Evidence Based

High & Low Mean Corpuscular Hemoglobin Concentration (MCHC)

Written by Helen Quach, BS (Biochemistry) | Reviewed by Selfhacked Science Team | Last updated:

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Your MCHC can help diagnose blood and iron disorders. Keep reading to find out about how high and low MCHC can affect your health, and how to increase or decrease it.

What is MCHC?

Mean corpuscular hemoglobin concentration (MCHC) is the average amount of hemoglobin per red blood cell, relative to the size of the cell. In other words, it tells you what percentage of your blood cells are made up of hemoglobin, the protein that helps transport oxygen in the blood [1, 2].

MCHC 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].

In short, MCHC is an indirect measure of how much hemoglobin you have. The added value of this test over direct hemoglobin is that it adjusts for the rate of production of red blood cells [3+].

In many cases, when hemoglobin production is reduced, the production of red blood cells is likewise reduced. However, in some cases, hemoglobin production can be reduced, while red blood cell production can increase. This can help differentiate one condition from another [3+].

GI bleeding is an example where both hemoglobin and red blood cells may be reduced in a similar fashion [3+].

However, in iron deficiency, hemoglobin can go down, while red blood cells can be less affected. In these cases, MCHC would be lower than GI bleeding [3+].

Normal MCHC

MCHC normally ranges from 320 – 360 g/l [4].


A low mean corpuscular hemoglobin concentration (MCHC) can cause hypochromia (“hypo-” = low, “chromia” = color), or paler red blood cells. Hypochromia is an indicator of anemia [2].

Causes of Low MCHC

1) Iron Deficiency

One of the most common causes of low MCHC is iron deficiency and iron deficiency anemia [5, 4]. Iron is necessary to produce hemoglobin, so if you are deficient in iron, you will produce less hemoglobin for each given red blood cell.

2) Thalassemia

Thalassemia is a blood disorder that causes abnormal hemoglobin production. Patients with alpha- and beta-thalassemia have lower MCHC than healthy people [6, 7, 8].

3) Reticulocytosis

Reticulocytes are immature red blood cells; reticulocytosis occurs when there is a high level of reticulocytes in the blood. Since reticulocytes have less hemoglobin in each cell relative to the size than mature red blood cells, they can lower your overall MCHC [8].

4) Infections

Many different types of infection can also reduce MCHC, such as:

  • Hookworm [9]
  • H. Pylori [10]
  • Tuberculosis [11]
  • HIV [12]

Infections cause inflammation, which in turn causes people to produce less hemoglobin. Presumably, in these infections hemoglobin is being reduced more than red blood cells, so MCHC is lower.

Consequences of Low MCHC

Low MCHC is Associated with Depression

Insufficient hemoglobin and depression share several symptoms and often occur in the same patients [3].

Women with low MCHC have a greater risk of developing depression symptoms, and it’s a better predictor than low hemoglobin [3].

Low MCHC Increases Death Risk

Low MCHC is associated with poorer outcome and a higher risk of death in heart attack patients [13].

Ways to Increase MCHC


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, and eggs [14, 15].

Decrease the amount of tea and coffee you drink. These can lower hemoglobin levels by decreasing the absorption of iron into the body [16, 14].


A high mean corpuscular hemoglobin concentration (MCHC) can cause hyperchromia, or darker colored red blood cells [17].

Causes of High MCHC

1) Vitamin Deficiency

Vitamin B12 deficiency increases MCHC [18].

The reason is that B12 deficiency can cause a decrease in red blood cells, but there does not decrease hemoglobin [19].

2) Hemolysis

Hemolysis is the rupture or destruction of red blood cells. It is one of the most common causes of increased MCHC [20, 21]. This is because red blood cells are decreasing, while hemoglobin is relatively unchanged.

3) Hereditary Spherocytosis

Hereditary spherocytosis (HS) is a condition with red blood cells being destroyed and jaundice. During HS, red blood cells become thicker and MCHC increases. HS patients have significantly higher MCHC than healthy people [17].

4) Cold Agglutinins

Cold agglutinins is a condition where antibodies cause red blood cells to clump together. The cold antibodies increase MCHC [1, 22].

Ways to Decrease MCHC


If you are deficient, you should increase your dietary intake of foods that are rich in vitamin B12. Vitamin B12 is abundant in meat products including chicken, turkey, lamb, beef, and pork liver [23].

Lifestyle Suggestions

Alcohol consumption can reduce B12 levels. Avoid alcohol if your MCHC is high due to vitamin B12 deficiency [24, 25, 26].

Smoking (nicotine) can also lower B12 levels [27].


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 [28, 29].

Irregular MCHC Levels?

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About the Author

Helen Quach

BS (Biochemistry)

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