Trehalose is a disaccharide food product that is used as a sugar substitute. It is found naturally in mushrooms and shellfish. It is now sold retail in North America and can be obtained from Cumberland Packing Corp. via mail order at http://www.brooklynpremium.com/neurocoat.html.

This agent is thought to work by stabilizing protein and membrane structure.

Researchers have shown that trehalose stabilizes the structure of the polyglutamine repeat in huntingtin, the abnormal protein present in Huntington's disease. This stabilization decreases the ability of huntingtin to aggregate. Trehalose improves motor ability, decreases brain damage, and prolongs the life span in a transgenic model of Huntington's disease (Tanaka et al. 2004).

There is no definitive recommended dosage, but based on animal studies, I recommend 25 grams (6 tsp) three times per day. Each dose (25 gm) is about 90 calories. Trehalose is only 50% as sweet as sugar, and does not increase blood sugar or insulin levels nearly as much as the same dose of regular sugar. It is best used as a sugar substitute, so that total calorie intake is unchanged. Trehalose has received "GRAS" approval from the U.S. Food and Drug Administration (FDA). GRAS approval means that this food product is "generally recognized as safe" and can be marketed as a food.

Side effects include bloating and diarrhea. Trehalose is a safe agent even at very high dosage. Side effects can be minimized by starting with smaller doses, then "working up" to full dose over a period of a week or more.

• Tanaka, M., Y. Machida, S. Niu, T. Ikeda, N. R. Jana, H. Doi, M. Kurosawa, M. Nekooki and N. Nukina (2004). "Trehalose alleviates polyglutamine-mediated pathology in a mouse model of Huntington disease." Nat Med 10(2): 148-54.