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A carnivore diet is a restrictive diet that only includes meat, fish, and other animal products like dairy and eggs. More recently, it has been brought into the limelight by influencers and social media personalities. In fact, there is a whole community of "meatfluencer" who are sharing their meat-eating plans. One of them is Dr Paul Saladino MD, whose belief that there was no better way to prevent chronic diseases than a carnivore diet prompted him to write books and post videos regarding the same. He believed so much in this eating plan that he became a go-to person for many following the same plan, until recently, when he decided to quit.
Carnivore Diet Disrupted His Sleep
Switching to an all-meat diet isn't always straightforward, especially when it comes to digestion—a lesson Dr Saladino learned firsthand. He experienced sleep disturbances, likely due to the difficulty of digesting high-protein meals. Since protein takes longer to break down, it demands more energy from the body, which can interfere with rest.
According to Johns Hopkins Medicine, digestion slows by up to 50% during sleep. Additionally, many types of meat contain tyramine, a compound derived from the amino acid tyrosine. Increased tyramine intake can lead to health issues and also triggers the release of norepinephrine, a hormone that raises heart rate and blood pressure, making restful sleep harder to achieve.
He also experienced hypnagogic jerks—sudden muscle spasms that jolt the body awake. "I would fall asleep but then jerk myself awake like I was falling multiple times. It was stressful and traumatic, leading to poor sleep," he shared in his YouTube video.
Eating Only Meat May Have Triggered Heart Palpitations
Another concerning side effect Dr Saladino experienced was heart palpitations—episodes where his heart felt like it was racing or fluttering. While stress is a common cause, few would immediately link palpitations to meat consumption.
However, a sudden shift to an all-meat diet can lead to electrolyte imbalances. The elimination of carbohydrates lowers insulin levels, prompting the kidneys to excrete more sodium. This disrupts the balance of essential minerals like potassium and magnesium, which are crucial for heart function.
Muscle Cramps Became Persistent
Dr Saladino also suffered from frequent muscle cramps while following the carnivore diet. In a post on X, he emphasized the importance of maintaining adequate magnesium, calcium, and potassium levels to prevent cramping. He initially believed that animal-based foods provided sufficient minerals, but his ongoing cramps led him to reconsider.
"I started to think maybe long-term ketosis is not great for me,” he admitted on the *More Plates More Dates* podcast. “Probably not a great thing for most humans."
His Testosterone Levels Dropped Significantly
Dr Saladino also saw a decline in his testosterone levels after following the carnivore diet for over a year. "At the beginning of my carnivore experiment, my testosterone was about 800. After a year to a year and a half, it had dropped to around 500," he revealed.
The issue likely stems from excessive protein intake, which can elevate inflammation and disrupt hormone levels. A 2022 study published in Nutrition and Health found that consuming more than 35% of daily calories from protein can lead to various negative effects, including reduced testosterone.
He Had Chronically Low Insulin Levels
Because he largely eliminated carbohydrates—except for a small amount of fruit—Dr Saladino developed persistently low blood sugar. In his YouTube video, he explained, "I had very low insulin because I wasn’t eating carbohydrates, and the protein I consumed wasn’t insulinogenic enough."
While some diabetics report improved blood sugar control on the carnivore diet, its effects vary based on individual metabolic responses. For non-diabetics, low insulin can lead to hypoglycemia, causing symptoms like dizziness, confusion, a racing heart, and, in extreme cases, seizures or coma. Mild cases can be managed with fast-acting carbohydrates like juice or candy, but severe episodes require medical attention.
His Blood Test Results Showed Concerning Imbalances
Lab tests revealed that his magnesium levels were low, while his sex hormone-binding globulin (SHBG) was elevated—both potential red flags for long-term health issues.
A magnesium deficiency can cause numbness, tingling, fatigue, nausea, headaches, and muscle cramps. Since cramps often strike at night, low magnesium may also contribute to sleep disturbances.
High SHBG levels indicate an excess of circulating protein in the blood, which can increase the risk of heart disease, osteoporosis, and depression. To counteract these imbalances, introducing more magnesium-rich foods—such as leafy greens, nuts, beans, and yogurt—could be beneficial.
He Felt Cold All The Time
Electrolyte imbalances and metabolic disruptions can even affect body temperature, which Dr. Saladino experienced firsthand. "I was always cold,"he shared in his YouTube video.
Upon testing his thyroid function, he discovered that his total T3 and free T3 hormone levels were "not ideal." These hormones regulate metabolism, and low levels can slow down metabolic processes, leading to cold intolerance.
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For decades, thalassemia has been synonymous with lifelong blood transfusions, frequent hospital visits, and the persistent risk of iron overload. For patients and families, it has largely meant managing a chronic condition rather than truly treating it. That narrative, however, is beginning to change.
The recent approval of oral drugs for thalassemia by the US Food and Drug Administration marks a historic milestone. These oral, disease-modifying pyruvate kinase activators improve anemia in adults with non-transfusion-dependent (NTDT) and transfusion-dependent (TDT) \(\alpha\)- or \(\beta\)-thalassemia. For now, they are approved in the US and Saudi Arabia for adults with thalassemia, with European review ongoing.
It is offering a fundamentally different approach, one that targets the disease at its biological core rather than simply managing its complications. Yet, as this new era unfolds, a critical question remains: are patients being diagnosed early enough to benefit from it?
A shift from supportive care to targeted therapy:
Until recently, thalassemia management has depended heavily on blood transfusions and iron chelation therapy. While these interventions are life-saving, they do not correct the underlying defect in red blood cell production. Over time, repeated transfusions can lead to complications affecting vital organs such as the heart, liver, and endocrine system.
Oral drugs, however, work by activating pyruvate kinase in red blood cells, improving energy (ATP) production, and enhancing red cell survival. In simple terms, it helps the body produce more functional and longer-lasting red blood cells, leading to an increase in hemoglobin levels, reduced transfusion requirements, and improved quality of life, particularly with respect to fatigue, one of the most debilitating symptoms of the disease. Oral therapy working across a broader disease spectrum marks a significant advance.
India bears one of the highest burdens of thalassemia globally, with an estimated 10,000–15,000 affected children born each year and a carrier frequency of approximately 3–4% in the general population. Despite this, a large number of cases remain undiagnosed or are diagnosed late, particularly in individuals with milder forms who may live for years with unexplained anemia.
Delayed diagnosis has far-reaching consequences. Patients may develop preventable complications, families miss opportunities for genetic counseling, and access to emerging therapies is delayed or entirely missed. In the era of precision medicine, such delays are no longer acceptable.
A major challenge in India is the frequent misdiagnosis of thalassemia as iron deficiency anemia, especially in primary care settings. Many patients receive repeated courses of iron supplementation without clinical improvement, while the underlying genetic disorder remains unrecognized.
Certain clinical clues should prompt further evaluation: persistent microcytic anemia unresponsive to iron therapy, a family history of anemia or transfusion dependence, and a disproportionately high red blood cell count relative to hemoglobin levels. Diagnostic confirmation is straightforward with hemoglobin analysis using HPLC or electrophoresis; however, these tests are not always utilized at the appropriate time.
The approval of oral drugs underscores a fundamental shift, from managing symptoms to modifying disease biology. However, these benefits are maximized when therapy is initiated early, before irreversible organ damage occurs, for which timely diagnosis is pivotal.
Thalassemia diagnosis begins with a complete blood count demonstrating microcytic anemia with low mean corpuscular volume and a relatively high red cell count. Peripheral smear findings include target cells and anisopoikilocytosis. Confirmation is achieved through hemoglobin analysis using HPLC or electrophoresis, which typically shows elevated HbA₂ in β-thalassemia trait. Molecular testing further identifies specific gene mutations, enabling definitive diagnosis and prenatal counseling.
Screening programs play a pivotal role. Carrier detection through HbA₂ estimation, premarital and antenatal screening, and cascade testing within families are essential strategies, particularly in high-prevalence populations like India.
The mutation spectrum in India is well characterized. The most common β-thalassemia mutation is IVS-I-5 (G→C), accounting for nearly half of cases, followed by IVS-I-1 (G→T), codon 41/42 deletion, codon 8/9 insertion, and the 619 bp deletion. In α-thalassemia, the –α³․⁷ deletion predominates. This knowledge allows for cost-effective targeted molecular screening.
For years, the central question in thalassemia was: how do we manage this disease?
Today, it is shifting to: how early can we treat it effectively? Oral drugs represent a major therapeutic advance; however, cost considerations, accessibility, and long-term real-world outcomes will influence their widespread adoption. Nevertheless, the direction is clear: thalassemia care is entering a transformative era. In modern medicine, early diagnosis is no longer just beneficial; it is truly transformative.
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While the confirmation of the Andes strain of hantavirus behind the outbreak aboard the cruise ship MV Hondius in the South Atlantic has raised significant concerns of human-to-human transmission, experts from the International Hantavirus Society, as well as the World Health Organization (WHO), stated that the situation does not raise the risk of a pandemic.
So far, eight cases have been reported, including three deaths. The WHO has also confirmed that six cases have tested positive for the Andes virus, which can spread from person to person, through PCR testing.
The International Hantavirus Society, in a statement, warned that the virus differs significantly from most other hantaviruses because it can spread between people.
Founded in 2001, the Hantavirus Society is a global organization of scientists, clinicians, and researchers focused on studying hantaviruses, including their ecology, pathogenesis, and prevention.
“The virus on board the MV Hondius is the Andes strain of hantavirus. It is serious,” said the WHO chief Tedros Adhanom Ghebreyesus, in an open statement on the social media platform X.
However, the WHO and the members of the Hantavirus Society maintained that the current outbreak is not another COVID-19 outbreak.
So, first, let us understand all about the Andes Virus.
The Andes virus is a rare but highly dangerous pathogen of hantavirus, found primarily in Argentina and Chile. It is the only type of hantavirus known to man to spread among humans.
Unlike many hantaviruses seen in Europe, Asia, and North America, which are typically transmitted from infected rodents to humans, the Andes virus has repeatedly shown evidence of person-to-person spread.
As per experts, transmission usually occurs in situations involving prolonged or close contact. But how close is a question that has been recurring. The Hantavirus Society answers this.
“Over the past decades, multiple outbreak investigations, household clusters, nosocomial events, and genomic analyses have provided convincing evidence that ANDV can be transmitted between individuals under specific close-contact conditions. These may include household exposure, intimate contact, caregiving without suitable personal protective equipment, and prolonged exposure in poorly ventilated or crowded settings,” it said.
Pointing out decades of outbreak investigations, hospital clusters, and genetic studies, experts emphasized: “Human-to-human transmission of Andes virus should no longer be considered hypothetical”.
The scientists stressed that current evidence does not suggest the virus spreads easily through casual community interaction in the way diseases like measles, influenza, or COVID-19 do.
Also Read: Hantavirus Outbreak: How MV Hondius Passengers Will Be Screened And Evacuated
But the Andes virus is associated with hantavirus pulmonary syndrome (HPS) — a severe respiratory illness that can rapidly become fatal. Reported fatality rates range from 20% to 40%, depending on the outbreak setting, quality of medical care, and surveillance capacity.
Recent surveillance data highlight the seriousness of the disease:
The first major indication of person-to-person transmission emerged during the 1996 El Bolsón/Esquel outbreak. More recently, the 2018–2019 Epuyén outbreak infected 34 people after a single index case attended crowded social gatherings while symptomatic.
Strict public health interventions — including isolation, quarantine, and active contact tracing — reduced transmission.
Read More: Hantavirus: Israel Confirms 1st Case as UK, Spain Probe Suspected Infections; Should You Be Worried?
The Hantavirus Society noted that a confined environment aboard the MV Hondius means that passengers and crew may still be within the virus’s incubation period.
The scientists thus warned, "A negative PCR test shortly after exposure does not necessarily rule out future infection.” They recommend “ongoing monitoring, repeat testing where necessary, and antibody testing for close contacts”.
Experts are also examining whether transmission could occur during early or minimally symptomatic stages, rather than only after obvious illness begins.
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While thalassemia is known widely as a blood disorder, its impact can extend far beyond anemia and transfusions, said experts on World Thalassemia Day today.
World Thalassemia Day is observed every year on May 8 to raise awareness about the inherited blood disorder caused by faulty genes.
The disorder, which often requires blood transfusions every fortnight, affects approximately 1.3 million people living with severe forms of thalassemia worldwide. About 1.5 percent of the global population is carriers, and the disease claims nearly 11,000 lives annually.
Speaking to HealthandMe, health experts raised concerns about the growing mental health and neurological challenges faced by patients, especially children and young adults living with the condition.
Dr. Praveen Gupta, Chairman – Marengo Asia International Institute of Neuro & Spine (MAIINS), Gurugram, shared that repeated blood transfusions are important and save the lives of thalassemia patients, but long-term transfusion therapy can potentially lead to neurological complications if not properly monitored.
“Chronic transfusions can cause iron overload, which is the accumulation of iron in critical organs such as the brain, and may impact cognitive and psychological function, as well as mood,” Dr. Gupta explained.
He added that "changes in oxygen supply and related complications may make patients more vulnerable to headaches, lethargy, or even undetected brain injury".
However, experts stress that most neurological complications can be prevented through multidisciplinary care, iron chelation therapy, and regular monitoring.
The expert stated that thalassemia may also indirectly affect brain development in children, particularly when severe anemia continues for long periods and limits oxygen supply to the growing brain.
Dr. Gupta noted that poor oxygenation, nutritional deficiencies, iron overload from repeated transfusions, and metabolic complications may affect:
Also read: World Thalassemia Day 2026: Why Screening Before Marriage Or Pregnancy Is Important
Dr. Vipin Khandelwal, Sr. Consultant Paediatric Haemato Oncology & BMT at Apollo Hospitals Navi Mumbai, told HealthandMe that thalassemia affects the blood’s ability to carry oxygen, and prolonged disruption can impact growth, immunity, bone health, and learning abilities.
“The early signs of thalassemia are often subtle, which is why many families miss them until anemia becomes severe,” he said.
Parents should watch for persistent symptoms such as:
He stressed that while thalassemia is inherited, many serious complications can be prevented with early diagnosis, regular check-ups, timely transfusions, and proper iron monitoring.
Read More: Hantavirus Updates Of The Day: 8 May 2026 - US CDC Classifies Outbreak As 'Level 3' Emergency
Further, the experts also highlighted risk of anxiety, stress, low self-esteem, and depression among people with thalassemia who face lifelong blood transfusions, frequent hospital visits, leading to physical fatigue, and fear of complications. Over time, these challenges may increase, many often go unnoticed or untreated.
Dr. Roshan Dikshit, Senior Consultant, Haematology & Bone Marrow Transplant at Aakash Healthcare, told HealthandMe that thalassemia is not only a physical health condition, but also an emotional and psychological challenge. He stressed the need to provide mental support to thalassemic patients.
“Frequent hospital visits, lifelong blood transfusions, fear of complications, and social limitations can increase the risk of anxiety, stress, and depression, especially among teenagers and young adults,” said Dr. Roshan Dikshit, Senior Consultant, Haematology & Bone Marrow Transplant at Aakash Healthcare.
According to Dr. Dikshit, many patients struggle with:
Importantly, these emotional challenges often go unnoticed.
“Mental health support should be considered an essential part of thalassemia care. Counseling, family support, social acceptance, and open communication can significantly improve a patient’s emotional well-being and quality of life,” he said.
He also emphasized that early psychological intervention can help patients cope better with the disease and reduce the long-term mental health burden associated with chronic illness.
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