Carnivore Diet Year 4: Part 1
State of My Health 2024: Assessing My Lab Blood Work
This year marks 4 years of a mostly carnivore diet and my 36th trip around the sun. All the mainstream health outlets will decry red meat, eggs, butter, and salt; and on the flip side prominent figure heads will just a vehemently villanize deviation from their current protocols. So, what’s changed and am I going to die any time soon? Cholesterol? Saturated fat? Carbs? Keep reading!
This is going to be the first installment in a multi-part series. There’s plenty to cover with the basics of what’s pretty clear (in my lab work) and what I’m doing differently since I began, before even getting to what I might / need to change in the future and the relevant literature.
An Overview Since 2020:
Coincidentally, on Valentine’s Day 2020 I started a carnivore diet and got my purple belt in BJJ the same weekend — a good reminder that correlation is not causation! For about 10 years prior I had been on approximate “paleo” diet, though of course there were a lot of ups and downs and life struggles therein that caused major compromises in my diet.
In 2019 I started training BJJ again and wanted to get my diet back under control, and that was high time form keto and intermittent fasting (IF). After about one year of a ketogenic diet I found myself slipping into the grasp of too many shakes and bars and keto-complaint-fake-foods.
In my first 30-day review of a carnivore diet I described expecting the process to fail, but figured I was in good enough health to give it a fair shake for a month. That lead to a 45-day follow up review and then to a bunch of number crunching in a 90-day review. I’ve since gone on to write “state of my health posts” for 2022 and 2023.
I’ve also gone on to explore the specific nuances of:
With all of that out of the way, let’s get in to what my blood work looks like this year!
Note: You can download the PDF printout from Lab Corp at the bottom of this post.
2024 Blood Work:
The following is a simple overall panel that I ordered for myself for about $200 from Marek Health (no affiliation). Of course, these are only a starting point and as we’ll see it’s enough to get us curious about some more thorough testing.
Cholesterol: Total, Triglycerides, HDL, LDL, VLDL
Thyroid Panel: TSH, T4, T3
Testosterone: Free and Total
Hemoglobin A1c
Vitamin D
C-Reactive Protein
(Fasting) Insulin
Disclaimer: Nothing in this post should be considered medical advice. These are simply my observations, results, and information collected.
Cholesterol:
Total (TC): 273 (ref. 100 - 199)
Triglycerides (TG): 61 (ref. 0 - 149)
HDL: 108 (ref. 39+)
VLDL: 9 (ref. 5 - 40)
LDL: 156 (ref. 0 - 99)
The obvious outliers are that my TC and LDL are literally off the chart of LabCorp’s reference ranges; however, note too that my HDL is 2.5x the recommended minimum of 40. Additionally, LabCorp is kind enough to note my LDL/HDL ratio of 1.4 which puts me in the “1/2 Avg. Risk” of cardiovascular disease (CVD) (1.0 - 1.5).
There was a great meta-analysis done in 2023 reviewing the literature on TG:HDL ratio as a risk factor for CVD (1) and we would all do well to remember that 75% of heart attack patients do not have high cholesterol (2). There are numerous other sources, including AHA, that emphasize the importance of TG:HDL as a cardio-metabolic risk factor (3, 4, 5). The reference ranges I found were (lower is better), 0.5 - 3.0. My ratio was 0.6 — excellent.
Lipid-wise, I’m the prototypical “lean-mass hyper-responder (6).”
Thyroid Panel:
TSH: 3.980 (ref. 0.45 - 4.5)
T4: 6.2 (ref. 4.5 - 12)
T3 Uptake: 29% (ref. 24 - 39)
Free T4 Index: 1.8 (ref. 1.2 - 4.9)
This is not something I knew much about off the top of my head so I had to do a lot of digging. I’ll circle back to thyroid stuff in Part 2 since I suspect it ties into some other oddities below as well.
Testosterone:
Total (TT): 1167 (ref. 264 - 916)
Free (FT, blood): 18.0 (ref. 8.7 - 25.1)
I’m literally off the chart. I’ve never done any hormone replacement therapy (TRT/HRT). I’ve never taken any peptides. My supplement routine is pretty minimal, and I eat a ton of meat and animal fat. It’s well worth mentioning that the above cholesterol is required for the synthesis of both testosterone (7) and Vitamin D (8).
My FT level is a bit curious though, given how high my TT is. It would have been nice to have SHBG on this panel as well, to see if it’s fowling things up. Again, I’ll dig more into this in Part 2.
Diabetes:
HbA1c: 5.6 (ref. 4.8 - 5.6)
Insulin: 4.9 (ref. 2.6 - 24.9)
This was surprisingly not fantastic given that the A1c cut-off for pre-diabetes is 5.7, and 6.4 for Type 2 Diabetes (T2D). An A1c of 5.6% translates to an average blood glucose (BG)(9) of about 114. HOMA-IR is a model of insulin resistance that combines BG and insulin to give an aggregate risk factor for insulin sensitivity (10). My HOMA-IR, at the above values, comes out to 1.4; right at the cut off for the “healthy range” of 0.5 - 1.4.
There is some literature suggesting that fasting insulin is an independent risk factor for a myriad of health problems — including diabetes — independent of A1c (11). In that regard, I’m doing quite well, though a fasting insulin of less than 3 would be great!
As I described in last month’s oral glucose tolerance test I don’t think I’m metabolically broken, but I do have some hunches that I’ll follow up on in Part 2 regarding A1c being higher than I’d like despite good insulin levels.
Vitamin D:
Vitamin D, 25-Hydroxy (VD): 70.0 (ref. 30 - 100)
The power house. Given that it’s only mid-spring, these levels are pretty darn good. Note that the beneficial effect of VD on testosterone plateaus around 80 ng/ml (12). I was supplementing prior to these lab results fairly heavily throughout winter (10,000 IU / day) and intentionally lightened it up in the spring (5,000 IU / day) knowing that I’d be getting more sun.
D-minder estimated my blood levels at around 100 ng/ml which isn’t so much an error of the app’s computation algorithm, but more likely an error in how I was recording (e.g. cloud cover, skin color / exposure percent, etc.). Fortunately, the app lets you input an actual lab / blood value and retroactively adjusts the current estimate — pretty cool!
Recall again that VD is synthesized from cholesterol by UVB exposure to our skin (13) and has a half-life of about two weeks (14). That’s important to remember, because when it comes to winter your blood levels will be cut in half every two weeks — assuming no intake from sun, supplements, or diet during that time. So, this is a fairly active process to engage in, not something to just check once at the peak of the year (July / August) and assume you’re good through February.
C-Reactive Protein:
HS-CRP (CRP): 0.31 (ref. 0 - 3)
CRP is an inflammation marker and you can see that I scored quite low here — which is a good thing. However, one thing to note with this marker is that it’s very subject to change. For example, in my 2022 labs, my CRP and TG were through the roof, while HDL and VD were tanked.
Why? Because at that particular time, it was February (late winter, low VD), and I was also battling sinus and fungal infections. It makes a lot of sense for inflammation to be high when you’re sick as well as for those metabolites involved in immune function (cholesterol) to exhibit significant changes as well.
Conclusions and Questions:
The Good:
Total Testosterone
Vitamin D
HDL / TG
Remaining Questions: For Part 2
Further investigate thyroid panel (TSH is high-normal, T4 is low-normal)
Further investigate A1c being slightly elevated (high-normal)
Further investigate Free Testosterone (in relation to TT).
What about other biomarkers? I know people will ask. I have only had my current fitness watch for about two months, so I don’t have a ton of data for things like heart rate (RHR) and blood pressure (BP), but again, a couple months of data is the minimum to look at for these things because they can and do change in an instant; so an arbitrary snapshot isn’t very helpful.
At any rate, here’s what I’ve got to tack on the end:
Avg. RHR (2 months): 56 bpm
Avg. BP (1 year): 133 / 77 (MAP 95, < 92 preferred)
Wait:Height Ratio (visceral body fat): 0.4706 (ref. < 0.5)
Subcutaneous Body Fat: ~7%
6.99% Naval Tape Measure
7.22% JP4
Sleep (2 months): 8.65 hours / night
There you have it! My overall impression with these lab results is very positive. Nothing was extremely abnormal, though there are a few questions that came up that I want to run a finer comb over and do some investigating because the results were either not what I expected, or I simply don’t know a ton about.
I’m still lean. I’m still strong. My hormone, immune, inflammation, and metabolic functions are all very good. Of course, there’s always room for improvement and learning!
#happysteakday
#carnivoreanniversary
