To Carb or Not To Carb: Five Blood Tests to Perfect Your Metabolism

“You have R73.9 and E78.2—and if you don’t change you’ll get E11.65.” Your medical provider needs disease codes to justify treatment protocols and procedures. Implicit in this medical model is that you have the disease before you get treatment. But what if you want to prevent rather than have a condition? What if you are interested in awesome health, not merely average?

Certain blood tests indicate whether your path toward or away from metabolic illness, including cancer and heart disease. Yet some of these tests are not typically run by your physician, generally because of insurance reimbursement issues. Fortunately, you can get tests done directly and inexpensively and learn from the results yourself. If this sounds daring, let me demystify.

Blood test results are informative and empowering—they are like the displays on the dashboard of your car. If you are the driver, I’d want you to know what the dials and numbers indicate. For one example, unchecked and unresolved high blood sugar, long before type 2 diabetes occurs, results in a greater risk of stroke1, heart attack2, Alzheimer’s dementia3,4, and numerous cancers.5,6,7 Blood test results provide actionable answers about your innate metabolic environment and carbohydrate needs. Ready?

Blood Tests Map Your Metabolism

In the Blood Code8 there are several panels, but three affordable and understandable tests provide insight into your diet, carbohydrate and fitness needs.

  1. HgbA1C / HbA1c / Hemoglobin A1C: Also known as glycosylated hemoglobin. This calculation reflects your eight to twelve-week average blood glucose. Mildly elevated HgbA1C signals disease risks in non-diabetics.9
    • 4.5–5.7% is normal
    • 5.8–6.4% indicates significant insulin resistance
    • >6.4% indicates diabetes

  2. HOMA “IR” = Quantifies Your Insulin Resistance – Glucose X Insulin ÷ 405 A calculator is at:
    • 0.5-1 indicates insulin sensitivity unless high blood sugar is present
    • 1-2 Indicates a normal healthy insulin response
    • >2 indicates insulin resistance (IR)
    • >3 indicates substantial disease risk

    Serum Insulin: The Blood Code reference range for insulin is based upon current evidence10 and differs substantially from outdated conventional lab ranges.

    • Low is <3 uIU/mL
    • Optimal 3–8 uIU/mL
    • High is >8 uIU/mL

    Glucose, fasting. Baseline pre-meal circulating glucose. It’s helpful to realize that fasting glucose normally rises in the morning and more-so with panic, anxiety, stimulant medications and exertion.

    • 75–95 mg/dL is optimal
    • <75 mg/dL is too low
    • 96–100 mg/dL is borderline high
    • 101–125 mg/dL is high blood sugar, but not “yet” diabetic
    • >125 mg/dL is a diabetic level

  3. TG:HDL ratio: Triglyceride (TG) indicates your metabolic trend toward fat storage. HDL levels drop as TG storage burdens your liver.

    TG: Too low and your body is running lean, with few circulating fats to burn following a 12-hour fast. You may need to add carbohydrates if your TG is less than 40! Whereas, a TG of greater than 100 mg/dL and you are storing too much, you need to reduce your dietary carbs to lower your hormone insulin.

    HDL: Your fasting HDL cholesterol represents your liver “happiness”. I have seen honed athletes with low HDL due to excessive dietary carbs. Men and women should both be greater than 50 mg/dL.

    TG:HDL: Done on mg/dL. This simple ratio marks heart disease and stroke risk.

    • 0.5-1.5 is optimal.11
    • >2 borderline insulin resistance
    • >3 indicates excessive fat storage and IR

Choosing the right diet and finding the exercise habits that work for you does not require a nutritional authority or fad diet book. Those with elevated insulin clearly do best on a reduced carbohydrate diet. High blood sugar with high insulin is license to eat a very low carb diet—But wait before running out and buying the latest low carb-ketosis book. The book has been written—it’s inside you. Blood test results from your Blood Code panel provide actionable insight into your metabolic needs and super powers.

Join in the conversation at or follow along twitter @drrichardmaurer. Sign up at to receive your free 99-page PDF booklet on your blood test & body fat evaluation and interpretation.


  1. doi: 10.1177/1474651408096677
  2. Nanda, N., et al. Indian J Physiol Pharmacol. 2009 Oct-Dec;53(4):334-40.
  3. Crane, P., et al. Glucose levels and risk of dementia. N Engl J Med. 2013;369:540-548.
  4. doi: 10.2337/db06-0879
  5. Antoniadis, A. G., et al. Insulin resistance in relation to melanoma risk. Melanoma Res., vol. 21(6). 2011 Dec; 541–46.
  6. Giovannucci, E. Metabolic syndrome, hyperinsulinemia, and colon cancer: A review. Am J Clin Nutr, vol. 86, no. 3, 2007 Sept; 836–42.
  7. doi: 10.1007/s00125-010-1796-7
  8. Maurer, R. The Blood Code: Unlock the secrets of your metabolism, 2014.
  9. Matsushita, K., et al. The association of hemoglobin A1c with incident heart failure among people without diabetes: The Atherosclerosis Risk in Communities Study. Diabetes. 2010; 59:2020–26.
  10. Staten, M., et al. Insulin Assay Standardization: Leading to Measures of Insulin Sensitivity and Secretion for Practical Clinical Care. Diabetes Care June 2010 vol. 33 no. 6 e84.
  11. Jeppesen, J., et al. Low triglycerides-high high-density lipoprotein cholesterol and risk of ischemic heart disease. Arch Intern Med. 2001; 161:361–66.

About the Author

Dr. Richard Maurer

Dr. Richard Maurer is a naturopathic doctor, author, and expert in metabolic recovery and health. His 2014 book, The Blood Code, demystifies blood test results & body fat measurements to reveal the primal diet & fitness needs that lead toward health and longevity. Connect at or Twitter: @drrichardmaurer


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