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Ketogenic diet for mitochondrial disease: potential role in treating the Multiple Symmetric Lipomatosis phenotype associated with the common MT-TK genetic mutation

Dear Editor,

We read with appreciation the succinct and informative systematic review by Zweers et al. [1] on the effect of the Ketogenic Diet and/or the Modified Atkins Diet on various mitochondrial disease associated phenotypes.

While this review covered studies pertaining to epilepsy, skeletal and heart muscle, tonus dysregulation, movement disorder, developmental delay/intellectual disability, food intake, weight gain/growth, and hair growth, we note that the multiple symmetric lipomatosis phenotype, frequently associated with the MT-TK genetic mutation, was not covered.

We would like to highlight that a version of the ketogenic diet was employed successfully, along with other simultaneous lifestyle interventions, in treating a disabling multiple symmetric lipomatosis phenotype. This successful intervention was reported in 2020 [2] and warrants further consideration by care providers whose patients are in a similar predicament, and similarly motivated.


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Andre Mattman, MD, FRCPC

Adult Metabolic Diseases Clinic

Vancouver, Canada.

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  1. Zweers H, van Wegberg AMJ, Janssen MCH, Wortmann SB. Ketogenic diet for mitochondrial disease: a systematic review on efficacy and safety. Orphanet J Rare Dis. 2021;16(1):295. (PMID: 34217336).

    Article  PubMed  PubMed Central  Google Scholar 

  2. Nadeau E, Mezei MM, Cresswell M, Zhao S, Bosdet T, Sin DD, Guenette JA, Dupuis I, Allin E, Clarke DC, Mattman A. Self-initiated lifestyle interventions lead to potential insight into an effective, alternative, non-surgical therapy for mitochondrial disease associated multiple symmetric lipomatosis. Mitochondrion. 2020;52:183–9. (Epub 2020 Mar 29 PMID: 32234544).

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Andre Mattman.

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Mattman, A., Nadeau, E., Mezei, M.M. et al. Ketogenic diet for mitochondrial disease: potential role in treating the Multiple Symmetric Lipomatosis phenotype associated with the common MT-TK genetic mutation. Orphanet J Rare Dis 17, 12 (2022).

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