Coconut Oil vs MCT Oil

When writing about my fat fast, I mentioned that one positive about coconut oil is that it contains a lot of medium chain triglycerides (MCT). These are fatty acids that can be used for energy very quickly by the body in contrast to long chain triglycerides which need to be broken down by the liver. MCT can be transformed into ketones which is obviously popular to many paleos.

The consumption of coconut oil has exploded in recent years, and, as a result, MCT oil has grown in popularity as well. Since coconut oil is only about 60% MCT, some entrepreneurs are selling pure MCT by separating it from coconut oil or palm kernel oil.

I’m not going to delve into the health benefit debate between MCT v coconut oil. Suffice to say, there is a growing niche market in MCT, and its advocates argue that for optimal ketosis, it’s the right stuff to take. The process of separating MCT from coconut or palm looks safe too.

I’m more interested today in the price of these oils. Remember that coconut oil is about 60% MCT. All prices are in pounds sterling (i.e., British pounds).

The price for 1L of extra virgin organic coconut oil ranges from £6.66 to £16.00. The average price is around £9.00.

MCT oil, in contrast, ranges from a low of £16 per litre up to £35. Most of the oils are closer to the higher end. The average price is around £28.

Typically I eat a tablespoon of coconut oil a day on average. Some days I skip, others I may double up. The directions for MCT oil call for one tablespoon servings. So broadly speaking, one would take about the same amount of either oil per day.


For me the significantly higher price of MCT oil outweighs any possible health superiority over coconut oil. Even if I decided to double my coconut oil intake, it would still be significantly cheaper.

I’m sure there are people out there that will disagree with me and please point me in the direction of research papers that tell me I’m wrong, but I just don’t see the health benefits of MCT being hugely superior to coconut oil.

Ultimately, MCT is just too expensive.

A Hostile Doctor

After my diagnosis, I was lucky in that I was near a teaching hospital which had an endocrinology department. I was getting specialist treatment for my diabetes; the service and advice were good but conventional. Well the advice was good…at first.

My blood control was very good with my insulin injections, so I only needed to see the doctor for check-ups every six months. It was during one of these windows in 2012 when I adopted the paleo diet and no longer needed insulin. I had also stopped taking thyroxine, as I was eating coconut oil to heal my thyroid instead. I got my blood work done and went to my appointment.

I don’t know how that department was organised, but I rarely saw the same doctor twice. This time round, it was another new doctor. She went through my blood work (6.2 mmol/L) and said everything looked good including my thyroid levels.

That’s when I dropped the bombshell: I told her, I’d stopped insulin injections five months prior and thyroxine three months prior.

Her reaction was disbelief, “You need to be on insulin!” She didn’t like this. Was I lying? Crazy?

There wasn’t much she could do though? Tell me to go back on insulin even though I didn’t need it? She told me to come back in six months as usual. Her demeanour: frosty.

So, six months later I came back. My blood had been creeping up a bit. When looking back, it was because I was nowhere near as strict as I am now. I was still a little bit in limbo between the traditional Western diet and paleo. I was probably 85% paleo then. The bad habits I still had from my previous life led to a higher HbA1c.

So what was interesting at my next appointment was that I did have this doctor again. She looked at my blood glucose (7.6) and recommended insulin again. She prescribed me with something she described as a “background” insulin.

Some of you reading this may find this a strange treatment. My pancreas was clearly still functioning on some level. Insulin was not the typical first step here. Metformin was.

On my walk home I decided I wasn’t going to fill the prescription. I ignored her advice.

Fortunately at that time, I was also seeing a diabetes nurse at my local doctor’s office every three months. She was a diabetic herself; I told her about my change in diet and what had happened at the hospital.

Now it was her turn to be surprised. “Insulin? Metformin’s the half-way house for someone in your condition,” she said or words to that effect.

What did she think about my diet? I don’t think she cared. My nurse was a pragmatist and had been living with diabetes herself for thirty odd years. So long as it kept my blood at good levels, and I was feeling fine, keep on it. She wrote me a prescription for metformin and the rest is history. That was six or seven years ago.


I came up against a doctor who was blinded by conventional wisdom and not prepared to entertain anything that went against her world view. Whatever she had memorised from her textbook at medical school was all she needed to know. I believe Carol Dweck would call this a closed mindset. I’m sure the doctor thought she was doing a pleb like me a favour.

In contrast, my nurse was open to the possibility that diabetes affects everyone differently, and that whatever I was doing was working. She was sympathetic and gave me the correct treatment for my situation.

The whole episode made me realise I needed to take more ownership for my disease. I needed to research more about diabetes, paleo, fitness, food, etc.

Looking back, I’m so glad I ignored the doctor and listened to the nurse. My hostile doctor was not helpful.

Sitrep – One Week after Fasting

Readers will know that I went on a four-day, water/black coffee only, fast last week. My blood glucose levels came way down. On the morning of Day 4, my blood glucose was 4.1 mmol/L.

I’ve done similar fasts in the past, but I could not maintain ideal blood control due to bad habits: mainly red wine, too much protein, too much dark chocolate and too many nuts.

So where am I today one week later? Blood glucose is far better than in the past. My numbers, up until yesterday morning, were between 5.7 and 7.6. Unfortunately, after too many nuts and meat protein on Thursday night, I woke up with a reading of 8.6 mmol/L. Now historically, this is not that bad a reading for me. However, there is no way I’ll reach my 5.7 HbA1c this autumn if I tell myself “It’s not so bad, you’re sugar will go down during the day.” It will go down, but not enough.

So what to do?

Simple. I had a small breakfast on Friday and then went on a 24 hour fast. Result. I woke up this morning with a 6.2 mmol/L. This is my way forward I think. If my morning reading is above 7.6 then I have to go on at least a one-day fast to get close to optimal blood glucose.

We’ll see how this goes. It’s essentially intermittent fasting, but dictated by my blood-glucose readings.

My Four Day Fast

Photo by PhotoMIX Company on

I’ll have more to say about the ketogenic diet in later posts, and how it contrasts with paleo. For now, let’s just say it’s a more extreme form of the paleo diet, with even less carbs and higher fat. Take the standard food pyramid, invert it and delete the breads and sugars.

I’ve gone keto before, and the results were quite positive. My blood sugar levels were lower than normal paleo, and I felt better too. The fact that alcohol was a no-no during these periods obviously helped.

Why did I give it up if it was so good? The siren song of red wine, that’s why. No more!

One part of the keto lifestyle is intermittent fasting. I’ve done this a lot even while on normal paleo. If I’m not hungry, I don’t eat. Sometimes I forget to eat because I’m not hungry. This is one of the glories of paleo. It’s so high in fat that I feel satiated all the time. I don’t get hunger pangs anymore.

Keto goes a step further or it can go further if you want to go there. Instead of skipping a meal or two, one skips eating for a day or two or three, etc.

I’m going on a four-day fast after tonight’s Sunday roast chicken. Other than a black coffee in the morning and afternoon, there will be nothing else. I haven’t done a fast like this in a while, and, as I said, one of the reasons for this blog is to take my paleo-lifestyle to the next level.

I’ll update the site each evening about my blood levels and general well-being.

Youtube is full of videos on fasting. One chap I really find interesting is Dr Jason Fung:

Why Blog Now?

Have you heard about the 10,000 hour rule popularised by Malcolm Gladwell? The idea is simple. To become an expert at something, you need to invest 10,000 hours of blood, sweat and tears into that endeavour.

I’ve been living the paleo lifestyle since May 2013. My back of the envelope calculations tell me I’ve put in around 40,000 waking hours living as a paleo diabetic. I think that gives me some expertise that I can share with you.

It hasn’t been an easy journey at times either. If my mistakes can produce cautionary tales, all the better.

Alas, it’s not all altruism at The Paleo Diabetic. I think blogging is going to keep me more honest and help me cast aside the last vices that have slowed my path to optimal blood glucose levels. I’m calling you out red wine!

Those of you who come to the site welcome. I hope you can take away something of value.