Coconut Oil

Scientific Name(s): Cocos nucifera L.
Common Name(s): Coconut oil, Coconut palm oil, Copra oil, Virgin coconut oil

Medically reviewed by Drugs.com. Last updated on May 22, 2024.

Clinical Overview

Use

Coconut oil is promoted for a wide variety of health conditions and has been clinically evaluated for cardiovascular, CNS, and insect repellant effects. However, robust large-scale clinical trials are lacking to substantiate these benefits, and excessive consumption may contribute to dyslipidemia. Topical application is recognized as safe and may be effective in managing eczema.

Dosing

Clinical studies to inform therapeutic dosing are lacking.

Contraindications

Contraindications have not been identified.

Pregnancy/Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

None well documented.

Adverse Reactions

GI effects (cramping, diarrhea) have been reported.

Toxicology

No data. Coconut oil has generally recognized as safe (GRAS) status.

Scientific Family

• Arecaceae (palm)

Botany

The coconut palm grows in Florida, Hawaii, and North Carolina in the United States, and throughout tropical Asia, the Indo-Pacific region, Africa, and South America. There are 2 main varieties, distinguishable according to height. The tall variety (up to 27 m [90 ft] in height) is slow growing, producing fruit after 6 to 10 years, while the dwarf tree (9 to 18 m [30 to 60 ft] in height) bears fruit in 4 to 5 years. The coconut drupe weighs approximately 1.4 kg (3 lb), and like other fruits, has 3 layers (the green exocarp, the mesocarp or coir fibers, and endocarp). The fruit endosperm is the white, fleshy "meat" (or "copra") from which the oil is expressed, and the cavity at the center of the drupe is filled with coconut water and air.(Duke 2002, USDA 2022)

History

The coconut palm is a source of food throughout the world, especially in Indonesia, the Philippines, and India, and has been widely used in Asian cooking for many centuries. Many therapeutic claims exist, and in the traditional Ayurvedic medical system, the oil is used in hair loss, burns, and heart conditions. The tree has been called the "tree of life" and "the fruit of aspiration" and was traditionally offered to the gods at the start of new ventures in India. Coconut water was used as an intravenous fluid in World War II because the pH is consistent with plasma. Today, coconut oil is widely used in cosmetics, as well as in cooking.(Burnett 2011, DebMandal 2011, Duke 2002)

Chemistry

The white flesh/meat of the coconut consists of approximately 70% coconut oil, which is mechanically pressed from the fruit. It can then be further refined, bleached, and deodorized. Other techniques produce hydrogenated coconut oil, coconut acid, hydrogenated coconut acid, and esterification products. Virgin coconut oil is prepared with no heating during the extraction process, and the resultant oil does not have the same odor as ordinary coconut oil. Byproducts of oil production include coconut skim milk and insoluble proteins.(Naik 2012, Ng 2021)

Palms, in general, are rich in oils, terpenoids, and phenolic compounds. The fruits of many species are notable for their high content of healthy oils and fat-soluble bioactive compounds, mainly terpenoids, such as pigment carotenoids (and provitamin A), phytosterols, triterpene pentacyclics, and tocols (and vitamin E).(Agostini-Costa 2018)

Coconut oil is composed mainly of saturated fats (90%), primarily lauric acid and other monounsaturated and polyunsaturated fatty acids. The primary triglycerides include trimyristin, trilaurin, tripalmitin, and tristearin. Medium-chain triglycerides of caprylic, capric, and phenolic acids (eg, caffeic, coumaric, and ferulic acids) are also present. Minerals such as iron, phosphorus, and zinc, as well as vitamins E and K are found in minor amounts.(Burnett 2011, DebMandal 2011, DeDea 2012, Marina 2009, Naik 2012, Ng 2021)

The oil is heat stable and slow to oxidize or turn rancid. Standards have been published for coconut oil.(Burnett 2011, DebMandal 2011, DeDea 2012, Marina 2009, Naik 2012, Ng 2021)

Coconut palm (C. nucifera) is an important commercial crop in many tropical countries, but its industry generates large amounts of residue. One way to address this problem is to use this residue, coconut husk, to produce second-generation ethanol, also known as bioethanol.(Bolivar-Telleria 2018)

Uses and Pharmacology

Coconut oil has attracted attention due to its potential hypocholesterolemic, anticancer, antihepatosteatotic, antidiabetic, antioxidant, anti-inflammatory, antimicrobial, immunostimulant, and skin moisturizing properties. Despite possible health benefits, supportive clinical evidence is lacking.(Abujazia 2012, DebMandal 2011, Deen 2021, Zakaria 2011a)

Antiparasitic effect

Clinical data

In 2013, a 10-week randomized controlled field study in Madagascar documented rapid and significant improvements in tungiasis outcome measures in subjects treated twice daily with a coconut oil−based herbal repellent that included jojoba oil and aloe vera. Tungiasis is a parasitic sand flea skin disease that can cause significant morbidity in many resource-poor tropical communities. At 2 weeks, the sand flea attack rate was zero, and the intensity of infestation as well as severity scores for acute and chronic tungiasis were significantly decreased. Within 10 weeks, the degree of tungiasis-associated morbidity approached zero.(Thielecke 2013)

Cardiovascular risk factors

Animal data

Older experiments in rats demonstrated harmful effects of coconut oil as a dietary fat.(Assunção 2009)

Clinical data

Limited short-term studies (4 to 12 weeks) suggest that limited ingestion of coconut oil does not significantly affect lipid profiles.(Assunção 2009, Liau 2011, Vijayakumar 2016) Approximately half the saturated fat content of coconut oil is in the form of lauric acid, giving coconut oil a different profile from other highly saturated fats, such as butter and animal fats; this composition may be potentially responsible for the suggestion that coconut oil may not be as harmful as other saturated fats(Cunningham 2011, Willett 2011). When compared with sunflower oil in a single-blind randomized trial, use of coconut oil for cooking did not yield differences in body mass index, body fat percentage, lipid profiles, lipoprotein A, glycosylated hemoglobin, or surrogate markers of endothelial function in patients with coronary artery disease.(Vijayakumar 2016)

A systematic review and meta-analysis of interventional studies was conducted to quantify effects of coconut oil compared with other oils and fats on cardiometabolic parameters; results showed higher total cholesterol, LDL cholesterol, and HDL cholesterol with coconut oil versus other oils, suggesting consumption of coconut oil could be a possible risk factor for cardiovascular disease, particularly in high-risk populations (eg, South Asian population).(Jayawardena 2020) Such results were confirmed in a systematic review and meta-analysis of clinical trials that concluded that coconut oil consumption results in significantly higher LDL cholesterol than nontropical vegetable oils, and that this should inform choices about coconut oil consumption.(Neelakantan 2020) In a randomized crossover trial, corn oil produced a more favorable plasma lipid profile than coconut oil in adults with elevated cholesterol.(Maki 2018)()

CNS effects

The potential of coconut oil and medium-chain triglycerides in the prevention and treatment of Alzheimer disease has been evaluated in a review. The neuroprotective antioxidant properties of coconut oil have been attributed to its polyphenolic content. It is believed that medium-chain fatty acids may aid in compensating glucose hypometabolism observed in the Alzheimer disease brain.(Chatterjee 2020)

Animal data

In rats with induced paw and ear edema administered topical and oral virgin coconut oil, granuloma formation was decreased and writhing response was reduced; antipyretic effects were also observed.(Intahphuak 2010, Zakaria 2011b) Limited animal studies suggest that high-fat and ketogenic diets, including coconut oil−based diets, may exert positive effects on motor neuron disease.(ALSUntangled 2012)

Clinical data

Large clinical studies evaluating anti-inflammatory or antinociceptive properties of coconut oil are lacking. Coconut oil has been suggested for use as a "medical food" in the management of Alzheimer disease, amyotrophic lateral sclerosis, dementia, and other diseases of the nervous system; however, clinical trials to substantiate these claims are lacking.(ALSUntangled 2012, DeDea 2012) The basis of these claims derive largely from case reports as well as a clinical study of medium-chain triglycerides in patients with Alzheimer disease in which improved cognition scores were observed after 90 days of treatment with caprylic acid from coconut or palm kernel oil (marketed as caprylidene in the United States).(DeDea 2012)

In a prospective, longitudinal, qualitative, analytic, experimental study in patients with Alzheimer disease (N=44), patients were randomly divided into 2 homogenous groups (n=22). An experimental group followed a coconut oil−enriched Mediterranean diet for 21 days while the control group did not. Cognitive changes after intervention were evaluated using the 7 Minute Screen, which analyzes temporal orientation, visuospatial and visuoconstructive abilities, and semantic and episodic memory. After intervention with coconut oil, improvements in episodic memory, temporal orientation, and semantic memory were observed, with a positive effect more evident in women with mild-moderate Alzheimer disease states, although other improvements in males and severe Alzheimer disease states were also observed.(de la Rubia Ortí 2018)

Dental hygiene/oral health

Clinical data

Limited evidence from a systematic review suggests that oil pulling with coconut oil could be used as an adjunct to normal preventative regimes to improve oral health and dental hygiene, although further studies are needed to determine the level of effectiveness.(Woolley 2020)

Dermatological effects

Animal data

Coconut oil is considered safe for use in cosmetic and dermatological preparations, making data from animal studies largely irrelevant.(Burnett 2011) Improved wound healing has been demonstrated in rats with applications of virgin coconut oil.(Nevin 2010)

Clinical data

Limited robust clinical studies support potential therapeutic applications for eczematic conditions in addition to use in cosmetic preparations.(DebMandal 2011)

In a randomized clinical study in adults with atopic dermatitis (N=26), improvement in severity scores and a reduction in Staphyloccous aureus colonization were observed with twice-daily topical applications of virgin coconut oil over 4 weeks.(Verallo-Rowell 2008)

In a randomized, double-blind trial in patients with mild to moderate xerosis (N=34), coconut oil was superior to mineral oil in alleviating symptoms of xerosis, such as dryness and rashes. Also in randomized controlled trials of pediatric patients with mild to moderate atopic dermatitis, superiority of topical virgin coconut oil application over mineral oil in relieving atopic dermatitis–related symptoms and downregulating atopic dermatitis progression was observed.(Hussain 2017)

A randomized controlled trial investigated the effect of virgin coconut oil application on the skin of preterm newborns (N=2,294). The group receiving virgin coconut oil (n=1,146) experienced fewer incidences of hypothermia and apnea, with better skin maturity and neurodevelopmental outcomes. No significant adverse effects were noted with coconut oil application.(Konar 2020)

Diabetes

Clinical data

One review of interventional studies suggests coconut fat in meals may be associated with a diminished postprandial insulin response, resulting in a subtle increase in postprandial glycemic response. Long-term intake of coconut fat appears to increase insulin resistance, but does not seem beneficial for long-term glycemic control. Thus, results disprove the popular claim that coconut fat improves glycemic control.(Dhanasekara 2022)

Growth effects

Clinical data

In a study in very low body weight babies (N=60), breast milk supplemented with coconut oil did not increase growth parameters or result in change in body composition compared with breast milk alone.(Arun 2019)

Pesticide poisoning

Coconut oil is reported to be useful in the management of aluminum phosphate pesticide poisoning. The oil is thought to form a protective layer in the gastric mucosa and prevent absorption of phosphine gas, and may also dilute the hydrochloric acid present, thus slowing the breakdown of the phosphide.(Gurjar 2011, Mehrpour 2012)

Sugar source

In vitro data

A study comparing the antioxidant and nutritional properties of coconut sap with those of sugar palm and sugarcane juices showed that coconut sap could serve as a potential healthier sugar source.(Asghar 2019)

Dosing

Clinical studies to inform therapeutic dosing are lacking.

Pregnancy / Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking. Traditional use of ginger in coconut water as an emmenagogue suggests caution is warranted during pregnancy.(Duke 2002) A study in pregnant rats showed no effect of coconut oil on hematological or metabolic parameters.(Nandakumaran 2011)

Interactions

Limited information is available regarding potential drug interactions.

Adverse Reactions

Consumption of coconut oil can cause adverse GI effects, such as cramping and diarrhea.(DeDea 2012) Topical coconut oil is relatively nonallergenic even in pure form.(Burnett 2011)

Consumption of large quantities of saturated fats, such as those in coconut oil, is recognized to contribute to dyslipidemia and cardiovascular disease.(Cunningham 2011, Komaroff 2006, Willett 2011)

Related/similar drugs

Toxicology

Coconut oil has GRAS status. In cosmetic products, coconut oil is considered safe for use. Animal toxicology tests suggest coconut oil is nontoxic when ingested.(Burnett 2011) A study in pregnant rats found no effect of coconut oil on hematological or metabolic indices.(Nandakumaran 2011)

References

Disclaimer

This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.

This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.

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