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Therapeutic Ketogenic Diet (TKD)

The therapeutic ketogenic diet is designed for medical use under clinical supervision, often as part of treatment for epilepsy, neurological conditions, cancer, or other chronic diseases. Unlike standard or advanced keto approaches, it typically uses stricter ratios to maximize ketone production and maintain a therapeutic state of ketosis.

Here are a couple of good articles explaining Therapeutic Ketosis: Therapeutic Ketosis: A Powerful Approach to Treating Various Health Conditions, or Nutritional vs. Therapeutic Ketosis

Comparison: Therapeutic vs. Standard vs. Advanced Keto

Feature Standard Keto (SKD) Advanced Keto (AKD) Therapeutic Keto (TKD)
Carbs 5–10% (20–50g/day) 5–15% depending on variant 2–5% (often <20g/day)
Protein 20–25% 20–35% 10–20% (kept moderate)
Fat 70–75% 60–70% 75–90%
Ratios ~3:1 fat-to-non-fat 2:1 to 3:1 depending on variant 4:1 or even 5:1 fat-to-non-fat
Use Cases Weight loss, metabolic health Athletic performance, muscle preservation, carb cycling Medical therapy (epilepsy, cancer, neurological disorders)
Macro & Ratio Ranges (Therapeutic Keto)
Ratio Fat (% calories) Protein (% calories) Carbs (% calories) Use Case
4:1 85–90% 6–10% 2–4% Standard medical ketogenic ratio (often for epilepsy)
3:1 75–80% 15–20% 3–5% Sometimes used for cancer therapy or less strict neurological protocols

7-Day Sample Menu (Therapeutic Keto)

Note: Portion sizes are medically calculated to maintain a specific fat-to-non-fat ratio. Always follow a clinician’s guidance.

  • Day 1: Egg yolk omelet with cream, buttered spinach, macadamia nuts
  • Day 2: Heavy cream smoothie (with avocado, MCT oil, and cocoa), cheese crisps
  • Day 3: Salmon with cream sauce, steamed zucchini in olive oil
  • Day 4: Chicken thighs with butter and cream cheese, side of creamed broccoli
  • Day 5: Keto “pudding” (heavy cream, coconut oil, gelatin), almonds
  • Day 6: Beef patty with cheddar and butter sauce, sautéed mushrooms
  • Day 7: Creamy egg salad with olive oil, avocado slices, whipped cream dessert

1-Day Therapeutic Keto Menu with Macro Breakdown (4:1 Ratio Example)

  • Breakfast: Egg yolks scrambled in butter with heavy cream (Protein: 10g, Fat: 40g, Carbs: 2g)
  • Lunch: Salmon fillet with cream sauce (Protein: 15g, Fat: 45g, Carbs: 2g)
  • Dinner: Chicken thighs with butter and olive oil (Protein: 20g, Fat: 60g, Carbs: 3g)
  • Snacks: Macadamia nuts, whipped heavy cream (Protein: 5g, Fat: 30g, Carbs: 1g)

Daily Totals: ~50g Protein, 175g Fat, 8g Carbs (~87% Fat, 10% Protein, 3% Carbs)

Recommended Books on Therapeutic Keto

Book Description Link
The Metabolic Approach to Cancer book cover
The Metabolic Approach to Cancer 		Explores how a therapeutic ketogenic diet and metabolic therapies can support cancer treatment.
★★★★☆ (4.8/5)
Approx. $25 		This Book on Amazon
Ketogenic Diet for Epilepsy cover
The Ketogenic Diet for Epilepsy 		A clinical guide to the therapeutic ketogenic diet for seizure management and neurological disorders.
★★★★☆ (4.7/5)
Approx. $30 		This Book on Amazon

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