06/11/2026
Interesting, worth following
Medium chain triglycerides have emerged as potentially important players in the management of coronary artery disease and congestive heart failure. A little-known condition called triglyceride deposit cardiomyovasculopathy (TGCV) is attracting growing attention because it may represent a fundamentally different type of coronary artery disease. Rather than being driven primarily by extracellular cholesterol-rich plaque formation, TGCV appears to involve abnormal intracellular accumulation of triglycerides within the heart muscle and coronary artery wall, associated with impaired triglyceride breakdown inside cells. Japanese researchers have proposed that some patients with diffuse coronary disease, particularly those with diabetes, dialysis-dependent kidney disease or refractory multivessel disease, may actually have this under-recognised metabolic form of cardiomyopathy and coronary artery disease, rather than ‘ordinary’ atherosclerosis alone.
The condition was first identified in patients with rare genetic defects affecting the enzyme adipose triglyceride lipase, but Japanese investigators now argue there may also be a broader acquired form that can potentially affect anyone. Pathology studies suggest the vascular lesions differ from classical focal cholesterol-rich atheroma, instead showing diffuse concentric narrowing with triglyceride accumulation in vascular smooth muscle and myocardial tissue. Because the clinical presentation can resemble advanced diabetic coronary artery disease, heart failure or diffuse multivessel atherosclerosis, TGCV may frequently be conflated with conventional heart disease. Diagnosis is also difficult outside Japan because it often relies on specialised metabolic imaging techniques such as BMIPP scintigraphy, which are rarely used in Western cardiology practice.
Interest in the condition has intensified after reports that supplementation with tricaprin (glyceryl tricaprate), a triglyceride composed of three capric acid (C10) molecules (a medium chain fatty acid), was associated with remarkable regression of this diffuse coronary disease in a small number of patients. The doses used were surprisingly modest, approximately 1.5 to 4.5 g/day of tricaprin, far lower than doses typically used in ketogenic therapies. The proposed mechanism was not simply ketone generation, but restoration of intracellular triglyceride handling and lipolysis within cardiac and vascular tissue. Blood lipid levels changed little, suggesting the intervention may have been acting at the level of cellular fat trafficking rather than a plasma lipid reduction.
This has naturally raised interest in whether ordinary medium-chain triglyceride (MCT) oils might provide a practical source of tricaprin-like compounds. Most commercial MCT oils contain mixtures of caprylic acid (C8) and capric acid (C10) triglycerides, with typically around 30 to 50% C10. On that basis, the doses used in the TGCV reports roughly correspond to about 1 teaspoon to 1 tablespoon daily of a standard MCT oil. However, ordinary MCT products are not equivalent to purified tricaprin preparations, and it remains uncertain whether they would reproduce exactly the same biological effects. Nonetheless, the work is intriguing because it suggests that at least some forms of cardiovascular disease may involve disordered intracellular energy and lipid handling, rather than issues related to cholesterol deposition.
This concept might be explored in patients with diffuse or treatment-resistant cardiometabolic disease, especially those with diabetes, metabolic syndrome, heart failure, myocardial steatosis or diffuse multivessel coronary disease that appears disproportionate to conventional lipid findings. It may also be particularly important in renal dialysis patients, where Japanese studies have reported unexpectedly high rates of a TGCV-like pathology. In such settings, tricaprin at approximately 1.5 to 4.5 g/day, or roughly 1 teaspoon to 1 tablespoon daily of a typical C10-containing MCT oil, might be considered as an adjunctive metabolic-supportive strategy, although the evidence remains early and highly exploratory. It is harmless and easy to do at those doses.
For more information: https://scitechdaily.com/scientists-say-this-simple-supplement-may-actually-reverse-heart-disease/
