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So you can make this dish keto by adding the MCT or coconut oil and more keto with high fat toppings at the end. If you happen not to be in ketosis don’t add the oil or toppings and drain the oil from the meat after browning. If you like heat like me, make it with full hot Italian sausage. Some heat, half hot and half sweet. No heat? All sweet sausage. Feel free to add additional chopped vegetables like celery, peppers or carrots. You can substitute any grated cheese for the Asiago you can also use breadcrumbs which are not keto instead of almond flour. This can either be a meal or an hors d’oeuvre.




12 ounce Italian sausage, hot, sweet, or combination

2 tablespoons of MCT oil or coconut oil and more for rubbing the mushrooms.

4 Portabella mushrooms, remove and chop up the stems and reserve

1/2 cup chopped onion

Two cloves of garlic, chopped

1/4 cup almond flour for keto or 1/2 cup plain or Italian breadcrumbs if not keto.

1/2 cup Asiago cheese, grated or cheese of your choice. OK to leave out the cheese if you’re dairy sensitive.

1/4 cup minced parsley or cilantro and reserve a few sprigs for garnish

One egg or Vegan egg if egg sensitive

Full fat ranch, Caesar salad dressing or MCT oil if you need extra fat for the day.




Preheat the oven to 400°, toaster oven should do if big enough

ub both sides of the mushrooms with oil.  Cook the sausage in a skillet on medium heat (I like cast iron but any skillet will do) until cooked through then add onion and chopped Stems and cook until soft. Remove from the heat and stir in chopped garlic as the residual heat will cook it.

Move to a mixing bowl and mix in the cheese, flour, parsley and egg mix with a fork to combine and then divide and spoon onto four mushroom caps and place on a pan that fits in your toaster oven if your toaster oven is big enough to accommodate, otherwise regular oven. Bake 20 minutes and the tops should be a little brown and the mushroom should feel soft when poked with a fork.

Garnish with parsley or cilantro and if you need more fat for the day sprinkle with ranch, Caesar salad or MCT oil.



Dr Mike

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