08:00 · Breakfast
Baked eggs in avocado with smoked salmon
½ avocado · 2 eggs · 40 g smoked salmon handful of spinach · olive oil · sea salt
480 kcal·fat 38 g·protein 26 g·carbs 6 g
Consultation topic
Keto & therapeutic ketosis
Ketogenic and low-carbohydrate nutrition are dietary approaches whose suitability can be discussed at a consultation, taking into account your health, medications, history and goals. This page offers a brief neutral overview. Educational materials on keto are available at the Academy.
Consultation topics
When low-carbohydrate nutrition can be discussed
The topics listed below can be discussed at a consultation. The list is neutral and is not a treatment recommendation, list of indications or promise of any specific outcome. Every situation is assessed individually.
Type 2 diabetes or prediabetes
Insulin resistance (high fasting insulin or HOMA-IR)
Metabolic syndrome (high triglycerides, low HDL, excess weight, high blood pressure, high uric acid)
Excess weight
If you take medications (especially for diabetes or blood pressure), always discuss dietary changes with your treating physician in advance.
Standalone service
Keto and therapeutic ketosis — in-depth consultation package
Clinical assessment combined with objective measurement: a 45-minute visit with Dr Sergey Saadi and a 14-day SiBio ketone monitor. At the end of monitoring you send the data by email and receive a written interpretation. We cover both ordinary nutritional ketosis and ketosis used for therapeutic purposes.
€550Package · 45-min visit + 14 days of measurement
Included in the price
- 45-minute visit at the clinic in central Tallinn or by video call
- Assessment of your health status and of keto-related risks (medication, kidneys, liver, thyroid, eating disorders)
- Review and interpretation of your existing lab results
- SiBio ketone monitor for 14 days — fitted at the clinic or self-applied following our instructions
- Written analysis of your ketone dynamics by email at the end of monitoring
- Detailed instructions: food amounts, electrolytes, adaptation period, measurement methodology
- Comprehensive written material on ketogenic nutrition and therapeutic ketosis
Not included
- New laboratory tests (ordered separately if needed, paid to the lab)
- Care for children under 18
- Treatment of epilepsy with a ketogenic diet
- Continuous glucose monitor (CGM) — a separate service
Book the keto package
Pay at the visit or in installments via Montonio (partner Inbank).
Scientific background
Nutritional ketosis, therapeutic ketosis and ketoacidosis — the difference
Ketosis and ketoacidosis are two fundamentally different states that are often confused. The difference lies in ketone concentration and in whether insulin can still restrain the process. Physiological ketosis in a healthy person is self-limiting; ketoacidosis occurs when insulin action is essentially absent.
| Parameter | Ketosis (nutritional / therapeutic) | Ketoacidosis |
|---|---|---|
| Blood ketones (BHB) | 0.5–3 mmol/L (up to ~5 in therapeutic use) | above 15–25 mmol/L |
| Blood pH | normal (7.35–7.45) | acidic, below 7.30 |
| Blood glucose | normal or low | usually very high (except euglycemic DKA) |
| Insulin action | present — limits ketogenesis | essentially absent |
| Who develops it | healthy people during fasting or low-carb eating | mainly type 1 diabetes, rarely SGLT2 drugs, alcohol |
| Clinical nature | physiological, self-limiting | life-threatening emergency |
Blood ketones (BHB)
- Ketosis (nutritional / therapeutic)
- 0.5–3 mmol/L (up to ~5 in therapeutic use)
- Ketoacidosis
- above 15–25 mmol/L
Blood pH
- Ketosis (nutritional / therapeutic)
- normal (7.35–7.45)
- Ketoacidosis
- acidic, below 7.30
Blood glucose
- Ketosis (nutritional / therapeutic)
- normal or low
- Ketoacidosis
- usually very high (except euglycemic DKA)
Insulin action
- Ketosis (nutritional / therapeutic)
- present — limits ketogenesis
- Ketoacidosis
- essentially absent
Who develops it
- Ketosis (nutritional / therapeutic)
- healthy people during fasting or low-carb eating
- Ketoacidosis
- mainly type 1 diabetes, rarely SGLT2 drugs, alcohol
Clinical nature
- Ketosis (nutritional / therapeutic)
- physiological, self-limiting
- Ketoacidosis
- life-threatening emergency
Nutritional ketosis
When carbohydrates are restricted (usually below 30–50 g per day) or during longer fasting, the liver starts producing ketone bodies. Blood BHB typically stays between 0.5 and 3 mmol/L and falls as soon as carbohydrates return.
Therapeutic ketosis
A deliberately deeper and more stable ketosis maintained under medical supervision in metabolic conditions — insulin resistance, type 2 diabetes, metabolic syndrome, fatty liver disease, PCOS. It requires measurement rather than guesswork.
Why a monitor
Urine strips only show excess and are distorted by fluid balance. A continuous ketone monitor shows the real day-by-day dynamics: whether ketosis occurred at all, when it stopped and what stopped it.
Limits and contraindications
- I do not work with children and adolescents under 18.
- I do not treat epilepsy with a ketogenic diet — such cases are referred to a specialized center.
- Type 1 diabetes requires your treating physician's supervision; SGLT2 inhibitors increase the risk of ketoacidosis.
- Pregnancy, breastfeeding, an active eating disorder, pancreatitis and fatty-acid oxidation disorders are contraindications.
- This is not a promise of any specific outcome — every situation is assessed individually.
Low-carb vs Keto
What is the difference between low-carb and ketogenic nutrition?
Both approaches restrict carbohydrates, but they differ in carb amount, goal, metabolic state and clinical use. The overview below is neutral — suitability is always assessed individually.
Low-carb
Low-carbohydrate (Low-carb)
Carbohydrate restriction usually in the 50–130 g/day range. The aim is to stabilize blood glucose and insulin and reduce appetite while keeping dietary flexibility. Blood ketones rise only modestly or stay low.
- Carbs: 50–130 g/day (~10–25% of energy)
- Fruits, legumes and root vegetables allowed in moderation
- Ketosis is not the goal — flexible everyday eating
- Suitable to start with, for mild insulin resistance and weight goals
- Easier to follow socially and long-term
Keto
Ketogenic (Keto)
Significant carbohydrate restriction, typically below 20–50 g/day, combined with high fat and moderate protein. The aim is to induce nutritional ketosis, where ketone bodies (β-hydroxybutyrate) become the brain's primary fuel.
- Carbs: <20–50 g/day (~5–10% of energy)
- Fat 70–80%, protein 15–25% of energy
- Blood ketones 0.5–3.0 mmol/L (measurable)
- Clinical use: epilepsy, T2DM, NAFLD, PCOS, neurology
- Requires more planning and often medical supervision
| Parameter | Low-carb | Keto |
|---|---|---|
| Carbohydrates (g/day) | 50–130 | <20–50 |
| Fat share | 30–50% | 70–80% |
| Blood ketones | Low (<0.3 mmol/L) | 0.5–3.0 mmol/L |
| Primary fuel | Glucose + fatty acids | Fatty acids + ketones |
| Goal | Stabilise blood glucose | Nutritional ketosis |
| Flexibility | High | Lower, more structured |
| Social adaptation | Easy | Requires planning |
| Clinical indications | T2DM, weight, metabolic syndrome | Epilepsy, T2DM remission, NAFLD, neurology |
| Supervision | Recommended | Especially recommended with medications |
Carbohydrates (g/day)
- Low-carb
- 50–130
- Keto
- <20–50
Fat share
- Low-carb
- 30–50%
- Keto
- 70–80%
Blood ketones
- Low-carb
- Low (<0.3 mmol/L)
- Keto
- 0.5–3.0 mmol/L
Primary fuel
- Low-carb
- Glucose + fatty acids
- Keto
- Fatty acids + ketones
Goal
- Low-carb
- Stabilise blood glucose
- Keto
- Nutritional ketosis
Flexibility
- Low-carb
- High
- Keto
- Lower, more structured
Social adaptation
- Low-carb
- Easy
- Keto
- Requires planning
Clinical indications
- Low-carb
- T2DM, weight, metabolic syndrome
- Keto
- Epilepsy, T2DM remission, NAFLD, neurology
Supervision
- Low-carb
- Recommended
- Keto
- Especially recommended with medications
Research · 2019–2024
12 peer-reviewed studies on ketogenic nutrition + Recent studies on low-carbohydrate nutrition
Research · 2019–2024
12 peer-reviewed studies on ketogenic nutrition + Recent studies on low-carbohydrate nutrition
Recent peer-reviewed publications on the effects of the ketogenic diet across different areas of health and life. Click a card to open the study in Europe PMC.
2024 · Psychiatry Research
PsychiatryKetogenic Diet Intervention on Metabolic and Psychiatric Health in Bipolar and Schizophrenia: A Pilot Trial
Stanford pilot trial: a 4-month ketogenic diet significantly improved metabolic markers and psychiatric symptoms in patients with bipolar disorder and schizophrenia.
Read in Europe PMC2024 · J Nutr Health Aging
Alzheimer'sEffects of ketogenic diet on cognitive function of patients with Alzheimer's disease: a systematic review and meta-analysis
Meta-analysis: ketogenic diet improved cognitive scores (ADAS-Cog, MMSE) in patients with early and moderate Alzheimer's disease compared with standard nutrition.
Read in Europe PMC2024 · Nutrients
Mental healthThe Potential Effects of the Ketogenic Diet in Stress, Anxiety, Depression, Schizophrenia, and Bipolar Disorder
Review of the role of β-hydroxybutyrate in reducing neuroinflammation and restoring neurotransmitter balance in mood and anxiety disorders.
Read in Europe PMCResearch · 2024
Recent studies on low-carbohydrate nutrition
Recent peer-reviewed publications on the effects of low-carb on body weight, diabetes and overall health.
2024 · Front Nutr
General healthImpact of low-carbohydrate diet on health status: an umbrella review
Umbrella review of meta-analyses: low-carbohydrate nutrition improves body weight, glucose regulation, lipid profile and blood pressure.
Read in Europe PMC2024 · Front Nutr
Type 2 diabetesThe effects of low-carbohydrate diet on glucose and lipid metabolism in overweight or obese patients with T2DM: a meta-analysis of RCTs
Meta-analysis of RCTs: a low-carb diet lowers HbA1c, fasting glucose and LDL in overweight patients with T2DM.
Read in Europe PMC2024 · Food Funct
Diabetes remissionA network meta-analysis of the comparative efficacy of different dietary approaches on glycemic control and weight loss in T2DM
Network meta-analysis: low-carbohydrate and ketogenic diets are among the most effective dietary strategies for glycemic control and weight loss.
Read in Europe PMC Sample menu
Ketogenic menu — one day
A sample day of about 2000 kcal: high in fat, moderate in protein and low in carbohydrate. Portions and ratios depend on weight, activity and health — adjust in consultation with your doctor.
13:00 · Lunch
Grilled salmon with arugula salad
150 g salmon · lemon · rosemary asparagus · arugula · olive oil · parmesan
560 kcal·fat 40 g·protein 38 g·carbs 8 g
16:30 · Snack
Nuts, cheese and olives
20 g almonds · 15 g walnuts 30 g aged cheese · 5 green olives
310 kcal·fat 28 g·protein 10 g·carbs 5 g
19:00 · Dinner
Ribeye steak with roasted vegetables
180 g ribeye · rosemary butter broccoli · cauliflower · herb butter · sea salt
680 kcal·fat 52 g·protein 46 g·carbs 9 g
Daily total
2030 kcal·fat 158 g·protein 120 g·carbs 28 g
This is an educational example, not an individual treatment plan. If you take medications, consult your doctor before making dietary changes.
FAQ
Frequently asked questions
Ketogenic nutrition is a dietary approach where carbohydrate intake is significantly restricted and the body uses mainly fatty acids and ketone bodies for energy. Suitability is always assessed individually, taking into account health status and medications.
No. Ketogenic or low-carbohydrate nutrition does not suit everyone and may be contraindicated for certain health conditions and medications. Suitability can be discussed at a consultation.
If you take medications (especially for diabetes or blood pressure), I do not recommend making big dietary changes without your treating physician's assessment. For general information see the Academy's educational materials; for an individual assessment, book a consultation.
At the consultation we review your health data, goals, history and possible next steps together. A consultation does not guarantee any specific outcome.
Saadi Akadeemia
Additional educational materials at the Academy
Saadi Academy offers educational materials on ketogenic nutrition, metabolism and lifestyle. The materials are educational and do not replace individual medical consultation, diagnostics or treatment. (English-language programs coming soon.)
Why you can trust us
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Medical services are provided by OÜ MediArte, license L07540. Appointments are held by a doctor.
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The price is shown on the page before you book. Questions: info@synage.ee.