Top 10 Blood Tests for Vegetarians and Vegans : An Exlusive Renegade Health Article by Dr. J.E. Williams

Thursday Aug 25 | BY |
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If you eat a vegan or vegetarian diet, you’ll most likely boost your folic acid and antioxidant levels; but, you could be vulnerable to low B12, iron, and albumin.

Resident Medical Authority: J. E. Williams, OMD, FAAIM

PART I – Blood Testing for Vegetarians & Vegans

Personally, I started my own personal experiment with vegetarianism and vegan lifestyle in 1972, and I also conceived and raised children as vegetarians (until they were pre-teen). I have 30 years of clinical experience in natural medicine, and for 25 years, I was a busy clinician in Southern California. Thus, I have earned my credentials and have seen it all.

I know through all of this that if you want to get your cholesterol and LDL (“bad” cholesterol) down to bare bones levels, go vegan. If you want to boost your folic acid and antioxidant levels to new heights, eat more plants. It is the same with reducing your risk for a heart attack to zero, and preventing many types of cancer. But, if you want to have strong vitamin B12 levels, and enough iron and albumin, vegetarians and vegans are vulnerable.

This blog is the first in a series where I discuss the basic laboratory tests most important for plant-based diets. Let’s look at the 10 most helpful ones for evaluating deficiencies and the consequences of not having adequate levels of certain nutrients.

    1. CBC – Complete Blood Count with Differential and Platelets: This group of tests tells if you are anemic, immune deficient, or have an infection or allergies. Low RBC (red blood count), hemoglobin, and hematocrit are signs of anemia. The CBC helps determine your general health status. If have fatigue or weakness, or suspect an infection, this test can help determine what is the cause.

    2. CMP – Comprehensive Metabolic Panel: The CMP is a group of 14 tests that provides information about the status of your kidneys, liver, and electrolyte and acid/base balance, as well as of your blood sugar (glucose) and blood proteins (total protein, albumin, and globulin). Abnormal results, especially combinations of abnormal results, indicate a problem that needs to be addressed. Total protein below 6.5 and albumin below 3.9 are signs of protein deficiency. Glucose (blood sugar) is also tested in this panel. It is uncommon for plant-based eaters to be diabetic. Some times, however, glucose can be too low, suggesting hypoglycemia.

    3. Ferritin: This test helps assess iron stores in the body. It is useful in combination with an iron and TIBC to evaluate the severity of iron deficiency or overload.

    4. Folic Acid: This test gives an idea of your level of folate. It is rarely low in plant-based diets. However, higher than normal levels, common in vegetarians and vegans, combined with low vitamin B12 levels, magnifies vitamin B deficiency in the body. The amount of folate inside the red blood cell (folate, RBC) may also be measured and is normally higher inside the cell than in the serum.

    5. Homocysteine: An elevated homocysteine level helps determine B12 or folate deficiency. Elevated levels of homocysteine (above 10 micromoles/liter) are associated with atherosclerosis (hardening and narrowing of the arteries) and suggest an increased risk of heart attacks, strokes, blood clot formation, and Alzheimer’s disease. I want my patients to be lower than 9 micromoles/liter and optimally less than 6 micromoles/liter.

    6. Iron – total and TIBC (total iron binding capacity): Vegetarians can have adequate iron levels if they eat quantities of iron-containing vegetables and fruits, like spinach and raisins. However, raw vegans often show low levels of red blood cells and iron deficiency in their tests. Early iron deficiency causes no physical effects, so you may not know you levels are going down; but, as hemoglobin levels drop below 10 g per deciliter, things can get challenging. As the iron-deficiency progresses, symptoms begin to develop, including fatigue and tiredness, weakness, dizziness, and headaches. As iron reserves continue to be depleted, you can experience shortness of breath, ringing in the ears (tinnitus), drowsiness, and irritability.

    7. Lipid Profile: This group of tests measures your blood fats (total cholesterol, LDL, HDL, and triglycerides) to determine risk for coronary heart disease. Vegetarians typical have normal lipid profiles, but vegans may have cholesterol levels that are too low (less than 135 mg/dL). Cholesterol is essential for life. A waxy substance manufactured from raw materials supplied in the diet, it is used to produce hormones and cell membranes and is transported in the blood. Cholesterol is the primary building block for steroid hormones like estrogen and testosterone, and adequate levels are required for health.

    8. MMA – Methylmalonic Acid, serum: MMA, along with homocysteine, help diagnose an early or mild B12 deficiency. If MMA and homocysteine levels are increased, then vitamin B12 deficiency may be present, indicating less available B12 at the tissue level. If only homocysteine is elevated, then folic acid may be low or not being metabolism properly. If MMA and homocysteine levels are normal, it is unlikely that there is a B12 deficiency.

    9. Vitamin B12: Both B12 and folate are necessary for normal red blood cell formation, tissue and cellular repair, DNA synthesis, and for nerve health. A deficiency in either B12 or folate causes macrocytic anemia. Also called megaloblastic anemia, this type of anemia is characterized by the production of fewer – but larger – red blood cells called macrocytes, leading to fatigue, weakness, and all the other symptoms of anemia. If your levels are below 400 pg/mL, suspect B12 deficiency. I like my patients to be at least 600-900 pg/mL.

    10. Vitamin D, 25-Hydroxy: This test determines vitamin D3 status. It tells if you are susceptible to bone weakness, bone malformation, or abnormal metabolism of calcium. Since vitamin D is a fat-soluble vitamin and absorbed from the intestine like dietary fat, low-fat diets are prone to vitamin D deficiency. Also, people with conditions that interfere with fat absorption, such as cystic fibrosis and Crohn’s disease, irritable bowel syndrome, and Celiac disease are not able to absorb enough Vitamin D.

Dr. Williams’ Suggested Panels for Vegetarians/Vegans

  • Complete Blood Count with Differential and Platelets
  • Comprehensive Chemistry/Metabolic Panel
  • Ferritin
  • Folic Acid
  • Homocysteine
  • Iron, total and IBC
  • Lipid Panel
  • Methylmalonic Acid, Serum
  • Vitamin B12
  • Vitamin D3, 25 Hydroxy

For more information on lab testing:


Here’s How You Can Access Some of Dr. Williams’ Most Important Health Secrets and Protocols…

Dr. J. E. Williams has over 30 years of clinical experience in the natural health world and has had over 100,000 patient visits over that time.

We’ve recently created a selection of programs based on his work, to help you get real, tested and effective natural solutions.

These programs include how to improve thyroid function, how to read your blood tests, and how to support your adrenals naturally.

To learn more about these programs or to get one today, please click here!

Dr. J. E. Williams


Dr. Williams is a pioneer in integrative and functional medicine, the author of six books, and a practicing clinician with over 100,000 patient visits. His areas of interest include longevity and viral immunity. Formerly from San Diego, he now resides in Sarasota, Florida and practices at the Florida Integrative Medical Center. He teaches at NOVA Southeastern University and Emperor’s College of Oriental Medicine.

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  1. Katya says:

    Wow! Thanks for this comprehensive list. It’s hard to find this esoteric information all in one place to help you when you walk into your physician’s office. I have conventional medical insurance, but they will do tests for things I ask. You have done a great service by helping all of us “alternative” eaters dig in the right places to make sure we’re doing it right. Quite a life-saver, especially when you don’t have the extra bucks to pay out of pocket for alternative health coverage.

  2. Satori says:

    This list is amazing. First thing I will do when I saved up a bit of money is getting my blood tests done.

    Dr. Williams is fantastic. I’m following his twitter now. Did you know he follows Dalai Lama? hehe:)

  3. maca says:

    I got mine done last October and have been having regular follow-ups. Results have improved every time and I’m getting very close to optimal levels. Not there yet though, so still have some work to do.

    A very big thanks to Kevin for getting me started on blood testing. Buy his blood testing book and audios. Well worth the investment.

  4. Jason says:

    I intend to take this list to my doctor when I go for blood tests. I’m sure he’ll have his own opinions about what is necessary, but I’m going to see if I can get them all done.

    Thanks so much for posting it.

  5. WONDERFUL information of high utility.
    Every one should know how to look after their health – all our educational insttns and systems should have it all. so that the world needs doctors and hospitals very very rarely as it was 50yrs ago in places like India.

  6. Edith says:

    what would be a reasonable fee for these tests to be conducted, and results analyzed?

  7. Barbara says:

    These tests are a good idea to help track your health and help you to adjust your diet and tweak things for optimal benefit.

    Just keep in mind that people that eat animal products are also at risk for deficiencies such as B12 vitamin D3.

    It is not just a question of how much of a nutrient you take in to your body, but also how your body metabolizes and synthesizes these nutrients. In my practice I work with hundreds of people (Vegetarian, Vegan & meat eaters) that are low in these nutrients.

    For Vitamin D3 – keep in mind there is no plant source so get out into the sun and don’t use all that sunscreen (it block the healthy rays too).

  8. bernadette says:

    I can not help but wonder….If being a vegetarian is such a good thing, I meant, surely if our diet was good for the human body, we would be getting all the things it need, not always being natorious low in certain thing, a good example is B12 let alone everything else. surely our diet should be able to give us these things. After all, people in the past did not have these health issues/deficiency’s did they???

  9. Sue Rushford says:

    Just got my results a few weeks ago based loosely on tests recommended by Dr. Karen Vieira – been vegetarian 25 yrs, vegan 10 yrs, raw 5 yrs but was on the Pill 23 yrs & was obese on a French Fry diet for most of those years – here are some of my numbers – all results were normal unless otherwise indicated:

    Complete Blood Count with Differential and Platelets – WBC 5.4, RBC 4.36, Hemoglobin 13.2, Hematocrit 41.5, MCH 30.3; MCHC 31.8 LOW, RDW 13.6, Platelets 200, Neutrophils 62, Lymphs 29, Monocytes 7……absolute….

    Comprehensive Chemistry/Metabolic Panel – Glucose 81, BUN 12, Calcium 9, Phosphorus 3.6, Albumin 4.2, Biliruben .6.

    Ferritin – will definitely test next month

    Folic Acid – will definitely test next month

    Homocysteine – 8.0

    Iron, total and IBC – just tested Iron – 248 – SUPER HIGH = HEMOCHROMATOSIS!

    Lipid Panel – Cholesterol 177 (Triglicerides 57, HDL 79, LDL 87, ratio 2.2

    Methylmalonic Acid, Serum
    Vitamin B12 – Urine MMA 18.4, Normalized 1.2

    Vitamin D3, 25 Hydroxy – 32.4 LOW END OF NORMAL but got it up from 7 last year!

    C-Reactive Protein – 1.10 LOW END OF NORMAL

    Thyroid – THS 4.33. HIGH END OF NORMAL – indicates hypothyroid (low thyroid function), T4 6.8, T3 Uptake 30

    Supposedly high serum iron means low iron in cells indicating a problem metabolizing iron – so I need to up my calcium & zinc, & I’ll be completing a liver cleanse this weekend. I’ll retest along with ferritin next month. If anyone has any suggestions, I’d love to hear!

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