What Is MCH And What Do High And Low Values Mean? - Healthline

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Key takeaways

Mean corpuscular hemoglobin (MCH) refers to the amount of hemoglobin in a red blood cell.
Low MCH levels are often associated with iron deficiency anemia, which can result from inadequate dietary intake, blood loss, or, in rare instances, genetic conditions or autoimmune diseases.
High MCH levels can be caused by deficiencies in vitamin B12 or folate, as well as thyroid, liver, or lung diseases.

An MCH value refers to the average quantity of hemoglobin present in a single red blood cell. Hemoglobin is the protein in your red blood cells that transports oxygen to the tissues of your body.

Your MCH value is related to two other values, mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC). Together, MCH, MCV, and MCHC are sometimes referred to as red blood cell indices.

This article explores healthy MCH levels, how doctors test them, and what the results mean.

What does it mean if my MCH is low?

An MCH value calculated below 27.5 pg is considered low MCH. This means that there’s a low amount of hemoglobin present per red blood cell.

Causes of low MCH

A low MCH value typically indicates the presence of iron deficiency anemia. Iron is important for the production of hemoglobin. Your body absorbs a small amount of iron that you eat to produce hemoglobin.

Some of the general causes of iron deficiency include eating a diet that is low in iron, major surgery or trauma, or blood loss.

In rare cases, low MCH can be caused by a genetic condition called thalassemia. In this condition, the production of hemoglobin is limited. This means there aren’t as many red blood cells circulating in your bloodstream.

Low MCH levels may also be caused by autoimmune diseases.

Symptoms of low MCH

If you have a low MCH value, you may experience the following symptoms:

shortness of breath
chest pain
fast heartbeat
fatigue or weakness
very pale or yellowish skin
headache

Should I worry if my MCH is low?

Causes for concern depend on how low your levels are and the underlying cause. A doctor can determine what’s causing your low levels of MCH and whether you need treatment.

Treatment for low MCH caused by iron deficiency include:

adding iron-rich foods to your diet (there are vegetarian options)
taking iron supplements
receiving iron supplementation through an IV

In rare cases, such as when symptoms are severe or blood loss has occurred, you may need a blood transfusion.

What does it mean if my MCH is high?

An MCH value calculated above 33.2 pg is considered high MCH. This means that there is a larger amount of hemoglobin present per red blood cell.

Causes of high MCH

High MCH value can often be caused by anemia due to a deficiency of B vitamins, particularly B-12 and folate. Both of these vitamins are required by your body to make red blood cells.

These types of anemia can develop if your diet is low in B vitamins or if your body does not absorb B-12 or folate properly. It’s important to be aware of the symptoms of a B-12 deficiency.

High MCH levels may also be a result of overactive thyroid, liver disease, COPD, or other lung diseases.

Symptoms of high MCH

If you have a high MCH value, you may experience the following symptoms:

shortness of breath
chest pain
fast heartbeat
fatigue or weakness
very pale or yellowish skin
headache

If you have anemia that’s due to B-12 deficiency, you may also experience:

tingling or “pins and needles” in your hands or feet
nausea or vomiting
bloating and gas
mental symptoms, such as depression or confusion

If you have anemia due to folate deficiency, you could experience the following additional symptoms:

diarrhea
decrease in appetite
irritability
a smooth or sensitive tongue

Should I be concerned if my MCH is high?

A doctor can help you determine whether you need treatment. The treatments for abnormally high MCH levels depend on how high your levels are and the underlying cause.

Anemias caused by B-12 or folate deficiencies are commonly treated by supplementing these vitamins to further boost B-12 and folate levels. If absorption is a problem, B-12 injections may be prescribed.

Your doctor may also recommend lifestyle changes and adding foods rich in vitamin B-12 and folate to your diet.

Management of high MCH due to hyperthyroidism, liver disease, or lung disease typically includes managing the underlying condition.

What’s the outlook for a person with low or high MCH levels?

The outlook for people with abnormal MCH values depends on the condition that’s causing it.

Low MCH values are often caused by iron deficiency anemia. This condition can typically be treated with lifestyle changes, including consuming iron-rich foods and taking iron supplements.

In the rare case that your low MCH value is caused by thalassemia, you may require blood transfusions if your symptoms are severe. If you have an autoimmune disorder, you may be prescribed steroids or other immunosuppressants.

High MCH values caused by a deficiency of the vitamins B-12 or folate can also often be treated with lifestyle changes, including dietary modifications, supplements, or injectable B-12.

Other causes of high MCH, such as hyperthyroidism or lung or liver diseases, require addressing the underlying condition.

If you’re concerned about your MCH results, be sure to talk to your doctor about them. Together, you can decide on the best way to move forward.

How is MCH level determined?

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Doctors determine your MCH level with a complete blood count (CBC) panel. Your doctor will order a CBC panel to screen for many conditions, including anemia and infection. The CBC tests red and white blood cells, as well as platelets. MCH is calculated using red blood cell analysis.

MCH is calculated by dividing the amount of hemoglobin in a given blood volume by the number of red blood cells present.

MCH ranges

As part of a CBC, your doctor will measure your MCH levels in picograms (pg) per red blood cell. The typical ranges are:

MCH ranges	MCH levels (pg)
low	under 27
typical	27 – 31
high	over 31

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.

Ankar A, et al. (2022). Vitamin B12 deficiency.https://www.ncbi.nlm.nih.gov/books/NBK441923/
CBC blood test (Complete blood count). (2022).https://www.testing.com/tests/complete-blood-count-cbc/
Iron-deficiency anemia. (n.d.).https://www.hematology.org/education/patients/anemia/iron-deficiency
RBC indices. (2022).https://www.ucsfhealth.org/medical-tests/rbc-indices
Thalassemia. (2024).https://rarediseases.info.nih.gov/diseases/7756/thalassemia

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Medically reviewed by Megan Soliman, MD — Written by Jill Seladi-Schulman, Ph.D. — Updated on September 24, 2024

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Key takeaways

What does it mean if my MCH is low?

Causes of low MCH

Symptoms of low MCH

Should I worry if my MCH is low?

What does it mean if my MCH is high?

Causes of high MCH

Symptoms of high MCH

Should I be concerned if my MCH is high?

What’s the outlook for a person with low or high MCH levels?

How is MCH level determined?

MCH ranges

How we reviewed this article:

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