Few dietary fats stir up as much debate as coconut oil. Walk into any health food shop and you’ll find it marketed as everything from a weight loss aid to a cure for Alzheimer’s disease. Meanwhile, cardiologists warn about its high saturated fat content. So what’s actually going on here?

The reality, as with most nutrition topics, is messier than either camp suggests. Coconut oil does have some genuinely interesting properties, but many of the health claims you’ll hear are based on studies of medium-chain triglycerides (MCTs) rather than coconut oil itself. This matters more than you might think.

What is coconut oil, exactly?

Coconut oil comes from the flesh of mature coconuts. Virgin coconut oil is extracted without chemical processing, meaning it hasn’t been bleached, deodorised, or refined. Unlike olive oil, there’s no regulated standard for what “virgin” means for coconut oil, so quality varies between brands. [1]

The oil contains roughly 82% saturated fat, which is higher than butter (63%) or even lard (39%). This high saturation is why coconut oil stays solid at room temperature and has a long shelf life.

The medium-chain fatty acid confusion

Here’s where things get complicated. Much of the enthusiasm for coconut oil stems from research on medium-chain triglycerides (MCTs), which are absorbed differently from most dietary fats. Instead of travelling through your lymphatic system, MCTs go directly to your liver via the portal vein, where they can be quickly converted to energy. [2]

Coconut oil contains four MCTs:

Lauric acid (47%): 12 carbon atoms
Capric acid (7%): 10 carbon atoms
Caprylic acid (9%): 8 carbon atoms
Caproic acid (1%): 6 carbon atoms

The catch? Lauric acid, which makes up nearly half of coconut oil, doesn’t behave like a typical MCT. Research shows that only 20-30% of lauric acid is absorbed directly via the portal vein, while the remaining 70-75% is absorbed through chylomicrons like regular long-chain fats. [3] True MCTs are absorbed directly at rates of 95%. [4]

This means many benefits attributed to MCTs in research don’t automatically apply to coconut oil. It’s a distinction that often gets lost in marketing materials.

What are the potential benefits of coconut oil?

1. Mixed effects on cardiovascular markers

Let’s start with the elephant in the room: heart health. Cardiovascular disease remains a leading cause of death worldwide, and dietary fat is a major focus of prevention efforts.

The relationship between coconut oil and heart disease is genuinely unclear. A review of 21 studies found that coconut oil raises both LDL (“bad”) cholesterol and HDL (“good”) cholesterol compared to unsaturated vegetable oils. The increase in total cholesterol was less than butter but greater than oils like olive or rapeseed. [5]

Traditional populations in the Pacific Islands who eat coconut-heavy diets have historically shown low rates of heart disease, but their overall lifestyle differs dramatically from modern Western patterns. They typically consume whole coconut rather than extracted oil, eat far less processed food, and are more physically active. Drawing conclusions about coconut oil from these populations is a stretch.

I’ll be honest: if your primary concern is cardiovascular health, the evidence doesn’t support choosing coconut oil over unsaturated alternatives. But if you’re using small amounts for cooking or flavour, it probably isn’t the disaster some headlines suggest.

2. Modest effects on body weight

Obesity affects a significant portion of the global population, and any food that might help has understandably attracted attention.

The theory behind coconut oil for weight loss involves those medium-chain fatty acids again. MCTs are metabolised faster than long-chain fats and may increase calorie burning slightly. A 2009 study found that women consuming coconut oil showed greater reductions in waist circumference compared to those consuming soybean oil. [6]

A 2015 study of 116 patients with cardiovascular disease found that adding 13ml of coconut oil daily led to improved waist measurements and higher HDL cholesterol compared to dietary advice alone. [7]

However, the weight loss effects in these studies were modest. You shouldn’t expect coconut oil to melt away fat on its own. Combined with a calorie-controlled diet and exercise, it might offer a small advantage for reducing abdominal fat specifically.

3. Unclear effects on blood sugar

Type 2 diabetes affects hundreds of millions worldwide and can lead to serious complications including kidney damage and nerve problems.

The evidence on coconut oil and blood sugar is mixed at best. A systematic review of 18 studies found that consuming coconut fat with meals increased postprandial glucose levels. Long-term consumption was associated with higher insulin resistance scores, though fasting glucose and insulin weren’t significantly affected. [8]

This isn’t what you’d hope for if diabetes prevention is your goal. If you have type 2 diabetes or prediabetes, coconut oil doesn’t appear to offer any metabolic advantage and might actually work against you.

4. Antimicrobial properties

Coconut oil’s antimicrobial effects are better documented than many of its other claimed benefits. Lauric acid, when converted to monolaurin in the body, has demonstrated activity against certain bacteria, viruses, and fungi in laboratory studies. [9]

Capric acid and caprylic acid also show antimicrobial properties. These compounds can disrupt the cell membranes of various pathogens.

Whether eating coconut oil provides meaningful protection against infections in real-world conditions remains less clear. Laboratory studies and human immunity aren’t the same thing. Still, the antimicrobial compounds in coconut oil are real and have been developed into commercial products.

5. Skin protection in premature infants

The skin of premature babies isn’t fully developed and is vulnerable to damage and infection. Topical applications need to be chosen carefully.

A randomised trial of 72 preterm infants (younger than 30 weeks’ gestation) compared topical coconut oil application to standard care. Infants treated with coconut oil showed better skin condition scores, with improvements in dryness, redness, and cracking. No significant adverse effects were observed. [10]

This is a specific medical application where coconut oil has reasonable evidence behind it. It’s quite different from claims about eating coconut oil for general health.

6. Oral health through oil pulling

Oil pulling is an ancient Ayurvedic practice involving swishing oil in your mouth for 15-20 minutes. The idea is that oil traps bacteria and removes them from your mouth.

A systematic review of 4 randomised trials (182 participants) found that coconut oil pulling reduced bacterial counts in saliva and plaque index scores. [11] The lauric acid in coconut oil may contribute to these effects through its antimicrobial properties.

I’ll admit I’m somewhat sceptical about whether 20 minutes of swishing is practical for most people, but the research does suggest some benefit. It shouldn’t replace brushing and flossing, though.

7. Skin moisturisation and protection

Coconut oil has been used for skincare across tropical cultures for generations. Research backs up some of these traditional uses.

A small controlled study found that applying coconut oil improved skin hydration and surface lipid levels in people with dry skin (xerosis), with effects comparable to mineral oil and no adverse effects observed. [12]

Coconut oil also provides modest UV protection, blocking about 20% of ultraviolet rays according to one study. [13] That’s nowhere near adequate for sun protection on its own, but it might offer a small additional benefit when applied alongside proper sunscreen.

For conditions like eczema, coconut oil’s antibacterial properties might help reduce skin infections that often complicate the condition. [14]

8. Possible cognitive effects in Alzheimer’s disease

Alzheimer’s disease involves problems with how the brain uses glucose for energy. Some researchers have theorised that ketones, which the brain can use as an alternative fuel, might help.

Medium-chain fatty acids can be converted to ketones in the liver. A small study of 20 patients with Alzheimer’s disease or mild cognitive impairment found that oral MCT consumption improved cognitive scores, particularly in subjects without the APOE4 gene variant. [15]

Another study of 44 Alzheimer’s patients found that 40ml daily of virgin coconut oil improved cognitive test scores over 21 days, with greater effects in women and those with more severe disease. [16]

These are intriguing findings, but the studies are small and short-term. I wouldn’t recommend coconut oil as an Alzheimer’s treatment based on current evidence, though it might be worth discussing with a doctor if you’re interested.

9. Quality of life during breast cancer treatment

Chemotherapy causes numerous side effects that affect quality of life. Finding ways to reduce these effects is an ongoing area of research.

A prospective study of 60 breast cancer patients found that virgin coconut oil consumption during chemotherapy improved function and quality of life scores. Symptoms including fatigue, breathing difficulties, sleep problems, and appetite loss were reduced in the coconut oil group. [17]

This is preliminary research, but it suggests a possible supportive role during cancer treatment that warrants further study.

10. Potential bone health effects

Osteoporosis becomes increasingly common with age, particularly in women after menopause. Any intervention that might slow bone loss attracts interest.

Virgin coconut oil contains plant polyphenols that function as antioxidants. Since oxidative stress contributes to bone loss, antioxidant compounds might theoretically slow this process. [18] Animal studies have shown that coconut oil can reduce bone loss and increase bone density. [19]

Additionally, the medium-chain fatty acids in coconut oil may enhance absorption of calcium and magnesium from the gut. [20]

Human studies are needed before drawing conclusions, but the mechanism is plausible.

11. Supporting ketogenic diets for epilepsy

Ketogenic diets have been used for decades to treat drug-resistant epilepsy in children. The diet works by shifting the body’s fuel source from glucose to ketones. [21]

Coconut oil is popular in ketogenic diets because its MCTs can be converted to ketones without requiring extreme carbohydrate restriction. [22] This makes maintaining ketosis easier and more sustainable.

For someone following a medically supervised ketogenic diet for epilepsy, coconut oil can be a useful tool.

Side effects of coconut oil

Like any food, coconut oil isn’t without potential downsides. Here are the main concerns worth knowing about.

1. May raise LDL cholesterol

Multiple studies confirm that coconut oil increases LDL cholesterol. [23] The American Heart Association specifically recommends against coconut oil for cardiovascular health, noting that it raises LDL similarly to butter and beef fat. [24]

If you have high cholesterol or heart disease, this is worth taking seriously.

2. Allergic reactions

Coconut allergies are uncommon but do exist. Symptoms can include hives, facial swelling, breathing difficulties, and in severe cases, anaphylaxis. [25]

Interestingly, coconut is classified as a fruit, not a tree nut, so people with peanut or tree nut allergies are less likely to react to coconut. [26] Still, if you notice symptoms after consuming coconut products, see a doctor.

A chemical called coconut diethanolamide, derived from coconut oil and used in some hand soaps, has caused contact dermatitis in some individuals. [27]

3. Cardiovascular disease risk

Beyond the LDL question, some research suggests that replacing coconut oil with unsaturated fats reduces overall cardiovascular risk. [28] A New Zealand study found coconut oil raised LDL more than unsaturated plant oils. [29]

The overall evidence points toward coconut oil being a less heart-healthy choice than olive oil, rapeseed oil, or other unsaturated alternatives.

4. Digestive upset

Some people experience diarrhoea, stomach cramps, or nausea when first consuming virgin coconut oil, particularly in larger amounts. These effects typically resolve within a week. [30]

Starting with small amounts and gradually increasing can help minimise these symptoms.

5. Theoretical liver concerns

MCTs travel directly to the liver for processing, which has led some to worry about hepatic stress from high coconut oil intake. One study found that repeatedly heated coconut oil had toxic effects on the liver in animals. [31]

For people with existing liver disease, caution may be warranted. Using fresh rather than reheated oil is prudent.

6. May worsen acne in some people

Coconut oil is comedogenic, meaning it can clog pores. For people with oily or acne-prone skin, applying coconut oil topically may trigger breakouts.

If you have acne-prone skin, consider using coconut oil only on areas less prone to breakouts, or use it as a carrier for other treatments rather than applying it directly.

7. Digestive issues from coconut-based products

Some coconut products contain fructans, which are chains of fructose molecules. People with fructose malabsorption may experience bloating, gas, and abdominal discomfort from these products.

Desiccated coconut may also contain sulphites, which cause reactions in sensitive individuals. Pure coconut oil shouldn’t contain these compounds, but other coconut products might.

8. Potential concerns for children with thyroid conditions

Some practitioners recommend caution with coconut oil in children with hypothyroidism, suggesting it might aggravate the condition. Evidence for this is limited, but checking with a paediatrician before giving coconut oil to children with thyroid disorders makes sense.

9. Detox reactions

People using coconut oil to address yeast overgrowth (candidiasis) sometimes experience headaches, fatigue, or flu-like symptoms. This “die-off” reaction occurs when antimicrobial compounds kill yeast cells, releasing their contents into the bloodstream.

Starting with small amounts can reduce the severity of these reactions.

10. Not ideal for everyone during oil pulling

If you’re sensitive to coconut, oil pulling with coconut oil could cause oral irritation or allergic reactions. Sesame oil or sunflower oil work equally well for oil pulling if coconut doesn’t suit you.

Remember that oil pulling supplements rather than replaces regular brushing and flossing.

11. Considerations as a personal lubricant

While some people use coconut oil as a sexual lubricant, it may impair sperm motility, making it unsuitable for couples trying to conceive. [32] Coconut oil also degrades latex, so it shouldn’t be used with latex condoms.

Water-based lubricants are generally safer options.

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