CARNIVORE DIET BLOOD TESTS


The carnivore diet is often seen as an elimination diet and as such has a reputation for being incomplete or possibly unhealthy. With that in mind, it's never been more important to be able to read your own blood tests so you can understand what's going on and why.

Alanine aminotransferase (ALT)

The Alanine aminotransferase (ALT) test is a test for liver damage. ALT is an enzyme found mainly in your liver but it's also present in smaller amounts in your kidneys and other organs.

The role of ALT in the liver is to break down food into energy. If your blood levels of ALT are high it can usually be a sign that your liver is damaged in some way and it's releasing more ALT as a consequence. ALT is usually done with a series of other liver function tests.

ALT ON CARNIVORE
Because of the zero carb nature of the carnivore diet your ALT levels may slightly increase during the first few months while your body adapts and you lose weight. After the weight loss and adaption period, ALT levels should return to normal.

REFERENCES RANGES
  • Women: 10-25 IU/L
  • Men: 10-33 IU/L

ALT TOO HIGH
A high level of ALT can be indicative of cirrhosis, mononucleosis, drugs such as statins, aspirin, blockage of the bile ducts, kidney damage or too much vitamin A.

COMPLETE BLOOD COUNT

A Complete Blood Count (CBC) is a measure of your red blood cells which transport oxygen, white blood cells which are for your immune system, and platelets which manage the clotting process.

A complete blood count is quite a general test and is often done by your doctor should you complain of fatigue, weakness or brain fog among other symptoms.

CBC ON CARNIVORE
If you do feel the symptoms of a potentially low CBC count then it's quite possible that you're not eating enough fat or salt. In fact, the adpation flu you feel can often be due to lower CBC.

REFERENCE RANGES
  • WBCs (white blood cells):
    4,500-10,000 cells/mcL
  • RBC (red blood ceel count)
    Women: 4 million-5 million cells/mcL
    Men: 5 million-6 million cells/mcL
  • Hb or Hbg (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

CBC TOO LOW
A low blood count could mean many things including anemia, liver disease or alcohol dependence. If you're an otherwise healthy person it ill more than likely be low salt or fat intake.

CBC TOO HIGH
A high complete blood count reading could be a sign of dehydration, sleep apnea, pulmonary fibrosis or that you've recently spent time at high altitude.

Creatinine

Creatinine tests are usually to check kidney function. Creatinine is a waste product created by your muscles and is filtered by your kidneys to be excreted in the urine.

The creatinine test is used to check that your kidneys are working properly and It's usually ordered along with another kidney test called Blood Urea Nitrogen (BUN)

CREATININE ON CARNIVORE
Creatinine levels usually increase slightly on the carnivore diet due to both loss of water retention and increased muscle mass. If you feel chronic fatigue, get swelling in your feet and/or ankles, decreased appetite, frequent and painful urination or your urine that is foamy or bloody, you may need this test to check for kidney failure.

REFERENCE RANGES
  • 0.8-1.4 mg/dL

CREATININE TOO HIGH
High levels of creatinine can be indicative of acute tubular necrosis, dehydration, diabetic nephropathy, glomerulonephritis, renal failure, hypothyroidism, muscular dystrophy or even a urinary track obstruction.

CREATININE TOO LOW
Low creatinine is usually less of a concern but can be due to muscle wastage, a decrease in overall muscle mass or something more serious like myasthenia gravis.

Complete Lipid Panel (Cholesterol)

Cholesterol is probably one of the most frequently checked blood test while at the same time, being the least understood, especially in the context of someone NOT on the standard American diet.

A complete lipid panel is ordered by your doctor to measure total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides. You'll usually be asked to be fasted for at least 12 hours before blood is drawn.

CHOLESTEROL ON CARNIVORE
Cholesterol, on any diet, is essential to human health. Less cholesterol and you subject yourself to a whole host of problems. No cholesterol and you die, so it doesn't make much sense to have less of it in the body. Furthermore, there's no meaningful research to prove LDL cholesterol is in any way related to cardiovascular disease. Only association.

REFERENCE RANGES
  • 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 TOO HIGH
To date, the science on cholesterol seems to be widely misunderstood. Some studies say the higher your cholesterol, the longer, happer life you'll live. Other studies point to LDL as a cause of carndivascualr disease but this is more likely due to other dietary factors.

One of the largest studies on LDL, Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review, found an inverse relationship between LDL and cholesterol.

That means the more LDL patients had, the longer they lived!

One thing is for sure, high fat in the absence of dietary carbohydrates almost always leads to positive results such as:
  • Decrease in body fat and abdominal fat
  • Decrease in triglycerides
  • Increase in HDL cholesterol
  • Decrease in small LDL particles
  • Lower blood glucose levels
  • Lower insulin levels
  • Increase in insulin sensitivity

Fasting blood glucose

FBG (or fasting blood glucose tests) are usually taken for a baseline, or annually, with the explicit purpose of monitoring hypoglycemia and hyperglycemia. It’s one of the main tests performed in order to diagnose and assess diabetes, as well as to help make better decisions in terms of treating diabetes.

FASTING BLOOD GLUCOSE ON CARNIVORE
FBG on the carnivore diet will typically be much lower than someone on the Standard American Diet or even on a low carb diet.

REFERENCE RANGES
  • Average diet: 65-100 mg/dL
  • Low carb diet: 54-100 mg/dL.
 
FBG TOO HIGH
Levels that are too high are typically considered an indicator of type 1 or type 2 diabetes. However, they may also be caused by acromegaly, Cushing’s syndrome, pancreatitis, pheochromocytoma, and stress. Higher levels of FBG can also be a side effect of glucocorticoid drugs.

FBG TOO LOW
Levels that are too low may indicate adrenal insufficiency, exogenous insulin, hypothyroidism, malignancy, malnutrition, and sepsis. Lower levels of FBG may also be caused by side effects of oral hypoglycemic agents.

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.

REFERENCE RANGES
  • Normal values: 4.0 to 5.5%
  • Pre-diabetes: 5.6 to 6.4%
  • Diabetes: ≥ 6.5%
  • Critical value: >7.0%

HBA1C TOO HIGH
Levels that are too high are usually considered an indicator of pre-diabetes or diabetes (type 1 or 2). They are also indicators of B12 deficiency, folate deficiency, and low red blood turn turnover (or anemia of iron deficiency.)

HBA1C TOO LOW
Levels that are too low could be indicators of hemolytic anemia, but are also seen as a result of hemodialysis treatments, treatments for iron, B12, or folate deficiencies, or in the case of use/abuse of erythropoietin.

Microalbumin:creatinine (urine)

This test is a marker for detecting early diabetic nephropathy, measuring the leakage of albumin from the kidneys into the urine. It’s done by collecting urine samples over 24 hours or through a spot urine sample, if the concentration is elevated. These have to be measured in two or three sessions over a two-three month period.

MICROALBIUM:CREATININE RATIO ON CARNIVORE
If you have a high microalbium:creatinine ratio you could have some kind of kidney disease. Be sure to check with a trained professional before embarking on a carnivore diet.

REFERENCE RANGES
  • 30-300 mg/L.

MICROALBIUM:CREATININE RATIO TOO HIGH
Levels that are too high may be caused by 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. These electrolytes are essential for blood volume and pressure regulation, fluid balance, acid-base balance, muscle contraction and a range of other functions.

ELECTROLYTES ON CARNIVORE
As part of the adaption period when starting out on a carnivore diet, electrolytes can often measure quite low tdue to decreased blood volume, but should stablise.

REFERENCES RANGES
  • 134-144 mEg/L.

ELECTROLYTE LEVELS TOO HIGH
Levels that are too high could indicate Cushing’s syndrome/disease, type 1 or type 2 diabetes, diabetes insipidus, excessive diaphoresis, and hyperaldosteronism. They can also be high as a result of too high dietary sodium intake, dehydration, taking oral contraceptive pills, advanced age, and vomiting.

ELECTROLYTE LEVELS TOO LOW
Levels that are too low 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). They can also be caused by side-effects of drugs like ACE inhibitors, excessive exercise, heavy sweating, vomiting, water intoxication, or too low dietary sodium intake.

Fasting insulin or c-peptide

This test assesses the creation and use of insulin, including the production levels, insulin sensitivity, and insulin resistance. As such, it can help diagnose metabolic syndrome, diabetes, and a range of other similar conditions. It’s also used to distinguish whether a patient has type 1 or type 2 diabetes, and is performed every six months if there are abnormal results to a baseline test.

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.

REFERENCE RANGES
  • Fasting insulin levels: 6.35 mU/mL
  • Fasting c-Peptide levels: 0.78-189 mg/mL

FASTING INSULIN TOO HIGH
Levels that are too high may be indicators of acromegaly, Cushing’s syndrome, type 2 diabetes, liver disease, insulinoma, obesity and uremia. They can also be caused by side effects of drugs such as glucocorticoids, hypoglycemic agents and insulin (exogenous).

FASTING INSULIN TOO LOW
Levels that are too low can be caused by chronic pancreatitis, type 1 diabetes, and hypopituitarism.

High-sensitivity c-reactive protein (hs-CRP) 

This test is used as a marker for inflammation and to help diagnose inflammatory conditions. It’s checked once every six months for those who are diagnosed with such a condition or are otherwise hyper-responsive to the test. It looks for the values of CRP, which is produced by the liver as an immune response, and as such can be a sign that the body is reacting to something that needs treatment.

HS-CRP ON CARNIVORE
Levels of HS-CRP usually reduce while on the carnivore diet due to it's anti-inflammatory nature.

REFERENCE RANGES
  • Under 3 mg/L.

HS-CRP TOO HIGH
Levels are are too high could be caused by atherosclerosis, rheumatoid arthritis, autoimmune disease, infections, inflammatory disease, or malignancy.

Nuclear magnetic resonance (NMR) lipoprofile

This test provides a detailed look at total cholesterol levels in the body, which can help highlight a patient's risk of developing cardiovascular disease. It can also measure the levels of LDL cholesterol (or low-density lipoproteins). After a baseline check, it should be checked annually in those who have had abnormal test levels before.

NMR ON CARNIVORE
People on the carnivore diet usually see an increase in total cholesterol. While this can be alarming to some, there is still very little to no strong evidence that indicates high cholesterol in the context of a health diet is bad for you.

REFERENCE RANGES
There are no standard reference ranges for this test, and is used for people who are believed to be at risk of cardiovascular disease or who have had a heart attack, but show normal results on a standard lipid panel.

NMR TOO HIGH
Levels that are too high can show LDL particles that are smaller and denser, which could be an indicator of developing cardiovascular disease.

Thyroid stimulating hormone (TSH)

This test is usually performed is someone has a history of hypothyroidism and Hashimoto’s disease and takes thyroid medication. It checks whether the thyroid is underactive or overactive, found 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 stabilised, it is to be carried out every year to ensure they stay that way.

TSH ON CARNIVORE
Some people with thyroid problems note improved thyroid function and better thyroid medication management while on a carnivore diet.

REFERENCE RANGES
  • 0.45-5.5 pU/mL.

TSH TOO HIGH
Levels that are too high are likely to be caused by hypothyroidism and Hashimoto’s disease. However, they can also be caused by the recovery phase of an acute illness.

TSH TOO LOW
Levels that are too low may be caused by hyperthyroidism or Grave’s disease. They may also be low in response to acute medical or surgical illness, as well as a response to some drugs such as glucocorticoids or somatostatin analogs.

Uric acid

This test is designed to help assess a patient and help find their place on the metabolic syndrome spectrum. It’s performed once as a baseline, then once every 6 months, and is primarily used for patients with a history of gout. It checks for uric acid, which is a product or purine breakdown and is a risk factor for diabetes, and a direct cause of gout and kidney stones.

URIC ACID ON CARNIVORE
Red meat consumption has been falsely accused of causing gout or kidney stones to it's higher protein content. These claims are yet to be proven correct on the context of a healthy diet.

REFERENCE RANGES
  • 4.0 to 8.0 mg/dL.

URIC ACID TOO HIGH
Levels that are too high could be a risk factor of diabetes, gout, and kidney stones. However, higher levels can be affected 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

Vitamin B12 is tested to help diagnose causes of fatigue and other symptoms related to malnutrition and malabsorption. It’s usually used to test vegetation 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 one of the best sources of bio available B12 so people on the carnivore diet rarely have issues.

REFRENCE RANGES
  • 130-700 ng/L

VITAMIN B12 TOO LOW
Levels that are too low are a clear sign of deficiency, which can be caused by a range of things, including macrocytic anemia, bowel resection, celiac disease, Crohn’s disease, dietary deficiency, helminth infection, hyperthyroidism, pernicious anemia and pregnancy.

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