C
The Carnivore Codex

Chapter IV

The bloodwork.

What conventional medicine measures, what it actually means, and what you should expect to see on a comprehensive panel after 90+ days of carnivore. Get baselines before you start.

Triglycerides
Often drop 30–60%
The single best fat-loss / metabolic marker. Triglycerides are made in the liver from excess carbohydrate. Remove carbs, they fall.
HDL Cholesterol
Typically rises 10–40%
Saturated fat raises HDL. High HDL is associated with lower cardiovascular risk and better hormonal status.
Triglyceride-to-HDL Ratio
Drops sharply
Arguably the single most predictive marker for heart disease and insulin resistance. A ratio under 1.0 is excellent. Under 0.5 is exceptional.
LDL Cholesterol
May rise — sometimes dramatically
The controversial one. Many lean carnivores become 'Lean Mass Hyper-Responders' (LMHR). Context matters: if HDL is high, triglycerides low, and CAC score is zero, the elevated LDL is mechanistically distinct from atherogenic LDL. Discuss with a lipid-literate physician.
Apolipoprotein B (ApoB)
Variable
A more refined measure than LDL-C. Tracks the actual number of atherogenic particles. Worth measuring.
Fasting Glucose
Falls into the 80s–90s
Note: a transient phenomenon called 'physiological insulin resistance' or 'adaptive glucose sparing' may temporarily elevate fasting glucose. This is not pathological.
HbA1c
Typically drops 0.3–1.5%
Three-month average blood glucose. Reliable indicator of metabolic improvement.
Fasting Insulin
Plummets
The most important marker almost no one measures. Should be in the low single digits. Predicts metabolic disease decades before glucose abnormalities appear.
hs-CRP (Inflammation)
Falls toward zero
C-reactive protein is the canonical inflammation marker. Most carnivores see it drop below 1.0, often below 0.5.
Liver Enzymes (ALT/AST)
Normalize
Fatty liver is driven by fructose and excess carbohydrate, not by saturated fat. Carnivore typically reverses NAFLD.
Ferritin / Iron
May rise
Heme iron is highly bioavailable. Excessive ferritin warrants donating blood. Most people normalize.
Uric Acid
Often rises transiently
Adaptation phase. Most stabilize within 3–6 months. Hydrate. Flares are rare in those without prior gout.
Thyroid (TSH, T3, T4)
Variable
Some see T3 drop slightly — this is adaptive, not pathological, and reflects efficient metabolism. If symptoms develop, consider adding small carbs from honey or fruit.
Electrolytes (Na, K, Mg)
Stable if salt intake is sufficient
Salt liberally — 6–10g per day is normal on carnivore. Most adaptation symptoms ('keto flu') are sodium deficiency.

Recommended Panel

Get this drawn before & after

  • Comprehensive Metabolic Panel (CMP)
  • Lipid Panel including ApoB and Lp(a)
  • Fasting Insulin + Glucose (calculate HOMA-IR)
  • HbA1c
  • hs-CRP and Homocysteine
  • Ferritin, Iron, TIBC
  • Vitamin D (25-OH)
  • Full Thyroid: TSH, Free T3, Free T4, Reverse T3
  • Testosterone (men), full hormone panel (women)
  • Coronary Artery Calcium (CAC) score — if over 40 or LDL is elevated

The LDL Question

High LDL ≠ heart disease

In a metabolically healthy individual — low triglycerides, high HDL, normal blood pressure, no insulin resistance, zero coronary calcification — elevated LDL appears to behave very differently than in a metabolically sick person.

Look up the work of Dr. Nick Norwitz, Dr. David Diamond, and the Lean Mass Hyper-Responder phenotype. Then talk to a physician who actually reads the literature.