husband of 40 years Steve has early on set Alzheimer's disease”
Dr. Richard Beach from the National Institutes of Health in Rockville, Maryland, has been studying ketone esters to treat Alzheimer's disease and other neurodegenerative diseases, reporting in 2000 that neurons survived better in cell cultures exposed to Alzheimer's or Parkinson's-causing substances when ketone body beta-hydroxybutyrate was added.
“they cited research by Dr Richard Beach from the uh National Institutes of Health in Rockville Maryland who has been studying Ketone Esters to treat Alzheimer's disease and other neurodegenerative diseases and he had found in reported in 2000 that more neurons survived in cell cultures when they were exposed to substances that cause Alzheimer's or Parkinson's disease when the Ketone body beta hydroxy uate was added to the mix”
While awaiting clinical trials of ketone esters, people can consume medium-chain triglycerides through their diet; MCTs are not available in typical oils consumed in the American diet (including olive oil and fish oil), but are available in MCT oil, coconut oil, palm kernel oil, and in the milk fat of humans, goats, and cows.
“while we are waiting for these clinical trials to be done you know for Ketone Esters you can consume medium chain triglycerides in your diet they are not available in the T typical oils that we eat in our American diet and that includes all oil and fish oil but they are available in MCT oil coconut oil palm kernel oil and in the milk fat of humans goats and cows”
You do not need to be in starvation to raise ketone levels; the classic ketogenic diet—a very high-fat, very low-carbohydrate diet with just enough protein to maintain lean body mass—can raise ketone levels and has been used successfully for over 90 years in children with drug-resistant epilepsy.
“but you don't have to be in Starvation to raise Ketone levels another way to do this is with the classic ketogenic diet and um what this diet is a very high fat diet and a very low carbohydrate diet and it has just enough protein to maintain lean body mass and has been used successfully for more than 90 years in children with drug resistant epilepsy”
By age 56, Steve had progressed to severe cognitive impairment where he could no longer do accounting work, use a calculator, perform simple math, read maps while driving, or drive safely, requiring him to cease driving.
“by 56 years old Steve could no longer do do any accounting at all he could no longer use a calculator and he could not even do simple math we found out that he couldn't read a map when he was driving home from Tallahassee one night and he got lost and ended up on the other coast of Florida about 3 hours away from home so he had to give up driving shortly thereafter”
By age 58, Steve exhibited a severe downward spiral including tremors in hands and jaw, inability to read due to visual disturbance, abnormal gait, loss of ability to run, personality and sense of humor disappearance, and displacement of purposeful activity (attempting to disassemble lawnmower rather than use it).
“by age 58 Steve was on a downward spiral he had Tremors in his hands and in his jaw he could no longer read due to a visual disturbance his gate was slow and weird and he could no longer run his personality and sense of humor had disappeared and he was much more likely to take his lawn tractor apart than to cut the grass with it”
Ketone esters are now in development at the National Institutes of Health and at the University of South Florida, with the potential to raise ketone levels many times higher than achievable with large amounts of coconut oil and MCT oil.
“keto estros are now in development at the National Institutes of Health and also here at the University of South Florida Ketone Esters can raise Ketone levels many times higher than what you can achieve with large amounts of coconut oil and MCT oil”
At another lab at the University of South Florida, researchers are studying ketogenic diets including medium-chain triglycerides and ketone esters in animal models to investigate effects on oxygen toxicity, Alzheimer's disease, epilepsy, amyotrophic lateral sclerosis (ALS), cancer, and wound healing.
“just down the road here at another Lab at you University of South Florida they are studying ketogenic diets with including medium chain Tri triglycerides and Ketone Esters in animals right now to study oxygen toxicity Alzheimer's epilepsy lugaris disease which is ALS cancer and wound healing they may very well have some very exciting and promising results are coming out of this”
Virtually all modern infant formulas contain medium-chain triglyceride oil or another oil that contains medium-chain triglycerides on the label.
“if you look at any infant formula can today virtually every one of them will have medium chain triglyceride oil or another oil that contains that on the label”
Since glucose is the primary fuel for the brain and other organs, and insulin is required for glucose to enter cells, insulin resistance and insulin deficiency in Alzheimer's brains causes cells to malfunction and die, with neuronal death eventually producing cognitive symptoms.
“with this means is that since glucose is the preferred and primary fuel for the brain and other organs that um without insulin glucose cannot get into cells so the cells begin to malfunction and die the neurons in the brain and then over time you begin to see symptoms”
People with Alzheimer's disease, conditions involving decreased glucose uptake into the brain, or risk factors for such diseases could benefit from daily consumption of medium-chain triglycerides, which may produce improvement or provide reprieve from disease progression.
“if you or anyone that you know or love has Alzheimer's disease or another condition that involves decreased glucose uptake into the brain or if you're at risk for one of these disease consumptions of medium chain triglycerides on a daily basis could possibly bring about some improvement a reprieve from the disease”
Steve began experiencing cognitive decline starting at age 51 with accounting errors and memory problems, initially attributed to depression, but by 2004 was formally diagnosed with early-onset Alzheimer's disease.
“at age 51 Steve began having problems with his accounting he began uh making payroll mistakes missing tax deadlines and then he couldn't remember if he'd been to the bank in the post office but at first this was attributed to depression but by 2004 he continue to have problems with his uh making accounting mistakes and with memory and so he was diagnosed with early onset Alzheimer's disease”
Coconut oil is 60% medium-chain triglycerides by fatty acid composition, which meant the 20-gram dose used in AC122 Phase 2 trials was equivalent to 7 teaspoons of coconut oil.
“the composition of coconut oil the fatty acid composition and I learned that coconut oil is 60% medium chain triglycerides so in the ac122 clinical trials they had used 20 gram and this equated to Seven teaspoons of coconut oil”
Medium-chain triglyceride oil is extracted from coconut oil, and the speaker discovered this fact while reading the patent application for AC122.
“that medium chain triglyceride oil is extracted from coconut oil and I did not know at that time that medium chain triglyceride oil was available over the counter”
Steve enrolled in a clinical trial after demonstrating cognitive improvement with coconut oil; the trial allowed his participation as a food supplement (reasoning it could not harm results); he was on placebo for the first 12-14 months of this crossover trial and still improved by 6 points on a 75-point cognitive scale during this placebo period.
“he did in fact uh enter a clinical trial at that point um they decided to let him in because this was only a food How Could It screw up their results so he had U quite a bit of cognitive testing during that first year and we found out later that he was on the placebo during the first 12 to 14 months of the sty of the study it was a crossover trial and what happened with Steve was that he actually improved by six points on a 75 point scale for a cognitive testing”
The speaker gave Steve seven teaspoons of coconut oil with breakfast the morning after learning about MCT's mechanism, and he screened again for clinical trial that day and scored 18 out of 30 (meeting the 16-point threshold) and qualified for the trial.
“the following morning I gave Steve Seven teaspoons of coconut oil with his breakfast and we went to the bird Institute here at University of South Florida and he screened again for a clinical trial and this time he scored 18 out of 30 needing 16 to qualify and he in fact did qualify for this clinical trial”
Steve also improved by 14 points on a 78-point activities of daily living (ADL) scale during the clinical trial, while other placebo-group participants declined by an average of 6 points on the same cognitive scale during the same year.
“he also improved by 14 points out of 78 points on the activities of daily living test um other people who were on Placebo during that year dropped by an average of six points on that same cognitive test that Steve had been scored for”
One main critique of the speaker's book was that the idea of ketone therapy for Alzheimer's needs clinical trials; the speaker's response was that raising public awareness of the idea is necessary to enable clinical trials to be conducted in the first place.
“one of the main critiques of my book was that this idea needs clinical trials well my answer to that is well that was the whole point of writing my book without awareness of this kind of idea how would clinical trials for coconut oil ever get done”
During the first months of coconut oil treatment, Steve experienced return of personality and sense of humor, decreased depression, resolution of tremors in hands and jaw, resumption of normal walking gait and ability to run, disappearance of visual disturbance, and resumption of household activities like cutting grass and vacuuming without destructive behavior.
“what we saw during the first months of coconut oil that his personality and sense of humor returned he was much less depressed his tremors resolved he was able to start walking normally again and even start running his visual disturbance disappeared and he was able to resume activities again such as cutting the grass and mowing uh vacuuming the house without taking the things apart and losing the pieces”
Steve had an MRI two years after starting coconut oil that was read as stable compared to his previous MRI; this represented a dramatic change from his prior history of significant worsening between 2004 and 2008.
“he also had an MRI 2 years after starting coconut oil that was read as stable compared to the previous and he had had a dramatic worsening from 2004 to 2008 on his uh MRI”
The speaker recognized the therapeutic potential of medium-chain triglycerides because as a neonatologist, she had used MCT oil in the late 1970s and early 1980s to supplement feedings of premature newborns to help them gain weight faster.
“this rang a bell with me because I'm a neonatologist we used to use medium chain triglyceride oil to supplement the feedings of our premature newborns in the late '70s and early 80s to help them gain weight faster”
During the first two months of coconut oil treatment, Steve's Mini-Mental Status Exam (MMSE) score improved from 12 points (measured ~two weeks before starting treatment) to 20 points out of 30 (~two months after starting treatment), representing an 8-point improvement.
“during the first two months of coconut oil his Min mental status exam the 30-point test improved from 12 points about two weeks before when he had screened for a trial to 20 points out of 30 about two months after starting coconut oil so that's a very dramatic Improvement in in the score”
About two-thirds of the 250 patient reports the speaker collected described some type of memory or cognitive improvement; many others reported improvements in quality of life, recognition of family members, relief from depression, improved mood and behavior, and relief from physical symptoms.
“about two-thirds of these people reported some type of memory or cognitive Improvement but many other reported improvements in quality of life recognition of family members again um relief from depression improve mood and improve behavior and uh relief from physical symptoms you know those kinds of things and some of those are very hard to measure on on tests”
Over weeks and months following the initial coconut oil dose, the speaker mixed MCT oil and coconut oil together (with MCT oil providing higher ketone levels and coconut oil providing longer duration), increased to three servings daily, and maintained around-the-clock ketone availability to Steve's brain.
“over the next weeks and months uh we began mixing MCT oil and coconut oil together MCT oil gives higher levels but coconut oil longer duration of ketones and so we also increased to three servings a day and eventually before so that he would get ketones Around the Clock available to his brain”
Steve reported that 'the light switch came back on' in his spring (sense of alertness/consciousness) the day he started coconut oil.
“Steve said many times after that that the light switch came back on in his spring that day”
Medium-chain triglycerides are simply food available on shelves and consumers 'have nothing to lose' by trying them, making the risk-benefit calculation favorable given their safety profile.
“medium chain triglycerides are just food they're available on the shelf and what do you have to lose”
By the fifth day of coconut oil treatment, Steve's personality, alertness, and sense of humor were so substantially improved that the speaker felt she had 'gotten her husband back,' and the couple stated together that 'our life has changed for the better.'
“by the fifth day Steve's personality and his alertness were so much improved in a sense of humor that I felt like I'd gotten my husband back and we said to each other uh our life has changed for the better”
The speaker began a letter-writing campaign to politicians and media figures in 2008 advocating for awareness of AC122 as a treatment for Alzheimer's, highlighting Steve's improvement and the urgency of clinical trials, but received no serious responses.
“I felt you know since Steve had improved so much other people would improve too and this is something that's on the Shelf now people don't shouldn't have to wait for a prescription medical food to come out a year from now that was already on the Shelf so I began a letter writing campaign and I uh sent it to many different politicians and media people and I you know told them about ac122 that she was just one example of somebody that had improved that this needed desperately needed and urgently needed clinical trials but that it was available on the Shelf now and people could use it if they they would just tell everybody about it but I got no uh serious response to any of my letters”
In fall 2008, the St. Petersburg Times published a story about Steve and the speaker, which 'went viral on the internet,' after which the speaker began receiving many reports from other people who had tried coconut oil and/or MCT oil.
“in the fall of 2008 the St Petersburg Times ran a story about Steve and I this went viral on the internet so thereafter I began to hear from other people who had tried coconut oil Andor MCT oil”
Steve's clock-drawing test improved dramatically from disorganized baseline (14-37 days after starting coconut oil) to much more organized drawings within 14 and 37 days of starting treatment.
“Steve had drawn a the day before he started the coconut oil and then he Dro Drew clocks 14 and 37 Days Later that were amazingly much more organized than before”
The speaker collected almost 250 reports from people who had tried coconut oil and/or MCT oil, with approximately 90% reporting some type of improvement; however, she acknowledges that people are less likely to email if they did not improve (selection bias).
“I've collected almost 250 reports now uh from people and about 90% of those are people who have had some type of improvement and I realized people are less likely to email me if they did not have an improvement”
Steve screened for a clinical trial the night before his first screening scored only 14 out of 30 on a memory test (needing 16 to qualify) and was rejected; the day before this screening, the physician noted that Steve was 'on the verge of severe Alzheimer's disease' based on a poorly organized clock-drawing test.
“Steve screened for the trial and he scored only 14 out of a simple 30o memory test and he needed 16 points to qualify for the trial so he was not accepted and we were very disappointed and he was asked to draw a clock by the doctor there a simple test for Alzheimer's and as you can see it was a poorly organized clock it doesn't look at all like a clock a few little random circles and a a few numbers and she told me that he was on the verge of severe Alzheimer's disease”
The speaker wrote a book to communicate the message about ketones as alternative brain fuel, achievable through dietary intervention, and to advocate for urgent clinical testing of coconut oil and ketone esters.
“many months were spent writing a book to try to get this message out about ketones as an alternative to fuel for the brain that this can be achieved through food that Ketone esters are in development and that they urgently need to have clinical testing of both coconut oil and Ketone Esters”
The speaker published an article in July 2008 intended for distribution at the Alzheimer's Association International Conference (attended by 5,000 researchers) but was denied a table in the exhibit hall, so she distributed it through health food stores and online instead.
“I put together an article in July of 2008 that I intended to distribute at the Alzheimer's Association International Conference to 5,000 researchers they have an exhibit hall but I was turned down for a table in their Exhibit Hall so I began to distribute at health food stores and online”
The ketogenic diet has also been used successfully in recent years in adults with epilepsy and other neurological conditions.
“it's been used successfully more recently in adults as well”
Variants of the ketogenic diet, including Atkins and South Beach diets, have been used for weight loss and represent more familiar forms of low-carbohydrate, high-fat dietary intervention.
“there are other forms of the ketogenic diet that people are more familiar with the Atkins and South Beach diets that are used uh for weight loss”
The speaker speculates that researchers at one University of South Florida lab studying ketogenic diet and ketone esters may be the ones to 'find a cure for cancer' given the breadth of their research.
“and they may very well be the ones to find a cure for cancer in this lab”