Ketogenic diet therapy · United Kingdom
Ketogenic diet therapy, delivered as medicine.
A medically-supervised very-low-carbohydrate, high-fat diet for drug-resistant epilepsy, GLUT1 deficiency, PDH deficiency and selected mitochondrial disorders — delivered by a specialist dietician inside a neurology or metabolic MDT.
Why patients choose us
- 01
A specialist dietician, in a real KDT service
Not a wellness clinic. A Matthew’s Friends-trained ketogenic dietician working inside a neurology or metabolic MDT — the same model as GOSH, UHB and Sheffield.
- 02
The right indications, honestly named
KDT is evidence-based for drug-resistant epilepsy, GLUT1 deficiency and PDH deficiency. For general wellness ketosis, we tell you it is not this service.
- 03
Independent, and free
We are paid by no clinic, so the referral is impartial and costs you nothing.
Indicative pricing
What a private ketogenic diet therapy service costs in the UK.
Indicative ranges across our partner centres. NHS specialist commissioning covers the recognised indications — for private care, we quote firm figures within one working day.
In short
Initial consultation: £350–£500, monthly review: £150–£300.
| Service element | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Initial KDT consultation (dietician + neurology) | £350–£500 | 90 min | Same visit |
| Pre-diet metabolic workup (bloods, ECG) | £250–£450 | Half-day | 3–5 days |
| Outpatient initiation programme (2–3 weeks) | £800–£1,500 | 2–3 weeks | Structured |
| Inpatient classical 4:1 initiation (paediatric) | £3,500–£6,500 | 3–5 nights | Same admission |
| Monthly review + dietician support | £150–£300/mo | 45 min | Same visit |
| Food, Ketocal, supplements (estimate) | £100–£300/mo | Ongoing | Ongoing |
Prices vary by centre, by whether the initiation is inpatient or outpatient, and by the diet variant chosen. NHS access via specialist commissioning is available for drug-resistant epilepsy in children and for the metabolic indications.
The problem
The right indication, the right variant, the right team.
KDT is a genuine therapy that is often confused with a lifestyle diet, and access to a proper UK service is patchy. We match you to the right centre — and tell you honestly if KDT is not the right step.
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Two anti-seizure medications failed?
NICE NG217 recommends considering KDT via a specialist centre. We route to a paediatric or adult service that actually runs one.
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Rare metabolic diagnosis?
GLUT1 and PDH deficiency are treatable with KDT — often lifelong, first-line. We refer to a metabolic team that manages both.
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Not sure it applies at all?
For wellness ketosis, weight loss or unproven indications, we say so up front — no unnecessary referral, no cost to you.
The journey
From enquiry to a 3-month trial — what happens, in order.
One dietician, one neurology or metabolic team, from first message through structured 3-monthly review.
Phase 1 · Before initiation
Concierge, off-stage for you
Phase 2 · Initiation
Outpatient or inpatient
Phase 3 · Follow-up
Structured monitoring
- 01
Before
You tell us what is going on
A short, confidential form. Diagnosis, current anti-seizure medications, seizure frequency, comorbidities, and who is asking — patient, parent or referring neurologist.
- 02
Before
We come back with a recommendation
Within one working day: the right KDT centre (paediatric, adult or metabolic), the likely diet variant, and an indicative cost. If KDT is not the right step, we say so.
- 03
Before
Pre-diet workup is arranged
Baseline bloods to rule out fatty acid oxidation defects (a contraindication), urate, lipids, renal, ECG if indicated. Seizure diary, food diary and family readiness reviewed.
- 04
Initiation
Initiation with the dietician
Gradual outpatient introduction over 2–3 weeks, or a 24–72 hour inpatient start for classical 4:1 in young children. Full education on ratios, weighing, ketones and hypo management.
- 05
Initiation
The MDT around you
Neurologist or metabolic physician, specialist KDT dietician, nurse and pharmacist. Medications reviewed for hidden carbohydrates and interactions.
- 06
Initiation
Home on the diet, with a plan
Meal plans, Ketocal or MCT prescriptions if needed, ketone monitoring kit, and a 24-hour helpline. You leave knowing exactly what to do at breakfast tomorrow.
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After
Structured follow-up
Weekly for the first month, then monthly, then 3-monthly. Blood β-hydroxybutyrate targeted 2–5 mmol/L. A minimum 3-month trial before judging response.
Minimum trial: 3 months. If effective, continue at least 2 years before considering a structured wean.
When it helps
When ketogenic diet therapy is the right step.
The proven indications — plus the emerging ones we discuss honestly, and the ones that fall outside a therapeutic KDT service.
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Drug-resistant paediatric epilepsy
Two or more anti-seizure medications have failed. NICE NG217 recommends a KDT trial via a specialist centre.
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GLUT1 deficiency syndrome
A metabolic disease where KDT is disease-modifying and first-line — lifelong, not a trial.
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Pyruvate dehydrogenase deficiency
A rare mitochondrial condition where ketones bypass the metabolic block — KDT is the treatment of choice.
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Dravet, Lennox-Gastaut, myoclonic
The paediatric epilepsy syndromes where KDT response is strongest — often 50–70% seizure reduction.
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Selected mitochondrial disorders
Chosen mitochondrial phenotypes may benefit from ketone-based fuel — reviewed case by case with a metabolic team.
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Adult drug-resistant epilepsy
A growing UK service via Sheffield, King’s and Chalfont. Response rates around 40% on Modified Atkins.
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Emerging: MCI, migraine, glioma adjunct
Trials in mild cognitive impairment (MCT), refractory migraine, T2DM (Virta model) and glioma adjunct — discussed honestly, without overclaim.
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Not for: general wellness ketosis
A therapeutic KDT service is not the same as a lifestyle keto diet. If wellness is the goal, this is not the right referral.
Diet variants
Classical KD is not the only variant.
What each variant on the table actually involves — and which fits which patient and household.
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Classical KD (4:1 or 3:1)
The strictest ratio — 4g fat per 1g protein-plus-carb. Usually inpatient initiation in young children. Highest ketosis, tightest adherence.
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Modified Atkins Diet (MAD)
10–20g carbohydrate per day, unrestricted fat, generous protein. The adult and adolescent workhorse — outpatient friendly.
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MCT ketogenic diet
Medium-chain triglyceride oil supplies ketones directly, allowing more protein and carbohydrate. Better palatability, more GI side effects.
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Low-Glycaemic Index Treatment (LGIT)
40–60g carbohydrate per day, all with glycaemic index below 50. The least restrictive variant — used when strict KDT is not tolerated.
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Formula (Ketocal) or enteral feeds
Ready-made 4:1 formula for infants, tube-fed children, or as a top-up in fussy eaters. Prescribable on the NHS via specialist centres.
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Combined and transition regimens
Some patients start classical and step down to MAD, or vice versa. The dietician tailors the ratio to response and tolerability.
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Structured wean at 2 years
If effective and stable, most children trial a gradual wean after 2 years to test whether the benefit holds off the diet.
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Consultation only
An honest discussion of whether KDT is likely to help, which variant fits, and what the workload actually looks like — no obligation.
Our vetted UK network
A small panel of KDT services, we picked them.
Matthew’s Friends clinics, GOSH, UHB, Bristol Royal, Alder Hey and the Sheffield adult KDT service. Introductions are made privately, once we understand the diagnosis.
Selection criteria
How we choose every KDT centre in our network.
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Specialist ketogenic dietician (Matthew’s Friends-trained) in every case
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Neurology or metabolic MDT, not a standalone diet clinic
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Full pre-diet workup including exclusion of fatty acid oxidation defects
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Structured follow-up with blood ketone monitoring and micronutrient cover
Safety and side effects
What to expect — honestly.
KDT is a real medical treatment with real side effects. Every one of them has a management plan, which is why the service model — dietician, doctor, pharmacist — matters more than the food itself.
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Early “keto flu” is normal
Headache, fatigue, GI upset and transient hypoglycaemia in the first 1–2 weeks — managed with hydration, electrolytes and gradual induction.
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Constipation is near-universal
Low carbohydrate means low fibre. Every KDT patient gets a fibre, fluid and (often) laxative plan from day one.
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Hypoglycaemia — watch the medications
Carbamazepine and some other anti-seizure medications need dose review at initiation to avoid symptomatic lows.
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Nephrolithiasis in 5–8%
Kidney stones are the classic long-term risk. Urine alkalinisation and prophylactic potassium citrate reduce it substantially.
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Growth and bone health in children
Height, weight and DEXA are monitored. Vitamin D, calcium, magnesium and selenium are mandatory — never optional supplements.
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Dyslipidaemia is expected and managed
Cholesterol and triglycerides often rise. The dietician adjusts fat quality and ratios rather than abandoning the diet.
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Metabolic acidosis is rare but checked
Bicarbonate is monitored at every review. Rare cases need dose or ratio adjustment.
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Adult adherence is honestly hard
40–50% of adults stop the diet by 2 years. This is not a failure of the patient — it is a known feature of the treatment.
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Red flags
Persistent vomiting, drowsiness, breathlessness, blood ketones above 5 mmol/L with symptoms — contact the KDT team the same day.
Reading your KDT plan
Your KDT plan in four parts. Read the last one first.
Whichever variant is chosen, the plan the dietician sends you keeps to the same shape.
A quiet reminder
Ratios and gram-weights can read intimidatingly — we translate them for you.
If you would like us to talk you through the plan before your review, just ask.
- 01 Header
Indication, diagnosis and diet variant
Why KDT was started — drug-resistant epilepsy, GLUT1 deficiency, PDH deficiency, mitochondrial disorder — and which diet variant was chosen.
- 02 Technique
Ratio, initiation and monitoring plan
Classical 4:1, 3:1, MAD, MCT or LGIT. Whether initiation was inpatient or outpatient. Blood β-hydroxybutyrate targets and monitoring schedule.
- 03 Findings
Response, side effects and supplements
Seizure diary response, ketone levels achieved, side effects noted, and the prescribed multivitamin, mineral and citrate cover.
- 04 Impression
Duration, review and wean plan
Read this first: minimum 3-month trial, ongoing 3-monthly reviews, and — if effective — a planned wean at 2 years.
Recognised by major UK insurers
Insurer cover for KDT varies — often funded for drug-resistant epilepsy and metabolic indications, self-pay for emerging indications. We confirm cover before referral.
Frequently asked
Everything we get asked about ketogenic diet therapy.
Quick answers on indications, cost, side effects, and how the diet actually looks day-to-day.
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Is ketogenic diet therapy the same as a lifestyle keto diet?
No. KDT is a medically-supervised, prescribed treatment delivered by a specialist ketogenic dietician inside a neurology or metabolic team. It is used for drug-resistant epilepsy, GLUT1 deficiency, PDH deficiency and selected mitochondrial disorders — not for weight loss or general wellness.
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Which UK centres deliver ketogenic diet therapy?
The established services include Matthew’s Friends (national charity and clinic), Great Ormond Street Hospital, University Hospitals Birmingham, Bristol Royal Hospital for Children, Alder Hey, and the Sheffield adult KDT service. Provision is expanding but still limited — we route to the right one.
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How well does KDT work for drug-resistant epilepsy?
Across paediatric drug-resistant epilepsy, roughly 50–70% of children achieve at least a 50% reduction in seizures, and 10–15% become seizure-free. Response is strongest in Dravet, Lennox-Gastaut, myoclonic epilepsies and GLUT1 deficiency. Adult response rates on Modified Atkins are around 40%.
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What does the diet actually look like day-to-day?
That depends on the variant. Classical 4:1 involves weighing every gram of food and following prescribed meal plans. Modified Atkins caps carbohydrate at 10–20g per day with unrestricted fat and generous protein. MCT and LGIT are less restrictive. The dietician builds a plan that fits your household.
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How much does a private KDT service cost in the UK?
Initial consultation is typically £350–£500, with a monthly review at £150–£300 and food plus supplements around £100–£300 per month. Inpatient classical initiation runs £3,500–£6,500. NHS provision via specialist commissioning is available for the recognised indications.
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What are the main side effects?
Early “keto flu”, constipation (near-universal), transient hypoglycaemia, dyslipidaemia and — long-term — a 5–8% risk of kidney stones. Growth and bone health are monitored in children. Every side effect has a management plan, which is why supervision matters.
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Are there conditions where KDT is unsafe?
Yes. Fatty acid oxidation defects, pyruvate carboxylase deficiency, primary carnitine deficiency and porphyria are absolute contraindications. This is why a pre-diet metabolic workup is mandatory — starting KDT in these disorders can be dangerous.
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How long do people stay on the diet?
A minimum 3-month trial is standard before judging response. If effective, most children continue for at least 2 years and then trial a structured wean. GLUT1 deficiency and PDH deficiency are usually lifelong. Adult adherence is genuinely challenging — around 40–50% stop by 2 years.