Low MCHC In Blood Tests: Symptoms And Causes

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Causes

medical professional touching a screen and holding a blood test. — Lourdes Balduque/Getty Images

Anemia is a low level of hemoglobin. This may stem from typical conditions, such as pregnancy or an iron-deficient diet. In rare cases, it may result from life threatening illnesses, including cancer.

Factors that cause low levels of hemoglobin include:

fewer blood cells being produced
red blood cells die quickly
blood loss

Causes of blood loss include wounds, ulcers, hemorrhoids, or cancers. It can result from regular events, such as frequent blood donation and menstruation.

The following types of anemia link with a low hemoglobin concentration:

Iron deficiency anemia: This condition can result from an iron-deficient diet or an inability to absorb iron. When less iron is available for red blood cell development, the red blood cells become smaller and paler.
Pernicious anemia: This results from a diet that is deficient in vitamin B12. Pernicious anemia also affects individuals who are unable to absorb vitamin B12.
Aplastic anemia: This condition involves a reduced number of red blood cells, white blood cells, and platelets.
Hemolytic anemia: Hemolytic anemia happens when red blood cells die in the body before the end of their life span without quick enough replacement from the bone marrow.

Other conditions with MCHC

In rare cases, anemia may point to other more serious conditions, including:

cancer or leukemia treatments
bone marrow defects
gastrointestinal tumors
kidney and liver disease
inflammatory disorders

Kidney disease may cause anemia because the kidneys are not able to produce enough erythropoietin. This is a hormone that signals the bone marrow to make red blood cells.

Chemotherapy for cancer treatment may also affect the production of new red blood cells, resulting in anemia.

Symptoms

A slightly low hemoglobin concentration does not always produce noticeable symptoms and may not always indicate an illness. Some people are unaware that they have low hemoglobin until they have a routine blood screening.

Other people may develop noticeable symptoms, including:

weakness and fatigue
shortness of breath
pale skin and gums
fast or irregular heartbeat
cold hands or feet
dizziness or headache
lack of concentration
chest pain

These symptoms will alert a doctor to the possibility of anemia.

Diagnosis

There are many underlying causes of anemia. The first step in developing a treatment plan is to determine the type of anemia present and assess its severity. An MCHC test will help point a doctor in the right direction.

Anemia is the hemoglobin value being less than 13.5 grams per deciliter (g/dL) in men or less than 12.0 g/dL in women. In children, typical hemoglobin values vary with age. The typical MCHC range for an adult is 33 to 36 g/dL or 320–360 g/L.

A doctor may also check the following values:

vitamin B-12 and folate
ferritin and iron saturation

Folate and vitamin B-12 help the body produce red blood cells. Ferritin is an iron-containing blood protein, while iron saturation is the amount of iron that is available to use.

If internal bleeding is a factor, then a person may require an endoscopy or an X-ray. During an endoscopy, a camera detects possible causes of bleeding in the upper gastrointestinal tract.

Treatment

Treatment for anemia may include dietary changes, supplements, medication, or blood transfusions. Some of these treatments may be in a hospital.

Severe iron-deficiency anemia may require iron supplements, intravenous iron therapy, or a blood transfusion. The aim is to restore red blood cells, hemoglobin, and iron levels.

On average, adult men require 8 milligrams (mg) and adult women require 18 mg of iron per day. After menopause, women can reduce their iron intake to 8.7 mg per day.

A synthetic form of the human erythropoietin protein can sometimes be an alternative to a blood transfusion. This medication stimulates the bone marrow to produce more red blood cells, thereby increasing hemoglobin levels.

While this treatment has been approved by the FDA for some applications, such as anemia caused by chemotherapy, it has not been approved for all types of anemia. It is still prescribed if necessary to avoid blood transfusions.

Prevention

A person can prevent some types of anemia by following a diet that contains sufficient iron, vitamin B12, folate, and vitamin C to produce healthy blood cells.

Red meat, poultry, and seafood are all good sources of iron. Vegetarians and vegans may need to increase their iron intake by incorporating foods like beans, lentils, tofu, and peas into their diet.

Iron-fortified food products can also be helpful. These include cereals, soya, nut milks, and some orange juice brands.

Frequently asked questions

Should a person be worried if their MCHC is low?

Low MCHC levels in a blood test may indicate iron-deficiency anemia or thalassemia. However, in some cases, it may point to a more serious underlying condition, such as celiac disease or cancer.Further testing is necessary to make the diagnosis.

Low MCHC levels in a blood test may indicate iron-deficiency anemia or thalassemia. However, in some cases, it may point to a more serious underlying condition, such as celiac disease or cancer.

Further testing is necessary to make the diagnosis.

What level of MCHC is concerning?

A typical MCHC reference range is 33-36 g/dL. However, this may vary according to the lab. Levels outside of this range may be concerning.

Summary

Many types of anemia are mild and easily treated. Some types may last a lifetime but a person can manage with medication and dietary changes.

The MCHC test can help a doctor determine the cause and severity of anemia. While a low hemoglobin level may help identify anemia, treatment will involve various factors, including the individual’s general health and any underlying health conditions.

Blood / Hematology
Nutrition / Diet

How we reviewed this article:

SourcesMedical News Today 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.

Anemia. (n.d.).https://www.hematology.org/education/patients/anemia
Anemia: Iron-deficiency anemia. (2022).https://www.nhlbi.nih.gov/health/anemia/iron-deficiency-anemia
Anemia: Treatment and management. (2022).https://www.nhlbi.nih.gov/health/anemia/treatment
Hemoglobin and cancer: What’s the connection? (2023).https://blog.dana-farber.org/insight/2022/05/hemoglobin-and-cancer-how-are-they-linked/
Iron. (2023).https://ods.od.nih.gov/factsheets/Iron-Consumer/
MCHC blood test (Mean corpuscular hemoglobin concentration). (2022).https://www.testing.com/tests/mchc-test/#google_vignette
Shah AP, et al. (2025). Engineering synthetic signaling receptors to enable erythropoietin-free erythropoiesis.https://www.nature.com/articles/s41467-025-56239-5

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Medically reviewed by Avi Varma, MD, MPH, AAHIVS, FAAFP — Written by Peter Morales-Brown — Updated on December 18, 2025

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What level of MCHC is concerning?

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