MCT Oil

Mechanism of action

MCTs bypass the standard fat digestion pathway, absorbing directly into portal circulation and metabolised by the liver into ketone bodies (beta-hydroxybutyrate, acetoacetate). Ketones cross the blood-brain barrier via the MCT1 transporter and serve as fuel for neurons. C8 (caprylic acid) produces the fastest and largest ketone elevation; C10 (capric acid) is slower but more sustained. Coconut oil contains roughly 60% MCTs but is dominated by C12 (lauric acid), which behaves more like long-chain fats.

History

MCTs were originally developed for clinical nutrition in patients with malabsorption disorders. The ketogenic application emerged from the 1971 modified Atkins ketogenic diet for refractory epilepsy. The cognitive applications emerged with the work of Veech, Newport, and Cunnane in the 2000s-2010s — Alzheimer's disease shows reduced glucose metabolism in cortical regions, and ketone supplementation appears to partly bypass this defect. Unscheduled globally and widely available.

Benefits

• Rapid ketone elevation

  EVIDENCEA

  Pharmacokinetic studies establish dose-response.

• Cognitive function in Alzheimer's

  EVIDENCEB

  Cunnane 2020 trial.

• Endurance during fasting/keto

  EVIDENCEB

  Multiple metabolism studies.

Side effects

• GI upset (large dose)commonmoderate
• Diarrhea (dose-related)commonmoderate

Cited research

• MCT oil and ketone-fueled cognitive performance in Alzheimer's (Cunnane)2020
  PMID 32488912 ↗
• MCT oil pharmacokinetics: C8 vs C10 (St-Pierre)2019
  PMID 30951114 ↗
• Caprylic acid for cognitive function in mild-to-moderate Alzheimer's (Henderson)2009
  PMID 19664276 ↗

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