By Richard Isaacson
+Alzheimer's Reading Room
As a result of these experiences, I am a strong advocate for a comprehensive approach toward disease management (including FDA-approved drugs, FDA-regulated medical foods, specific vitamins, supplements, extensive dietary and lifestyle modification, targeted cognitive activities, and caregiver support).
The treatment recommendations I make to my patients (and to my own family members) are supported by evidence, grounded in safety and based on many years of personal experience with patients in my clinic.
I advocate for the use of the medical food Axona based on my clinical experience, the existing clinical data and the ongoing studies.
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Last week’s questions on Axona only scratched the surface of the complexity of this topic.
See - What is Axona?
As my patients and their caregivers will tell you, I treat every patient in my clinic as if they were my own family members. Because there are no scientific studies that have yet tested the potential effects of the variety of types of coconut oil in Alzheimer’s, I do not suggest it.
Instead, I do consider Axona since 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 that may be found in these products (which may worsen obesity, diabetes and additional health conditions).
Additionally, coconut oil is not regulated nor standardized and the amount of coconut oil a patient would need to purchase to reach the same level of caprylic triglyceride levels found in Axona could cause increased side effects and would be more expensive than a 30-day supply of Axona.
Since Axona requires a prescription by the treating physician, it ensures that therapy will continue under medical supervision, which is an important factor in ensuring safety during use. Until further research is completed, in my clinical practice I prescribe Axona instead of coconut oil, for all of these reasons.
Recent research shows that Alzheimer’s may be effectively managed through diet and nutrition, and these non-drug dietary approaches that balance safety with scientific evidence are essential considerations for comprehensive management.
Last month, research was presented at the international Clinical Trials in Alzheimer’s disease meeting in Monte Carlo, Monaco. My colleagues (Drs. Ochner, Barrios, Lee, Greer) and I identified clinical trials and additional studies addressing the relation between dietary practices and memory function.
Evidence (focusing on clinical trials) surrounding the use of dietary interventions for the prevention and treatment of Alzheimer’s and mild cognitive impairment (MCI) was rated as: Strong, Moderate, Weak or Insufficient for several dietary areas (J Nutrition Health & Aging. Vol 16:9; 9 Nov 2012).
We concluded that due to the lack of empirical evidence and potential for adverse effects, at this time there is Insufficient evidence (meaning, not enough research has currently been done yet to prove) for coconut oil for Alzheimer’s.
Ultimately, there remains a clear need for further scientific evaluation. For more of a direct comparison between the differences between Axona and coconut oil, view the chart below.
Richard S. Isaacson, MD serves as Vice-Chair of Education and Associate Professor of Clinical Neurology at the University of Miami Miller School of Medicine. He is the author of the several books including: The Alzheimer's Diet: A Step-by-Step Nutritional Approach for Memory Loss Prevention, and Treatment and Alzheimer's Treatment Alzheimer's Prevention: A Patient Family Guide (in English/Spanish).
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