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Alzheimers Dement. 2015 Jan;11(1):99-103. doi: 10.1016/j.jalz.2014.01.006. Epub 2014 Oct 7.

A new way to produce hyperketonemia: use of ketone ester in a case of Alzheimer's disease.

Author information

1
Spring Hill Neonatology, Inc, Spring Hill, FL, USA.
2
Department of Medicine, St. Luke's Hospital, New York, NY, USA.
3
Division of Neurology, Tominaga Hospital, Osaka, Japan.
4
Laboratory of Metabolic Control, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA.
5
Laboratory of Metabolic Control, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA. Electronic address: rlveech@comcast.net.

Abstract

BACKGROUND:

Providing ketone bodies to the brain can bypass metabolic blocks to glucose utilization and improve function in energy-starved neurons. For this, plasma ketones must be elevated well above the ≤ 0.2 mM default concentrations normally prevalent. Limitations of dietary methods currently used to produce therapeutic hyperketonemia have stimulated the search for better approaches.

METHOD:

Described herein is a new way to produce therapeutic hyperketonemia, entailing prolonged oral administration of a potent ketogenic agent--ketone monoester (KME)--to a patient with Alzheimer's disease dementia and a pretreatment Mini-Mental State Examination score of 12.

RESULTS:

The patient improved markedly in mood, affect, self-care, and cognitive and daily activity performance. The KME was well tolerated throughout the 20-month treatment period. Cognitive performance tracked plasma β-hydroxybutyrate concentrations, with noticeable improvements in conversation and interaction at the higher levels, compared with predose levels.

CONCLUSION:

KME-induced hyperketonemia is robust, convenient, and safe, and the ester can be taken as an oral supplement without changing the habitual diet.

KEYWORDS:

Brain insulin resistance; Fasting; Ketogenic diet; Ketone bodies; Ketone monoester; Medium-chain triglyceride; Pyruvate dehydrogenase; β-Hydroxybutyrate

PMID:
25301680
PMCID:
PMC4300286
DOI:
10.1016/j.jalz.2014.01.006
[Indexed for MEDLINE]
Free PMC Article

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