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MCH Blood Test: High & Low Levels + Normal Range

Written by Puya Yazdi, MD | Last updated:
Medically reviewed by
Genius Labs Science Team | Written by Puya Yazdi, MD | Last updated:

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Mean corpuscular hemoglobin (MCH) measures the amount of hemoglobin in your red blood cells. It can be used to help diagnose blood and iron disorders. Keep reading to learn more about the causes and health effects of low and high MCH.

What is Mean Corpuscular Hemoglobin (MCH)?

Mean corpuscular hemoglobin (MCH) is the average amount of hemoglobin in your red blood cells. Hemoglobin is the protein that stores (binds) oxygen, which is what allows your blood to transport oxygen throughout your body. MCH is normally part of a complete blood count, which measures your hemoglobin, hematocrit, and red blood cell count. Medical professionals can use MCH to help diagnose anemias and iron disorders [1, 2].

MCH values parallel those of mean corpuscular volume (MCV). This means that when your MCV increase, MCH usually increases as well [1].

Normal Range of MCH

MCH usually ranges from 27 – 31 pg per cell [1].

Low MCH

A low mean corpuscular hemoglobin (MCH) means that your red blood cells are smaller than normal (microcytic) [1].

Microcytosis patients often do not show any symptoms unless their anemia is severe. Other blood tests can help determine the cause of microcytosis, such as MCV, RDW, and iron markers [3].

Causes of Low MCH

Causes shown here are commonly associated with low MCH. Work with your doctor or other health care professional for an accurate diagnosis of the underlying cause.

1) Iron Deficiency

Iron deficiency is one of the most common causes of low MCH [4, 5, 6].

In a study of 830 subjects, 679 (82%) of the iron deficiency patients also had low MCH [7].

Celiac disease and excess lead levels in the body decrease iron absorption, which can lead to iron deficiency and low MCH [8, 9].

2) Thalassemia

Thalassemia, a blood disorder with abnormal hemoglobin in the blood, also causes low MCH [10, 11].

Factors that Increase MCH

Work with your doctor to determine and treat the cause of low MCH. Attempting to raise MCH artificially may not address underlying health conditions and ultimately do more harm than good. If you have low MCH, your doctor may order additional tests and/or use this result to help make a diagnosis and determine an appropriate course of action, which may or may not include the strategies below.

Diet

Eating a healthy and nutritious diet should prevent iron deficiency. The foods richest in iron include liver, meat, fish, eggs, tofu, beans, nuts, seeds, whole grains, and dried fruits [12, 13].

Coffee and tea can lower hemoglobin levels by decreasing the absorption of iron into the body. If you have low MCH, you may choose to reduce your intake of caffeine [14, 12].

High MCH

A high mean corpuscular hemoglobin (MCH) means that red blood cells may be larger than normal (macrocytic) [1].

By itself, macrocytosis does not seem to cause any symptoms. However, a diagnosis of macrocytosis can help provide information about any underlying health conditions that require treatment [15].

Causes of High MCH

Causes shown here are commonly associated with high MCH. Work with your doctor or other health care professional for an accurate diagnosis of the underlying cause.

1) Megaloblastic Anemia

One of the most common causes of high MCH is megaloblastic anemia. Megaloblastic anemia is often caused by folate or vitamin B12 deficiency and may be treated with supplements of the deficient nutrient [1, 16].

2) Smoking

Smokers have significantly higher MCH than non-smokers [17, 18].

3) Alcohol

Heavy alcohol intake increases MCH levels. Chronic alcohol users have significantly higher MCH levels than non-drinkers [19, 20].

4) Malaria Infection

Malaria patients have higher MCH levels than non-infected people [21].

Factors that Lower MCH

Work with your doctor to determine and treat the cause of high MCH. Attempting to lower MCH artificially may not address underlying health conditions and ultimately do more harm than good. If you have high MCH, your doctor may order additional tests and/or use this result to help make a diagnosis and determine an appropriate course of action, which may or may not include the strategies below.

Diet

Patients with megaloblastic anemia are often advised to increase their consumption of foods rich in vitamin B12 and folate (vitamin B9). Folate is abundant in leafy green vegetables, while vitamin B12 is easiest to source from meat products including chicken, turkey, lamb, beef, and pork liver, and dairy products such as yogurt and milk [22, 23].

Lifestyle

Reducing your alcohol intake can prevent your MCH from becoming too high. Alcohol consumption has been linked to megaloblastic anemia and reduced vitamin B12 levels [19, 20, 24].

Nicotine has also been linked to lower B12 levels, which in turn are linked to megaloblastic anemia. Smoking is generally very bad for your health, and it may contribute to or aggravate low MCH as well [25, 17].

Supplements

If you are deficient in vitamin B12 or folate, taking supplements can increase your vitamin levels. Doctors often recommend these supplements to patients with megaloblastic anemia; talk to yours before supplementing [26, 27].

Irregular MCH Levels?

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About the Author

Puya Yazdi

MD
Dr. Puya Yazdi is a physician-scientist with 14+ years of experience in clinical medicine, life sciences, biotechnology, and nutraceuticals.
As a physician-scientist with expertise in genomics, biotechnology, and nutraceuticals, he has made it his mission to bring precision medicine to the bedside and help transform healthcare in the 21st century.He received his undergraduate education at the University of California at Irvine, a Medical Doctorate from the University of Southern California, and was a Resident Physician at Stanford University. He then proceeded to serve as a Clinical Fellow of The California Institute of Regenerative Medicine at The University of California at Irvine, where he conducted research of stem cells, epigenetics, and genomics. He was also a Medical Director for Cyvex Nutrition before serving as president of Systomic Health, a biotechnology consulting agency, where he served as an expert on genomics and other high-throughput technologies. His previous clients include Allergan, Caladrius Biosciences, and Omega Protein. He has a history of peer-reviewed publications, intellectual property discoveries (patents, etc.), clinical trial design, and a thorough knowledge of the regulatory landscape in biotechnology.He is leading our entire scientific and medical team in order to ensure accuracy and scientific validity of our content and products.

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