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Negative About Coconut oil
June 18, 2013
9:20 pm
Robert K. Su MD
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Annie said

Hi Dr. Su,

I'm wondering if you are planning on doing an article or podcast regarding the potential negatives of coconut oil? I ask because there seems to be a trend in some popular low carb and paleo sites to advocate for nutritional ketosis and the menus often use lots of coconut oil. I think your information and thoughts would be especially helpful and timely. I have not used coconut oil for months now but admit I miss it. I just use butter instead added to steamed veggies and I drizzle olive oil on eggs in the morning. I don't cook with olive oil -- I just drizzle it on poached eggs because I love the taste of it. The only other fats would be that which is found in the food itself -- such as olives, avocado, beef/fish/, nuts.Cool

Dear Annie:
I would love to come up with an article summarizing the benefits and downfalls of coconut oil some day, but not now, because so many promotors on coconut oil and I do not expect anyone would love to hear about the negatives of coconut oil. Rather, I would welcome more readers of this Forum share with us their own experiences with coconut oil, both good and bad. Perhaps, I can summarize them in an article or podcast soon.
As to the term, "nutritional ketosis", I assume it is ketosis as a result of ketogenesis with carbohydrate restriction, and I have no problem with that, because that is self-limited or self regulated with functioning insulin. However, we must be careful if we purposely create ketosis inside our body by consuming more Medium-chain triglycerides or coconut oil. The ketosis with the later approach is not self-limited and could be dangerous. If ketosis is so healthy for us, why do we have to worry about keto(acido)sis with the uncontrolled diabetics? They were supposed to be healthy, weren't they? Please read this at http://www.carbohydratescankil…..nd-ketosis.
Using coconut oil in cooking should not be a problem because it is small in quantity. However, people who daily use of 2-3 tablespoons of coconut oil should check their urinary ketone periodically and also the level of their serum uric acid, which tends to go up when more beta-hydroxybutyrate is found in the urine. There are a few writings citing the benefit of high level of serum uric acid as antioxidant. I have reviewed many research reports about the harms on our healthy by uric acid, and found the claim of uric acid as an antioxidant is questionable, to say the least. Smile

May 2, 2012
3:25 pm
Robert K. Su MD
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I do experience something negative with coconut oil. I just want to caution that, while I continue to believe MCTs from coconut oil are beneficial to those who suffer with neurodegenerative diseases including Alzheimer's disease, Parkinson's disease, intractable epilepsy, MS, ALS, and among other, I do recommend that those who adopt very low carbohydrate high fat diet should use coconut oil carefully. The VLCHF dieters might have adverse health issues after consuming coconut oil, especially in excess. I'll write about it when I get a better picture of this matter. However, in my opinion, my caution is necessary. 

As we know, it is beta-hydroxybutyrate, a metabolite of MCTs from foods such as coconut oil, and from gluconeogenesis with fat, Converting MCTs in the liver from coconut oil is not regulated by insulin like gluconeogenesis with fat. Therefore, it is highly possible that the more the coconut oil is consumed, the more the beta-hydorxybutyrate generated, consequently, the greater degree of ketosis with lots of ketone in the urine and the blood circulation. So, if someone with neurodegenerative disease who likely has not restricted carbohydrates is probably okay to consume a reasonable amount (or daily dose) of coconut oil for the ailment. However, he has started to severely restrict carbohydrate, he should be careful in consuming coconut oil. Someone wrote that the more ketosis is better. In my opinion, it is false and could be dangerous.

One more thing that you should have known, of course: Eating coconut and using coconut oil are two different things.Smile

May 31, 2012
10:18 am
JT
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Dr Su,

I would like to hear more of your thoughts regarding the negatives.

I also have had negative effects from MCT and coconut oil. It feels similar to a hangover from drinking too much alcohol. I also have a sensation of a burning smell.

Thanks

June 2, 2012
10:43 am
Robert K. Su MD
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JT, welcome to the Forums. I apologize for having not responded sooner. 

I am unsure of the negative effects, which you have experienced. I would like to know the amount and the way you took MCT and coconut oil.

The negative effects of coconut oil I am concerned about are still under my investigation. I agree that mild ketosis as a result of starvation or carbohydrate restriction should be safe, because the level of ketosis should be regulated by a level of "functioning" or "normal (in amino acid sequence)" insulin. Insulin is supposed to suppress gluconeogenesis, in which saturated fat is metabolized into glucose and beta-hydroxybutyrate. Therefore, it is less likely to have abundant of beta-hydroxybutyrate (ketone body) in the circulation unless insulin level is very low. Thus, the degree of ketosis in the healthy individuals in starvation or carbohydrate restriction should be mild. Usually, the urine ketone stick would show a trace of ketone when the urine test is done upon getting out of bed. During the daytime, urinary ketone may be trace or negative if the individual is physically active. On the other hand, dietary coconut oil or MCTs is transported to the liver where they are metabolized into beta-hydroxybutyrate. The rate of their metabolism, at this point of my knowledge, is not regulated by the amount of beta-hydroxybutyrate or the level of insulin. It is likely, the more the coconut oil or MCT is consumed, the more the circulating beta-hydroxybutyrate, and the higher the level of ketosis. 

There are studies about diabetic ketosis, in which the patient's insulin is non-functional. And, we know diabetic ketosis is detrimental to the patient's health and life. However, I have not seen study on the health impact of ketosis involving individuals who are healthy and in starvation or carbohydrate restriction. The urinary ketone could be trace or one or two, even three pluses, depending on the amount of coconut oil or MCT is consumed and the level of the individual's physical activity. I do not think excess or uncontrollable ketosis is desirable.

For now, my advice on the use of coconut oil or MCTs is (1) the individual is not severely restricting carbohydrate and his body does not produce beta-hydroxybutyrate, (2) the daily amount of coconut oil should be limited to recommended "dose", preferably well divided throughout the day or before physical activity, (3) the individual with carbohydrate restriction should be careful about using coconut oil or MCTs, because his body is supposed producing beta-hydroxybutyrate through gluconeogenesis from saturated fats.Smile

June 12, 2012
3:14 pm
JT
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Dr Su,
Thank you for the detailed response to my question. I would have responded sooner, but have been away from the computer.

I have experience using coconut oil and MCT many times over the last 10 years on both high and low carb diets and i dont think i ever have a good response, but it is definitely worse on low carb. I was taking a few teaspoons a couple times a day with food.

Im currently eating less than 50grams carbs a day. I'm lean healthy and physically active. I don't seem to have much of a problem transitioning from high to low carbs, so maybe my body naturally produces a lot of ketones easily, so adding the MCT creates too much ketones?

Do you think coconut/ MCT oil can be strenuous to the liver? Could this give the feeling similar to an alcohol hangover?

Thanks

June 13, 2012
10:12 am
ernie
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I take about 1 or 2 teaspoons a day of coconut oil in my coffee.  

Things that I noticed since starting (may or may not be related):

1) I stopped losing weight, I have been in the same weight range for 9 months.  Previously I lost rapidly.

2) I do not get hungry when I take Coconut oil with my coffee.

3) I am more clear headed and do not stall out (looking for the word) during a conversation.

 

comments?

June 13, 2012
11:45 am
Robert K. Su MD
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JT said:

Dr Su,
Thank you for the detailed response to my question. I would have responded sooner, but have been away from the computer.

I have experience using coconut oil and MCT many times over the last 10 years on both high and low carb diets and i dont think i ever have a good response, but it is definitely worse on low carb. I was taking a few teaspoons a couple times a day with food.

Im currently eating less than 50grams carbs a day. I'm lean healthy and physically active. I don't seem to have much of a problem transitioning from high to low carbs, so maybe my body naturally produces a lot of ketones easily, so adding the MCT creates too much ketones?

Do you think coconut/ MCT oil can be strenuous to the liver? Could this give the feeling similar to an alcohol hangover?

Thanks

JT:

Based your own experience in using coconut oil and MCTs while on either high carb or low carb diet, you did notice that you had less bad feeling with them while on high car than low carb diet. This is probably underscoring my observation that when one does not restrict carbohydrate, his body does not produce beta-hydroxybutyrate during most of the day except he does not eat at sleep. Therefore, producing beta-hydroxybutyrate by consuming coconut oil or MCTs might not cause a detrimental impact on the level of ketosis, unless, the consumption was high. On the other hand, when he restrict caarbohydrate, his body should produce beta-hydroxybutyrate, the amount of which is supposedly regulated by the level of "functioning" insulin, and keep the level of ketosis physiological. The level of ketosis should be low and harmless. He can check his urine ketone and find it trace or 1+, if he has not been physically or mentally active. Otherwise, his urine ketone could be negative when he is active during the daytime.

I have not seen any report about how consuming excess coconut oil or MCTs would affect the liver. Unfortunately, there is little research in this regard, as far as I know. In you case, I think the excess beta-hydroxybutyrate was probably making you feel alcohol hangover.

June 13, 2012
12:07 pm
Robert K. Su MD
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ernie said:

I take about 1 or 2 teaspoons a day of coconut oil in my coffee.  

Things that I noticed since starting (may or may not be related):

1) I stopped losing weight, I have been in the same weight range for 9 months.  Previously I lost rapidly.

2) I do not get hungry when I take Coconut oil with my coffee.

3) I am more clear headed and do not stall out (looking for the word) during a conversation.

 

comments?

ernie:

Thank you very much for sharing your own experience in using coconut oil. Taking one or two teaspoons a day of coconut oil might not be a problem yet. You should check the amount of ketone in your urine for confirmation. If your urine ketone is negative or trace or at least no more than 1 plus, I think you are okay. I was taking at least 2 tablespoons of coconut oil daily, which means at least twice more than you are taking. My urinary ketone was 3 plus.

The experience you described is very much in line with the expectation. Despite the commercial claim that coconut oil helps lose weight, an individual's net weight is the net of left-over energy after consumption. Coconut oil may help reduce the appetite and the total consumption of energy. However, that is not a rule for everyone.Smile 

June 26, 2012
9:43 am
JT
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Dr Su,

When I first experimented with MCT oil on a high carb diet I had no negative or positive effects. Later on when I experimented with coconut oil I had negative experiences. So I thought that maybe I had some sort of allergy to coconut. Coconut oil also causes bad stomach pains. I have known several people that could not tolerate coconut oil. Seems to have a high potential for allergic reactions.

My most recent experiment was with pure MCT oil to see if I could tolerate this instead of the coconut oil. But, it was refined from coconut, so maybe this was the problem.

I have a Nova Max blood ketone meter and I am always in ketosis. Usually around 1.5 to 2.5. Gone as high as 4 after a workout. So, maybe I don't need the extra from the MCTs. I should check my ketone levels with my meter to see how high it goes with MCT, but I haven't done this yet.

June 27, 2012
8:57 pm
Robert K. Su MD
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JT, your personal experience with coconut oil and MCTs is very interesting. May I ask you to clarify that if you first experimenting with coconut oil, were you still on high carb diet? THank you very much for sharing your experience with us.Smile

June 28, 2012
1:36 pm
JT
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Dr. Su,

 

When I first tried MCT and coconut oil I was on a high carb diet.

 

Do you have an opinion on what the optimal blood ketone level is?

 

Thanks

June 28, 2012
11:19 pm
Robert K. Su MD
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JT, since your trial with coconut oil when you were still on high carb diet, you might be allergic to coconut oil or you might have taken too much of it.

The normal amount of ketone in the blood is supposed to be zero. However, it is positive in diabetes mellitus and alcohol intoxication, as well as starvation and carbohydrate restriction. However, the amount of ketone through gluconeogenesis in both starvation and carbohydrate restriction should be minimal and regulated by functioning insulin. Thus, the ketone in the urine should be negative or trace. Smile 

July 18, 2012
3:50 pm
Annie
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Hi Dr. Su,

This is an interesting discussion about coconut oil.  I find that both coconut oil and butter tend to increase my appetite but I'm not sure if that isn't simply because they both taste so good.  Regarding beta-hydroxybutyrate -- wouldn't butter increase this and ketones as well as coconut oil??

July 18, 2012
3:54 pm
Annie
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Sorry -- forgot to add another related comment/question to my previous post.  Given that some very low carbers eat around 80% fat -- they necessarily add butter or other fats (olive oil, coconut oil etc) to get that very high fat percentage.  How can one do this and avoid the problem with excessive ketone production? Could it be that 80% fat is neither necessary nor desirable?

July 21, 2012
4:01 pm
Robert K. Su MD
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Welcome back, Annie,

You posted:

This is an interesting discussion about coconut oil.  I find that both coconut oil and butter tend to increase my appetite but I'm not sure if that isn't simply because they both taste so good.  Regarding beta-hydroxybutyrate — wouldn't butter increase this and ketones as well as coconut oil?

Both coconut oil and butter increase your appetite is not really surprising. Indeed, both taste good. Beta-hydroxybutyrate is a ketone like acetoacetone and acetone. Yes, both butter and coconut oil increase beta-hydroxybutyrate. While butter, contains a mixture of long-chain triglycerides and middle-chain triglycerides, produces beta-hydroxybutyrate through ketogenesis and metabolism of middle-chain triglycerides, 50% of coconut oil are middle-chain triglycerides, which are metabolized to beta-hyroxybutyrate. While insulin regulates ketogenesis, insulin likely has not control over converting middle-chain triglycerides into beta-hydroxybutyrate. Thus, I am afraid that consuming too much coconut oil, say, more than 3 tablespoons a day, will result in a high level of ketosis. I believe a low level of ketosis as a result of gluconeogenesis is not harmful. However, I wonder staying a high level of ketosis for an extended period of time might be unhealthy.

You posted:

Sorry — forgot to add another related comment/question to my previous post.  Given that some very low carbers eat around 80% fat — they necessarily add butter or other fats (olive oil, coconut oil etc) to get that very high fat percentage.  How can one do this and avoid the problem with excessive ketone production? Could it be that 80% fat is neither necessary nor desirable?

I agree that beta-hydroxybutyrate is an excellent alternative fuel to cells especially those of which with damaged mitochondria as a result of hyperglycemia. However, if the body does not use up all the betahydroxybutyrate but discharges the excess ketones into urine, that might harm the body. I would emphasize keeping normal blood glucose level al times is far more important than having a state of ketosis more than that with gluconeogenesis. So, 80% of fat in the high-fat diet, in my opinion, might not be necessary in all cases. Smile

July 22, 2012
7:00 pm
Annie
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Thank you for your thoughtful responses Dr. Su.

 

You posted:

 

I agree that beta-hydroxybutyrate is an excellent alternative fuel to cells especially those of which with damaged mitochondria as a result of hyperglycemia. However, if the body does not use up all the betahydroxybutyrate but discharges the excess ketones into urine, that might harm the body. I would emphasize keeping normal blood glucose level al times is far more important than having a state of ketosis more than that with gluconeogenesis. So, 80% of fat in the high-fat diet, in my opinion, might not be necessary in all cases. 

 

I am tending to agree with you that 80% may not be necessary in all cases.   I believe this may be especially true once a person reaches goal weight.  Some low carb authors argue that once excessive body fat is lost via low carb dieting , then the dietary fat in the diet must be increased to fuel the body's energy needs.  They claim that a truly low carb high fat diet must be around 80% fat.  This strategy may very well be appropriate for some people but to say it's necessary for everyone I think creates more animosity against low carb diets in general  and amongst those following the low carb lifestyle who are running into maintentance troubles or who stop losing body fat short of their fat loss goals and don't see extreme ketosis solving their issues.  On various low carb and paleo forums,  I see people having trouble in maintenance and the usual advice is to keep going lower in carbs or cut protein back a bit but always always always up the dietary fat. ( Dietary fat in virtually any amount is seen as totally benign within the low carb context and the more ketones, the better.)  Yet this simply doesn't work for everyone.  Perhaps prolonged  excessive ketone production negatively impacts inuslin sensitivity or creates some other unknown harm.  Some long term very low carbers on paleo forums complain that over time their morning glucose has risen despite deep ketosis.  This is why maintenance is a highly individualized matter and I tend to agree with Taube's latest book where he mentions that nobody really knows if a high fat versus very high fat (80%+) is better within the low carb context.   Unfortunately, the lack of consensus amongst low carb experts creates confusion and disallusionment.  Same goes for the disagreement amongst low carb experts regarding types of dietary fat and whether saturated versus monosaturated is preferable during weight loss phase and/or if changes need to be made during maintenance. 

 

I would love to see more low carb experts discuss this topic.

July 30, 2012
9:13 pm
Robert K. Su MD
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Below is a copy of my e-mail correspondences with a lady, R.

On Jul 26, 2012, at 7:03 PM, R….. wrote:

Hello Dr. Su,

I just recently found your website! Great information, thank you. 

I have read and reread your posts on coconut oil. 

I have some questions remaining that I hope you may not mind answering. 

 

I am 30 years old, 133 lbs 5'2" I am Korean, although that may not matter. I started eating a primal diet about 2 years ago. I also practice intermittent fasting, with an 18/6 eating window. I have 2 meals per day. I have a very strong sensitivity to sugar, wheat/gluten. As of January 2012 I completely cut sugar out of my diet. I am very strict, no slip ups since then, not one.

My diet consists of grass fed beef, pastured pork, local farm eggs, some aged or raw cheese(just reintroduced) and lots of butter(4 oz of Kerry gold per day is usual). I recently cut back on veggies because I felt they were keeping me out of ketosis. I have also cut out unsweetened coconut flakes. Toasted coconut and butter was my former dessert. I drink only berkey filtered water. 

As for exercise, I walk 2 mi/6 days a week. My husband and I also work out with heavy weights 3-4 times a week moving at a fast pace. Our workouts are at most 35 minutes. We have a farm so I am use to intense labor in the heat. 

I recently introduced coconut oil to my diet, about one month ago. About two weeks ago I started feeling absolutely exhausted. We tapered back on the workouts. I still felt half dead. My body felt completely heavy. I was eating 2 tbsp of coconut oil with each meal, 4 tbsp all day. Previously, I had great energy never tiring. I also began getting mouth ulcers. I thought I may be eating too many vegetables(squash, broccoli) and my body could be having a difficult time choosing a fuel to run on. That is when I reduced veggies and upped fat even more. No increase in energy. I do not eat any starches, has been about a year. 

 

I have tried to find much info on coconut oil, but most is just about the benefits of it. I found your site which discussed some of the negatives. Could you please enlighten me more on the subject. I am a very high fat, very low carb eater who practices IF daily. I feel I may have negative effects from coconut oil, but can't decide if that is reality. 

I was interested in CO for fat loss benefits and hair/skin benefits. I have been trying to get a six pack and introduced coconut oil to break a stall. I am close, but not yet there. 

Beside yourself, Peter at hyperlipid is the only other blogger I have found who does not believe coconut oil is purely beneficial. He does not reccomend its use. Is it true that coconut oil results in thermogenesis because one's body wants to rid of it before burning any of the body's own fat? Therefore, making it not so beneficial. 

 

I do not know whether coconut oil is helping or hampering my fat loss or energy levels. What is your opinion? I may have provided you too much info, but I wanted to include all I could for your accurate opinion. 

 

Thank you. 

Best regards,

R

 

On Jul 26, 2012, at 7:33 PM, Carbohydrates Can Kill <mailto:carbohydratescankill@verizon.net. Or, with you permission, I'll post them without your name attached.

 

I personally experienced a terrible consequence with my health turning 180 degrees, from a healthy, full of stamina and improved blood pressure, to hypertension, left ventricular hypertrophy, and arrhythmia. I was almost dying. And, I stopped taking coconut oil immediately when I combed all the possible culprits. I am taking notes while continuing to reverse my course. When I completely reverse my illness and become healthy again, I'll share my experiences with everyone.

 

Thank you very much. Good luck.

 

Best regards,

 

Robert Su, Pharm.B., M.D.

carbohydratescankill@verizon.net

Author, Carbohydrates Can Kill

Podcast Talk Show Host,  Carbohydrates Can Kill 

http://www.carbohydratescankill.com

 

On Jul 30, 2012, at 8:41 PM, R…. wrote:

Thank you again for your response. Feel free to post our correspondence on your forum. It is very hard to get an accurate opinion of CO. Much of what I have read online is personal opinion or sales related and has no medical backing. 

 

My goodness, you really did experience negative effects from the CO. How very scary. I hope your health is now much improved. I have read so many positives about CO that I almost did not want to believe it could be hurting me. 

 

Thank you again,

R

July 31, 2012
5:52 am
Robert K. Su MD
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In my hindsight, I learned the following:

1. The moderate dieting approach described in a short five pages of my book, Carbohydrates Can Kill, under the heading, "My Suggestions For Dieting", is still the best for me, at least. I regret that I added coconut oil to it without first doing more research on the metabolic consequence of coconut oil.

2. Despite my ill personal experience with coconut oil, I still recommend it and MCTs for those who have suffered with degenerative disease as a result of having consumed high carbohydrate diet with hyperglycemia. However, I believe switching from HCLF with coconut oil or MCTs treatment to LCHF without coconut oil or MCTs is the preferred approach.

3. If I "REALLY" want to use coconut oil again, I would use it in a much smaller quantity and preferably for cooking only.

4. The level of ketosis requires everyone's attention. It is safer to keep the level of ketosis within the physiological range.Smile

July 31, 2012
8:24 am
Robert K. Su MD
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While we realized coconut was part of the foods, which our ancestors consumed. However, refined coconut oil was not there at that time. Coconut oil was contained in the raw coconut and is no comparison to today's pure, virgin coconut oil. Therefore, the method and the amount of consumption today must be a matter of concerns in terms of its health impact.Smile

July 31, 2012
11:11 am
Mary Titus
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Doc, When I began consuming coconut oil, it made me sick. I backed off and increased it as I felt comfortable doing it. MCT oil gave me a jittery feeling so I back off from that too but I still take it. I recently learned that if you become ill that is indicative of your body not absorbing fat very well. As your body adjusts to the new intake of the fuel it is absorption improves. It is absorption that I think should be more of a focus and not so much ketosis. If you are not absorbing the fat very well it will be removed from your body through urine, feces and hurling  Embarassed  It will also show a high level of ketones. This may not necessarily be a manifestation of ketosis causing a problem but simply the inability to absorb that amount of coconut oil. 

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