Primal + Keto Pizza

When people say they won’t do keto because they find it too limiting, we shake our heads because it just doesn’t have to be that way. Rich and hearty salads, succulent meats, tender roasted veggies, tempting snacks and desserts—there’s not much you can’t eat on keto if you know how to do it.

This fresh and flavorful pizza is proof positive that you don’t need to give up great food (even comfort food!) to enjoy all the health benefits of keto living. We love this recipe for the substantial crust, the creamy cheese, bright tasting sauce and all the amazing toppings. (Hint: make a couple crusts at a time and freeze one between waxed paper in a sealed freezer bag.) Once you try this pizza, you’ll definitely want to make it again!




  • 1 cup sliced Cremini/button mushrooms
  • ¼ cup sliced red onion
  • 2 Campari tomatoes, quartered
  • ½ Tbsp. olive oil
  • ½ Tbsp. Primal Kitchen Avocado Oil
  • 2 cloves garlic, minced
  • ¼ tsp. dried oregano
  • Pinch of salt


  • 4 oz. cooked Italian sausage, sliced
  • 4 oz. fresh mozzarella
  • 1/3 cup marinara sauce, such as Primal Kitchen Tomato Basil Marinara
  • 3 Tbsp. thinly sliced fresh basil
  • olive oil to brush the crust with


Preheat the oven to 375º degrees. In a bowl, combine the almond flour, flaxseed, collagen and 1 tablespoon of tapioca starch. Stir in the salt, garlic powder, dried oregano and baking soda. Slowly add in the coconut milk, olive oil and avocado oil. Whisk the egg and add it to the dough. Allow the dough to rest for a few minutes.

Toss the mushrooms, red onion and campari tomatoes with the olive oil, avocado oil, minced garlic, oregano and salt. Lay the vegetables out on a parchment covered sheet pan and roast for 15-20 minutes, flipping once in between.

Slice the fresh mozzarella into thin slices and place them between two pieces of paper. Allow them to dry out like this for 30 minutes.

Dust another parchment covered sheet pan with half a tablespoon of tapioca starch. Pour out the dough onto the parchment and spread it out so it is in a rectangular shape. Sprinkle more tapioca starch on the dough and your hands as you work. The dough will be sticky so you can also use a silicone spatula to help you spread. Sprinkle the last of the tapioca starch over the top of the crust and spread it until it’s a rectangular shape around 10”x6”. Bake the pizza for ~10 minutes or until the crust is just set.

Heat a grill over medium heat. While it is heating, remove the crust from the oven. Spread on the marinara sauce, leaving a small amount of crust around the outside of the pizza. Sprinkle half of the basil all around the sauce. Lightly press the mozzarella slices onto the sauce. Arrange the sausage slices and mushroom mixture on the pizza. Brush a little olive oil on the crust. Carefully move the pizza from the pan to the grill, making sure to place it over indirect heat. Cover the lid and cook for 2-3 minutes, or until the cheese starts to melt slightly and the bottom of the crust is a little browned. Remove the pizza from the grill and garnish with the remaining basil immediately. Cut into 6-8 squares and enjoy!

**This pizza has a dense crust that’s a perfect vehicle for all sorts of topping goodness. The pizza crust is pre-baked and then grilled with the toppings. If you don’t have a grill, you can bake the pizza from start to finish in the oven – prebake the crust as directed and then finish baking at 400 ºF for about 5-7 minutes after you’ve added the toppings. This recipe uses fresh mozzarella which is dried out before baking, but it will get watery on your pizza if you grill it for too long. If you want more of a melted and browned cheese, swap out fresh mozzarella for a block or shredded mozzarella that has moisture already removed.

Nutrition Information (1/6 of pizza):

  • Calories: 367
  • Total Carbs: 9 grams
  • Net Carbs: 5 grams
  • Fat: 29 grams
  • Protein: 17 grams
TAGS:  Keto Recipes

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17 thoughts on “Primal + Keto Pizza”

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  1. Or get a low carb ‘Mission Carb Balance’ whole wheat
    Burrito and use that as a shell. 8 net grams of carbs in the whole thing.

  2. Nice Sunday with Sisson, Mark, thank you. I found myself looking up Nassim Taleb and then Antifragile. The description of it reminded me of people with ME/CFS (myself included). Jen Brea, the producer and star of a documentary about that illness figured out what was causing it for her.

    That illness has a serious image problem as most people assume the patient is faking it and being “lazy” but considering Ms. Brea had to have three surgeries and now she’s fine, I’d say… no. Looks like for some reason certain neurological issues are on the rise. It’s tempting to say “because diet.” But if that was the only cause, then changing it would work and it doesn’t, not completely. It only helps.

    People with ME do something called “pacing” which is designed to not activate AMPK, which is far too active and also dysfunctional in the illness. AMPK is what makes you have that irresistible sleep after a long workout and then you wake up refreshed. It’s easily triggered in ME and it doesn’t result in the person being refreshed. “Pacing” can sound a lot like laziness since it advises that people do not do more than they can very comfortably handle, ever. It’s the opposite of athleticism.

    It’s the illness that isn’t believed until someone close to you has it.

    Every time I think I’m ready to look for work, I get sick for two weeks again. I had torticollis when I was a child and I’m wondering if should seek out one of those specialists she’s talking about. I hate the idea of surgery but if it means I get my life back…

    So about procrastination specifically, there’s a long tradition of the wisdom of procrastinating… the fabled “work avoidance gene” where you procrastinate until it becomes moot anyway. It could be an instinct that says “this work won’t matter, focus on the important things.” And the students who always procrastinate because working under pressure gives them more focus. That was me in college. Except for math, you can’t do math that way. But writing a paper, it was always the night before. I just “couldn’t think” before that. Procrastination is instinctive up to a certain point. Sure it can go wrong. That’s not the point.

  3. Is almond flour just not absorbent enough? I hesitate to use tapioca starch in a recipe, even for “dusting.” I’d probably stick with a cauliflower crust over this. Easier to make it organic too.

    1. Easier to make? Seems like a lot of prep for a cauliflower crust to me. Do you have a link to an easy recipe pls? ty

  4. I am interested in trying this pizza but at the same time, I am trying to restrict calories. I think my problem is appetite, I am trying to suppress my appetite a little more.

    What are your thoughts on the red tea diet ~ apparently that helps suppress appetite? I’m debating whether or not to buy it, anyone have any good appetite suppressors and\or tried this one in particular?

    Let me know, thanks.

    1. I have used MCT oil as an appetite suppressant and it works really well, as long as you’re actually taking in nutrition, that is. Make your keto diet more strict and the diet itself will suppress excess appetite. But if you’re restricting calories (ie. 1200 Calories or less per day), then I think all bets are off. Such diets are usually medically supervised. Keto isn’t a calorie restriction diet, verly low calorie diet (VLCD) or otherwise. Paleo/Keto is a way of eating that maximizes nutrition while helping the body fix its own metabolic issues, which often leads to weight loss because people often have some excess weight. It’s not a crash diet though. The insulin manipulation of the keto diet and ketones are the key to why this works for some people. There are several good books on the subject, Mark has one and there are others too. It takes a bit of research and reading, but it’s not hard to do.

    2. Fiber and bulk is the greatest suppressor of appetite. Stop eating meat and dairy (high calories, low bulk, no fiber) and eat whole grains, legumes, and veggies (foods with low caloric density, high fiber, high bulk) and you’ll be satiated all day with just two meals. No snacks, no tricks.

      1. No, it doesn’t work that way.

        low caloric density = low nutrient density

        The lower the nutrient density, the more food your body demands, and the hungrier you will be.

        Meat, especially, is nutrient dense and as all know, extremely satisfying compared to carrots and celery.

      2. That may work well for you, but I think this is a YMMV thing. Animal protein and full-fat dairy (along with high-fat plant foods, like olives and avocados) does more to lower my appetite than any combination of plant-based foods ever did. Bonus perk–it is the only thing that’s ever reduced my sweet tooth.

  5. Mark,
    I’d be interested to hear your take on oxalates since the recipe above includes almond flour which is very high in oxalates. I recently listened to the Human Performance Outliers podcast with Sally Norton as a guest. (I saw that you also did a podcast with them.) Do you think oxalates are a problem for most people like she does? Thanks!

  6. If you bake a mound of shredded cheddar you get a quick and easy base for a pizza. I call it cheeza. 400 degrees F for 10 minutes on parchment. Take it out and add toppings and back in the oven for a few more minutes. You don’t need to measure anything. Tastes amazing.

    1. We do “meatzza”. we mix a pound of chorizo or Italian sausage with an egg spread it thin on a pan and bake until cooked ~ 6 min @ 400. Then top it with warmed sauce, cheese and veggies; back in the oven until the cheeses bubbling. It is fantastic!

      1. Meatzza is the best! My family and I do that often, topped with our favorites and have a simple Caesar salad with it (no bread croutons, but I am thinking about making crispy pork belly ‘croutons’)

  7. This looks fantastic! Thank you… gonna try it soon and report back… 🙂 <3

  8. I have tried recipes very similar to this. I find the taste of the almond flour dominates the overall flavour of the pizza regardless of the toppings. I’ll stick with fathead pizza until I find something better

  9. Are you using coconut milk out of a can – The thick full fat kind, Or are you using the coconut milk out of a curtain which is thinner?