Paleo Lab Testing 101: The Top 3 Blood Tests You Need

Thinking about lab testing to see how healthy you are?…

There are 3 major lab tests you need to do if you’re transitioning to a Paleo diet.

In Part 1 of this two-part series, I’m going to discuss the impacts lab tests you need to be checking and the results you need to be aiming for in order to be successful with your Paleo plan, including the impacts of paleo on cholesterol, inflammation, insulin and blood sugar.

Part 2 of the series will cover roadblocks to your success and what barriers might be preventing you from getting to the next level. To begin, let’s discuss the Paleo diet, or as I like to call it—the Paleo template.

Great Lab Testing Guarantee: The Paleo Template

I don’t like the word diet.

While that may be the common vernacular, I like to use the word template instead. A template is less constricting and provides more flexibility.

It gives us the ability to adjust our macronutrients – proteins, fats, and carbs (PFC) – according to our energy levels and metabolic needs (specifically our carbohydrate intake):

  • Some people are insulin-resistant and have blood sugar issues, and may really do well on a ketogenic style of Paleo template.
  • Other people are CrossFit types and may already be pretty healthy (meaning their body is able to process and handle blood sugar and insulin normally, so they can handle a little more carbohydrate).

Using Paleo as a template allows this room for variation and adjustment based on individual needs.

Paleo = Anti-inflammatory

When we talk about Paleo, what we’re really talking about is anti-inflammatory, nutrient-dense, low-toxin foods; foods that we’ve had enough time to evolutionarily adapt to.

Our Standard American Diet today consists of grains and a lot of refined sugar (non-Paleo foods), so our goal is to eliminate these foods and reap the health benefits of improved blood sugar, energy levels, weight normalization, and more.

The Paleolithic era began about 2 million years ago, and we’ve only been consuming grains for about ten thousand years, a very small percentage of that time!

We evolved for millions of years as hunter-gatherer societies, which consumed lots of meat and bone marrow, starchy tubers, and fruit and vegetable carbohydrates (not grain-based). But the evolution to grain-based diets has been at a rapid pace, which is highly problematic because our bodies haven’t had enough time to adapt to those foods. Some people can handle neolithic foods better than others, but for people who are sick or inflamed, grains are dietary kryptonite.

A Paleo template will bring your body back in-line with its evolutionary expectations.

Lab Testing 101: The Top 3 Blood Markers to Track When Going Paleo

As my patients begin a Paleo template, I run labs to check for 3 key markers of health: inflammation, blood sugar, and lipids.

Testing these markers will ensure that their Paleo plan is making them healthier, and allows us to adjust as needed. To access software that can help you track your lab and bio-markers, go to HeadsUpHealth and sign up for a free account.

Inflammation Markers

Inflammation is a sign that your body is breaking down faster than it’s building up because of some type of physical, chemical, or emotional stressor. These can include the following:

  • Gluten in the diet
  • Sleep deprivation
  • Excessive exercise
  • Toxin exposure (pesticides, herbicides, rodenticides, fungicides)
  • Hidden infections
  • Consuming high-glycemic index foods

The toxins mentioned above have only been around for 40 to 80 years, grains have been around for 10,000 years, and flour only for 200 years. People think organic food is a fad, but if you look at history beyond 60 years ago, everything was organic. We didn’t douse our foods in pesticides. There was no GMO. Cutting out these toxic foods will significantly improve inflammatory markers. Going Paleo and placing an emphasis on food quality is a great start to cutting these things out.

When looking for inflammation markers through lab testing, I like to see:

  •  C-reactive protein (CRP) below 1 


  • Homocysteine below 7.5-8
    Homocysteine is good sign of vascular integrity and vascular inflammation. B vitamins—folate, B12, B6—can have a big effect on homocysteine. Inability to methylate (which is important for detoxification and brain health and gut absorption issues can also impact homocysteine levels.


  • Low Fibrinogen.
    Fibrogen is a measure of our clotting factor, and elevations of it can make our cells “sticky” and cause occlusions and blockages. So, the healthier and less inflamed we are, the smoother our blood flows, and the less chance of blockages and heart attacks, another one of the great benefits of going Paleo.

Blood Sugar Markers

  • A1C
    A lab test I like to look at for blood sugar markers is A1C, a 90-day window of how our blood sugar fluctuates. When we are on the Paleo template, our blood cells get healthier because they’re exposed to fewer toxins, so we may see slightly high A1Cs (5.6–5.7) even though we’re eating healthy. This means that A1C isn’t the be all or end all, but it’s good to keep an eye on it.


  • Fasting insulin below 5.
    Insulin basically opens the door for blood sugar to come into the cell. The more we spit out sugar, the more we spit out insulin, and the more numb to insulin we become; this is what’s known as insulin resistance.There’s a strong relationship between high levels of insulin and tumors and cancer. We also see insulin resistance associated with hormonal disorders like elevations in testosterone and androgens for women.When fasting insulin is below 5, it means our body is very sensitive to sugar. It’s more likely to take that sugar into muscle and be able to burn it, instead of storing it as fat. Basically, when we’re more sensitive to insulin, we store less fat and we burn our sugar for fuel.


  • Fasting Glucose. 
    Getting this number below 100 is ideal – some even say below 90. This really depends on our stress levels and cortisol levels, as increased cortisol can increase blood glucose. To measure blood glucose, we can test for functional glucose tolerance: we would measure glucose levels each hour for three hours after our regular meal and see how we do in those intervals. Ideal levels are below 140 within an hour, 120 within two, and back below 100 within three hours.

Lipid Markers

  • Triglyceride-to-HDL Ratio.
    Ideally we like a 1:1 ratio, but I’ll settle for 2:1. This is a really good indicator of insulin resistance. Basically, our triglycerides become elevated when we consume too much carbohydrate. Our HDL goes up when we’re consuming healthy quality fats, like fish oils, coconut oil, and grass-fed butter. As HDL goes up and triglycerides come down, our ratio improves. 


  • Total Cholesterol-to-HDL Ratio
    Around 3.5:1 to 4:1. So, if your HDL is at 60, your total cholesterol should be under 240. Contrary to common belief, total cholesterol by itself is not that important when we look at inflammation markers like CRP, homocysteine and fibrinogen. If inflammation levels are low, but cholesterol’s on the higher side, it may not necessarily be a bad thing, especially if examine…


  •  LDL particle size.
    Large LDL particles are good, and smaller particle size is bad. The larger, fluffier, and more buoyant our particle size is, the less likely it is to stick into the endothelial fissures and create blockages. We get more large particles when we consume healthy fats and restrict refined sugars, grains, and other inflammatory foods.


The Paleo template is a recipe for success because of its emphasis on the foods that we’ve had more time to adapt to: meats, vegetables, fruits, tubers, and healthy fats. These foods are lower toxicity, drive less inflammation, and have higher nutrient density. These foods that we’ve evolved to favor will improve biomarkers of health and disease, and the labs mentioned above are a great way to quantify progress on your Paleo protocol.

Stay tuned for part 2 of this series, where I’ll cover roadblocks to success on your Paleo template.

Lab Work photo licensed under the Creative Commons.


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Dr. Justin Marchegiani

Dr. Justin witnessed chronic disease like diabetes, heart disease, and obesity first hand while working in a surgical center at the University of Massachusetts. This experience shifted his focus from conventional medicine to a more holistic or natural approach to healing, where the underlying cause of his patient’s health issues are addressed and not just medicated and surgically removed.