Low MCHC: Causes, Symptoms, Treatments - Healthline

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Key takeaways

Low MCHC is often indicative of anemia, particularly hypochromic microcytic anemia, where red blood cells are smaller than expected and have reduced hemoglobin.
Low MCHC symptoms often mirror those of iron deficiency anemia, including fatigue, shortness of breath, and pale skin, though some people may not experience noticeable symptoms initially.

If a doctor suspects low MCHC levels, they may order a blood test. They may also do other tests to rule out any underlying conditions.

Keep reading to find out what causes low MCHC levels, how to recognize it, what an MCHC blood test involves, and what to do if your levels are low.

What is MCHC (mean corpuscular hemoglobin concentration)?

MCHC is the average concentration of hemoglobin in your red blood cells. Hemoglobin is the protein molecule that allows red blood cells to carry oxygen to tissues within your body.

Your MCHC can fall into low, normal, and high ranges, even if your red blood cell count is normal.

What might cause low levels of MCHC?

The most common cause of low MCHC is anemia. Hypochromic microcytic anemia commonly results in low MCHC. This condition means your red blood cells are smaller than usual and have a decreased level of hemoglobin.

This type of microcytic anemia can be caused by:

lack of iron
the inability of your body to absorb iron, which can be caused by conditions like celiac disease, Crohn’s disease, and gastric bypass surgery
chronic low-grade blood loss over time from a long menstrual cycle or peptic ulcers
hemolysis, or the premature destruction of red blood cells over time

In rarer cases, low MCHC and hypochromic microcytic anemia can be caused by:

cancer, including cancers that cause internal blood loss
parasitic infections like hookworm infections
lead poisoning

What symptoms might occur due to low levels of MCHC?

There are a number of symptoms that people with low MCHC levels often have.

They generally relate to iron deficiency anemia and include:

fatigue and chronic tiredness
shortness of breath
pale skin
easy bruising
dizziness
weakness
loss of stamina

People with slightly or recently low MCHC levels may not notice any symptoms.

How are low levels of MCHC diagnosed?

If your doctor suspects that you have a low MCHC, they will order a complete blood count (CBC).

This is a collection of tests that includes a blood test to examine your MCHC levels and a mean corpuscular volume (MCV) test, which measures the average volume of your red blood cells.

They will also check for:

Iron levels

Your doctor may check your iron levels and iron-binding capacity, which measures whether your body absorbs iron the way it’s supposed to.

All of this can be done from the same blood draw used for your CBC, and these two tests can help your doctor determine the cause of the anemia.

Blood loss

If your doctor suspects blood loss, they will look for the source. The easiest to detect is unusually long, frequent, or heavy menstrual cycles, as women can self-report this.

The results of the test will enable your doctor to determine what type of anemia you have, which will help pinpoint the underlying cause. They can then create a course of treatment.

Other diagnostic tests

Your doctor may also order diagnostic tests for other conditions, including:

An endoscopy, during which a lighted camera is moved through the upper part of your gastrointestinal (GI) tract. This can help show ulcers or cancer. Also, a biopsy performed during this procedure tests most reliably for celiac disease.
X-rays of your upper GI, which involves drinking a thick liquid containing barium. This substance makes it possible for some ulcers to show up on the X-ray of your stomach and small intestine.
fecal occult blood test (if test results are positive, doctors will recommend a colonoscopy)
Additional blood tests can provide some screening indicators for celiac or Crohn’s disease.

How to prepare for a CBC blood draw

Typically, there is no preparation to do before a CBC. However, if you are afraid of needles or injections, it might be a good idea to tell the healthcare professional who is handling the blood draw. They may be able to make adjustments to help you with this.

During the test, you can expect the following to happen. A healthcare professional will:

Find a vein in your arm, hand, or elsewhere from which to draw blood.
Clean the area with an alcohol wipe.
Place a band around your arm above the intended site to make the vein easier to see.
Insert the needle in your vein, at which point you may feel a pinch or a little pain.
Attach a blood sample tube to the needle.
Wait for the tube to fill with blood, which may take a few minutes.

After the test, the healthcare professional will remove the needle, wipe the area clean, and apply a dressing. They may ask you to press on the injection site for a few minutes to ensure it does not bleed.

Some people feel lightheaded or dizzy after a blood test, and the injection site may be sore or a little bruised. You may need to stay seated for a few minutes to ensure it is safe for you to walk or drive.

Before leaving, be sure to ask when and how you can expect to hear the results.

Understanding low vs normal results

A typical MCHC result is 32 to 36 grams per deciliter (g/dL) or 320 to 360 grams per liter (g/L), although this may vary depending on the lab. Levels outside this range can indicate anemia.

A healthcare professional will help you understand what your individual test results mean, and your recommended next steps.

What complications can occur from low levels of MCHC?

The most common complication of living with low MCHC levels is a lack of energy and decreased stamina. This can limit your activities.

In severe cases, anemic hypoxia can occur as a result of low MCHC levels. When MCHC levels are very low, your body struggles to provide enough oxygen to all its tissues.

As a result, these tissues are deprived of oxygen and unable to get rid of carbon dioxide. This can actually become life threatening.

Common symptoms of anemic hypoxia include:

fast heart rate
confusion
rapid breathing
sweating
shortness of breath
wheezing or coughing

How do doctors treat low levels of MCHC?

Once your doctor determines the underlying cause of your low MCHC levels, they’ll come up with a plan of treatment.

The most common cause of low MCHC is iron deficiency anemia. To treat this, your doctor may recommend the following:

Increase iron in your diet.
Take iron supplements.
Get more vitamin B6, which is necessary for proper absorption of iron.
Add more fiber to your diet, which can help improve the intestinal absorption of iron.
Take no more than the daily requirement of calcium, as too much can make it difficult for your body to absorb iron.

What can you do to prevent low levels of MCHC?

The best way to avoid low levels of MCHC level is to prevent iron deficiency anemia. To do this, try to make sure you’re getting enough iron and vitamin B6 in your diet.

Keep in mind that the iron in spinach is not as readily absorbed because of its oxalic acid content. This can be improved by consuming it with things like vitamin C, beef, poultry, or fish.

Foods rich in iron include:

spinach (best if cooked to reduce the oxalic acid content)
beans
seafood
red meat, pork, and poultry
peas

Foods rich in vitamin B6 include:

bananas
wild (not farmed) tuna
chicken breast
salmon
sweet potato
spinach

Frequently asked questions about MCHC

When should I be concerned about low MCHC?

Anything below or above the normal MCHC range can mean you have anemia. Common signs and symptoms include low stamina, tiredness, and difficulty breathing.

What level of MCHC is concerning?

A typical MCHC result is 32 to 36 grams per deciliter (g/dL) or 320 to 360 grams per liter (g/L), although this may vary depending on the lab.

Can MCHC be low without anemia?

Low MCHC concentrations in the blood may point to iron-deficiency anemia. You can also be deficient in iron without having iron-deficiency anemia, for example, due to heavy menstrual bleeding.

Other causes of low MCHC include other types of anemia, celiac disease, cancer, or lead poisoning.

Takeaway

MCHC refers to the average concentration of hemoglobin in your red blood cells. Hemoglobin is the protein that enables red blood cells to carry oxygen throughout the body.

A low result in an MCHC blood test may indicate iron-deficiency anemia. In some cases, it may be a sign of an underlying condition, such as celiac disease or cancer.

Dietary measures and supplements can often help treat anemia. The results of an MCHC test will help your doctor decide on the most appropriate treatment.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Brihi JE, et al. (2024). Normal and abnormal complete blood count with differential.https://www.ncbi.nlm.nih.gov/books/NBK604207/
Hematology complete blood count (CBC). (n.d.).http://www.meddean.luc.edu/lumen/meded/medicine/medclerk/2004_05/level1/cbcanemia/cbclesson.htm
Kaur K, et al. (2023). Fecal occult blood test. https://www.ncbi.nlm.nih.gov/books/NBK537138/
Ravi Sarma P, et al. (1990). Red cell indices.https://pubmed.ncbi.nlm.nih.gov/21250103/
Red cell indices. (2018).https://labtestsonline.org/tests/red-cell-indices
Upper gastrointestinal series. (n.d.).https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/upper-gastrointestinal-series
Warner JM, et al. (2023). Iron deficiency anemia.https://www.ncbi.nlm.nih.gov/books/NBK448065/

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Medically reviewed by Darragh O'Carroll, MD — Written by Ana Gotter — Updated on September 3, 2024

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Key takeaways

What is MCHC (mean corpuscular hemoglobin concentration)?

What might cause low levels of MCHC?

What symptoms might occur due to low levels of MCHC?

How are low levels of MCHC diagnosed?

Iron levels

Blood loss

Other diagnostic tests

How to prepare for a CBC blood draw

Understanding low vs normal results

What complications can occur from low levels of MCHC?

How do doctors treat low levels of MCHC?

What can you do to prevent low levels of MCHC?

Frequently asked questions about MCHC

When should I be concerned about low MCHC?

What level of MCHC is concerning?

Can MCHC be low without anemia?

Takeaway

How we reviewed this article:

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