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. It can be used 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].


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

Microcytosis patients usually 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

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].

How to Increase MCH


Eat a healthy and nutritious diet. In order to prevent nutrient deficiency, it is important that your diet contains the recommended amount of iron. If you are iron-deficient, eat more iron-rich foods include liver, meat, fish, eggs, tofu, beans, nuts, seeds, whole grains, and dried fruits [12, 13].

Decrease the amount of tea and coffee you drink. These can lower hemoglobin levels by decreasing the absorption of iron into the body [14, 12].

High MCH

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

By itself, macrocytosis does not cause any symptoms. However, the diagnosis of macrocytosis can help provide information about any underlying health conditions [15].

Causes of High MCH

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 [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

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

How to Lower MCH


If you have megaloblastic anemia, you should increase your dietary intake of foods that are rich in vitamin B12 and folate (vitamin B9). Folate can be found in leafy green vegetables, while vitamin B12 is abundant in meat products including chicken, turkey, lamb, beef, and pork liver, and dairy products such as yogurt and milk [22, 23, R].

Lifestyle Suggestions

Reducing your alcohol intake can prevent your MCH from becoming too high. This is because alcohol consumption reduced vitamin B12 levels and can cause megaloblastic anemia, which increases MCH [19, 20, 24].

Stop or cut back on smoking to prevent high MCH. This is because nicotine can also lower B12 levels [25, 17].


If you are deficient in vitamin B12 or folate, taking supplements can increase your vitamin levels. It can also help with deficiency-induced megaloblastic anemia [26, 27].

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