The purpose of this post is to equip followers of the carnivore diet, both established and new, with the knowledge to interpret their own blood work results. Over the past several years, tens of thousands of healthy carnivore diet adherents have reported specific trends and ranges in their bloodwork results, helping to form a clearer picture of what “healthy” looks like within the context of this diet. With mainstream dietary guidelines often heavily centered around carbohydrate intake, many health professionals and laypeople lack the necessary context to accurately assess the health status of someone following a carnivore diet. The information provided here aims to empower you, the carnivore dieter, to better understand your blood work results and engage in more informed discussions with your healthcare providers, dietitians, and others who may be less familiar with the unique parameters of the carnivore lifestyle. This material is merely reporting and does not or should it be considered medical advice. Always consult your doctor and make informed decisions.
ALANINE AMINOTRANSFERASE (ALT)
Alanine aminotransferase (ALT) is a test primarily used to identify liver damage. ALT is an enzyme that is primarily found in the liver but is also present in smaller quantities in other organs such as kidneys.
ALT’s function in the liver is to facilitate the transformation of food into energy. Elevated blood levels of ALT typically suggest potential liver damage leading to increased ALT secretion. A variety of liver function tests usually accompany ALT tests.
ALT IN THE CONTEXT OF A CARNIVORE DIET
Given the absence of carbohydrates in the carnivore diet, your ALT levels might experience a mild rise during the initial months of diet adaptation and weight loss. Following this period of adaptation and weight loss, ALT levels should stabilize.
Women: 10-25 IU/L Men: 10-33 IU/L
High ALT levels may signal conditions like cirrhosis, mononucleosis, the usage of drugs such as statins or aspirin, blockage of bile ducts, kidney damage, or an excessive intake of vitamin A.
COMPLETE BLOOD COUNT
A Complete Blood Count (CBC) measures red blood cells, responsible for oxygen transport, white blood cells, associated with immunity, and platelets, involved in clotting.
A CBC is a comprehensive test usually recommended by your doctor if you report symptoms like tiredness, weakness or cognitive fog among others.
CBC AND THE CARNIVORE DIET
If symptoms suggestive of a low CBC count arise, it’s likely due to insufficient fat or salt intake. Often, the so-called “adaptation flu” can be traced back to a lower CBC.
WBCs (white blood cells): 4,500-10,000 cells/mcL RBC (red blood cell count) Women: 4 million-5 million cells/mcL Men: 5 million-6 million cells/mcL Hb or Hgb (hemoglobin) Women: 12 to 15 gm/dL Men: 14-17 gm/dL Hct (hematocrit) Women: between 36% and 44% Men: between 41% and 50% MCV (mean corpuscular volume) MCV score is 80 to 95 Platelets 140,000-450,000 cells/mcL
A decreased blood count could suggest conditions like anemia, liver disease or alcohol addiction. For a generally healthy individual, it’s likely related to inadequate salt or fat consumption.
An elevated CBC could indicate dehydration, sleep apnea, pulmonary fibrosis or recent exposure to high altitudes.
Creatinine tests are primarily used to assess kidney function. Creatinine is a byproduct produced by your muscles and is eliminated through the urine after filtration by the kidneys.
The creatinine test is conducted to ensure your kidneys are functioning as expected. This test is typically performed alongside another kidney function test called Blood Urea Nitrogen (BUN).
Creatinine in Carnivore Diet
Creatinine levels tend to marginally increase while following a carnivore diet. This can be attributed to a decrease in water retention as well as a gain in muscle mass. A creatinine test may be necessary if symptoms such as chronic fatigue, foot or ankle swelling, reduced appetite, frequent and painful urination or bloody or foamy urine, suggesting possible kidney failure, are experienced.
Elevated creatinine levels may suggest conditions such as acute tubular necrosis, dehydration, diabetic nephropathy, glomerulonephritis, renal failure, hypothyroidism, muscular dystrophy or a urinary tract obstruction.
Lower creatinine levels, though usually less worrisome, could indicate muscle wastage, a decrease in total muscle mass, or more severe conditions like myasthenia gravis.
Complete Lipid Panel (Cholesterol)
Cholesterol tests are frequently conducted, though often misunderstood, especially for individuals not following the standard American diet.
Cholesterol is an essential component of human health. Its absence could lead to a range of problems, and a lack of it could be fatal. Research has not conclusively proven that LDL cholesterol directly contributes to cardiovascular disease.
- Total cholesterol: < 200 mg/dL (5.2 mmol/L)
- LDL cholesterol: < 100 mg/dL (3.4 mmol/L)
- HDL cholesterol: > 40 mg/dL (1.04 mmol/L) for men, > 50 mg/dL (1.3 mmol/L) for women
- Triglycerides: < 150 mg/dL (1.7 mmol/L)
Cholesterol science is complex and often misinterpreted. Some studies suggest that higher cholesterol could lead to a longer, happier life. Others associate LDL with cardiovascular disease, which could be linked more to dietary factors.
Fasting Blood Glucose
Fasting blood glucose (FBG) tests are often conducted for a baseline, or annually, with the main purpose of monitoring hypoglycemia and hyperglycemia. It’s one of the primary tests done to diagnose and assess diabetes.
Fasting Blood Glucose on Carnivore
FBG on a carnivore diet is typically much lower than that of someone on the Standard American Diet or even on a low-carb diet.
- Average diet: 65-100 mg/dL
- Low carb diet: 54-100 mg/dL.
Excessive levels could indicate type 1 or type 2 diabetes. They may also be caused by acromegaly, Cushing’s syndrome, pancreatitis, pheochromocytoma, and stress.
Decreased levels may indicate adrenal insufficiency, exogenous insulin, hypothyroidism, malignancy, malnutrition, and sepsis.
Hemoglobin A1C (HBA1C)
This test is done once as a baseline, then every three months if levels are abnormal. The HbA1c test checks the average level of glucose in the blood over a period of three months. This is done by checking the number of glucose molecules attached to red blood cells, also known as glycated hemoglobin. It’s regularly used as a check for diabetes and pre-diabetes.
HBA1C on Carnivore
Most people have elevated HBA1C levels before going on the carnivore diet and then generally see massive improvements after sustained periods of zero carb eating.
- Normal values: 4.0 to 5.5%
- Pre-diabetes: 5.6 to 6.4%
- Diabetes: ≥ 6.5%
- Critical value: >7.0%
Elevated levels typically indicate pre-diabetes or diabetes (type 1 or 2). They can also signify B12 deficiency, folate deficiency, and low red blood cell turnover (or anemia of iron deficiency.)
Reduced levels could signify hemolytic anemia but are also observed as a result of hemodialysis treatments, treatments for iron, B12, or folate deficiencies, or in cases of erythropoietin use/abuse.
Microalbumin: Creatinine (Urine)
This test is a marker for early detection of diabetic nephropathy, measuring the leakage of albumin from the kidneys into the urine.
Microalbumin: Creatinine Ratio on Carnivore
A high microalbumin: creatinine ratio could suggest some form of kidney disease. Professional medical advice should be sought before starting a carnivore diet.
High Microalbumin: Creatinine Ratio
High levels may be due to chronic kidney disease, cardiovascular disease, type 1 or type 2 diabetes, diabetic nephropathy, hypertension or vascular endothelial dysfunction.
Electrolytes (Sodium and Potassium)
Sodium and electrolytes can be checked as a baseline to help diagnose any issues related to low levels of sodium and potassium. A patient with chronic kidney disease should also be checked every six months to ensure that sodium levels are normal.
Electrolytes on Carnivore
Electrolytes often measure quite low due to decreased blood volume when starting out on a carnivore diet, but should stabilize.
High Electrolyte Levels
Elevated levels could indicate Cushing’s syndrome/disease, type 1 or type 2 diabetes, diabetes insipidus, excessive diaphoresis, and hyperaldosteronism.
Low Electrolyte Levels
Reduced levels may be an indicator of acute tubular necrosis, adrenal insufficiency, congestive heart failure, cirrhosis, diarrhea, hypothyroidism, malnutrition, nephrotic syndrome, or syndrome of inappropriate antidiuretic hormone secretion (SIADH).
Fasting Insulin or C-Peptide
This test assesses the creation and use of insulin, including the production levels, insulin sensitivity, and insulin resistance.
Fasting Insulin on Carnivore
These tests are usually done by your doctor to check specifically for insulin resistance, insulin sensitivity and insulin production. People on the carnivore diet will typically have more stable fasting insulin levels.
- Fasting insulin levels: 6.35 mU/mL
- Fasting c-Peptide levels: 0.78-189 mg/mL
High Fasting Insulin
Elevated levels may indicate acromegaly, Cushing’s syndrome, type 2 diabetes, liver disease, insulinoma, obesity and uremia.
Low Fasting Insulin
Reduced levels can be caused by chronic pancreatitis, type 1 diabetes, and hypopituitarism.
High-Sensitivity C-Reactive Protein (HS-CRP)
This test is utilized to determine inflammation and aid in diagnosing inflammatory disorders.
HS-CRP on Carnivore Diet
There is generally a reduction in HS-CRP levels when adhering to a carnivore diet, owing to its anti-inflammatory properties.
Less than 3 mg/L.
An increase in levels could be a result of atherosclerosis, rheumatoid arthritis, autoimmune diseases, infections, inflammatory diseases, or cancer.
NUCLEAR MAGNETIC RESONANCE (NMR) LIPOPROFILE
This test offers a detailed analysis of total cholesterol levels in the body, thereby assessing the risk of cardiovascular disease. It also measures the levels of LDL cholesterol. If the initial results are abnormal, it’s recommended to repeat the test annually.
NMR ON CARNIVORE
Individuals on the carnivore diet typically observe an increase in total cholesterol. However, there is still minimal to no solid evidence suggesting that high cholesterol, in the context of a healthy diet, is detrimental.
There are no standard reference ranges for this test. It’s utilized for people believed to be at risk of cardiovascular disease or who have experienced a heart attack but have normal results on a standard lipid panel.
NMR TOO HIGH
Elevated levels can indicate the presence of smaller and denser LDL particles, which could be a sign of developing cardiovascular disease.
THYROID-STIMULATING HORMONE (TSH)
This test is typically carried out in individuals with a history of hypothyroidism and Hashimoto’s disease, or those taking thyroid medication. It assesses the activity of the thyroid, indicated by levels of TSH in the blood. After the baseline test, it should be repeated every three months until treatment helps TSH levels stabilize. Once the levels have stabilized, it should be carried out yearly to ensure stability.
TSH ON CARNIVORE
Some individuals with thyroid issues report better thyroid function and improved thyroid medication management while on a carnivore diet.
The reference range is 0.45-5.5 pU/mL.
TSH TOO HIGH
Excessively high levels can indicate conditions like hypothyroidism and Hashimoto’s disease. However, they can also occur during the recovery phase of an acute illness.
TSH TOO LOW
Levels that are too low may indicate hyperthyroidism or Grave’s disease. They may also decrease in response to acute medical or surgical illness, as well as in response to certain drugs like glucocorticoids or somatostatin analogs.
This test helps evaluate a patient and determine their position on the metabolic syndrome spectrum. It’s primarily used for patients with a history of gout. The test checks for uric acid, a byproduct of purine breakdown, which is a risk factor for diabetes, gout, and kidney stones. It is performed once as a baseline, then once every 6 months.
URIC ACID ON CARNIVORE
The consumption of red meat, high in protein, has been erroneously linked to gout or kidney stones. These claims have yet to be substantiated within the context of a healthy diet.
The reference range is 4.0 to 8.0 mg/dL.
URIC ACID TOO HIGH
High levels could be a risk factor for diabetes, gout, and kidney stones. However, higher levels can be influenced by diet, alcohol consumption, and abnormal kidney function. Levels of uric acid can also increase in response to a low-carb diet or fasting, but only within the first six weeks.
Vitamin B12 is tested to help diagnose causes of fatigue and other symptoms related to malnutrition and malabsorption. It’s usually used to test vegetarian and vegan patients, as well as patients with a history of gastric bypass or lap-band surgery. If levels are found to be abnormal, it’s performed every 6 months.
VITAMIN B12 ON CARNIVORE
Animal foods are rich sources of bioavailable B12, so individuals on the carnivore diet rarely face issues.
The reference range is 130-700 ng/L.
VITAMIN B12 TOO LOW
Low levels are a clear sign of deficiency, which can be caused by various conditions, including macrocytic anemia, bowel resection, celiac disease, Crohn’s disease, dietary deficiency, helminth infection, hyperthyroidism, pernicious anemia, and pregnancy.