Therapeutic Diets: 3:1 and 2:1 Ketogenic Diets, Dietary Support for hEDS, MCAS & POTS

I currently offer Medical Nutrition Therapy (MNT) for those with Mast Cell Activation Syndrome (MCAS), Ehlers-Danlos Syndrome – hypermobility subtype (hEDS), Postural Orthostatic Tachycardia Syndrome (POTS), and two types of Therapeutic Ketogenic diets.

1. Services for hEDS, MCAS & POTS
 
Ehlers-Danlos Syndrome (hEDS)
Mast Cell Activation Syndrome (MCAS)
Postural Orthostatic Tachycardia Syndrome (POTS)
Histamine Intolerance

Learn about services for hEDS, MCAS, and POTS

 

2. Therapeutic Ketogenic Diets

NOTE: We provide specialized nutrition services for adults using therapeutic ketogenic diets (3:1 or 2:1 ratio) as an adjunct treatment under medical oversight. These diets are structured, clinically indicated protocols designed to support specific health goals in collaboration with a medical provider. Implementation requires careful planning, individualized monitoring, and collaboration with a physician (GP) or, in some cases, a psychiatrist for laboratory monitoring and medication review. Services are not intended to replace medical or mental health care. Clients must have an established relationship with a medical provider who agrees to oversee relevant health parameters throughout the program.

 

Therapeutic ketogenic diets are a type of medical nutrition therapy (also known as ketogenic diet therapy, or ketogenic metabolic therapy) used as adjunct therapy for specific physical and mental health conditions, implemented with medical oversight.

Note: These diets do not “reverse” or “cure” but, along with other treatments, can help put symptoms into remission. Please be aware that we do not provide dietary support for therapeutic ketogenic diets that we have not designed.

To understand what a therapeutic ketogenic diet is before requesting services, please read the article “A Keto Diet and a Therapeutic Ketogenic Diet are Very Different.

Two Types of Therapeutic Ketogenic Diet Services

2:1 Therapeutic Ketogenic Diet

A 2:1 Therapeutic Ketogenic Diet may be implemented as adjunct therapy (along with medication) and under medical supervision for depression, anxiety disorders, and some types of bipolar disorder.

This type of diet may also be followed by those seeking overall improved mental health and who are not taking any prescription medications.

Due to the exacting nature of a 2:1 therapeutic ketogenic diet, we do not provide services to adjust a self-directed keto diet.

 

3:1 Therapeutic Ketogenic Diet

A 3:1 Therapeutic Ketogenic Diet is used as an adjunct treatment in specific physical conditions (epilepsy, seizure disorder, glioblastoma, gliosarcoma, and recently in estrogen receptor-positive (ER+) breast cancer) as well as specific mental health conditions, under a doctor’s supervision.

Note: If you are considering trialing a 3:1 Therapeutic Ketogenic Diet for mental health purposes, the first step is to discuss this with your doctor. Please download the Medical Supervision of Patient Form for your doctor to complete and then have them fax it to the office.
There is no set package for the 3:1 Therapeutic Ketogenic Diet. 
 
For those seeking to adopt this diet as an adjunct treatment for glioblastoma, gliosarcoma, or estrogen receptor-positive (ER+) breast cancer, an Initial Consultation will enable us to discuss the timeframe required to design, teach, and implement this diet relative to chemo and radiation. Every effort will be made to book appointments as quickly as possible. 

Questions and Answers

Q: Do I need an official doctor’s referral to begin a therapeutic ketogenic diet?

A: A medical referral is not needed to book an Initial Consultation to discuss your needs; however, because 2:1 and 3:1 therapeutic ketogenic protocols require active Physician or Psychiatrist oversight before beginning. You will need to have an established medical provider to sign the Medical Supervision of Patient Form and monitor your laboratory results and medication reviews before therapeutic ketogenic diet services are started.


Q: Can a therapeutic ketogenic diet help with oncology care as an adjunct treatment?

A: Yes. A strict 3:1 therapeutic ketogenic diet can be implemented as an adjunct, supportive metabolic therapy alongside standard medical treatments (chemo, radiation) for specific physical conditions, including glioblastoma and gliosarcoma, and some types of breast cancer. In these advanced clinical situations, booking an Initial Consultation as early as possible allows us to strategically map, design, and coordinate the diet’s implementation timeline with your chemotherapy and radiation schedules.


Q: What is the dietary strategy for managing overlapping hEDS, MCAS, and POTS symptoms?

A: Managing the complex “trifecta” of hypermobile Ehlers-Danlos Syndrome, Mast Cell Activation Syndrome, and Postural Orthostatic Tachycardia Syndrome requires a highly individualized approach. Rather than relying on rigid, overly restrictive meal elimination sheets that can cause nutritional deficiencies, we build step-by-step medical nutrition therapies that target connective tissue health, stabilize mast cell triggers (including histamine intolerance), and optimize blood volume/electrolyte tracking safely.


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