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Purpose The short-term restriction of carbohydrate (CHO) can potentially influence iron regulation via modification of postexercise interleukin-6 (IL-6) and hepcidin levels. This study examined the effect of a chronic ketogenic low-CHO high-fat (LCHF) diet on iron status and iron-regulatory markers in elite athletes. Methods International-level race walkers (n= 50) were allocated to one of three dietary interventions:(i) a high-CHO diet (n= 16),(ii) a periodized CHO availability (n= 17), or (iii) an LCHF diet (n= 17) while completing a periodized training program for 3 wk. A 19-to 25-km race walking test protocol was completed at baseline and after adaptation, and changes in serum ferritin, IL-6, and hepcidin concentrations were measured. Results from high-CHO and periodized CHO were combined into one group (CHO; n= 33) for analysis. Results The decrease in serum ferritin across the intervention period was substantially greater in the CHO group (37%) compared with the LCHF (23%) group (P= 0.021). After dietary intervention, the postexercise increase in IL-6 was greater in LCHF (13.6-fold increase; 95% confidence interval [CI]= 7.1–21.4) than athletes adhering to a CHO-rich diet (7.6-fold increase; 95% CI= 5.5–10.2; P= 0.033). Although no significant differences occurred between diets, CI values indicate that 3 h postexercise hepcidin concentrations were lower after dietary intervention compared with baseline in CHO (β=− 4.3; 95% CI=− 6.6 to− 2.0), with no differences evident in LCHF. Conclusion Athletes who adhered to a CHO-rich diet experienced favorable changes to the postexercise IL-6 and hepcidin response, relative to the LCHF group …