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Mean corpuscular haemoglobin, shortened as MCH, is the amount of haemoglobin in a red blood cell. Haemoglobin is the protein in the red blood cells that help transport oxygen to tissues in the body.

The MCH value is often reported with mean corpuscular haemoglobin concentration (MCHC) and mean corpuscular volume (MCV). Together, these values are known as the red blood cell indices.

MCV is the average size of red blood cells. MCH results often mirror the results of MCV. The relationship between these two values is that the bigger the size of red blood cells, the more haemoglobin they will contain, and haemoglobin tend to be less in smaller red blood cells.

MCHC calculates the amount of haemoglobin in each unit volume of a red blood cell. However, MCHC and MCH differ because while MCHC measurement considers the size or volume of the red blood cells, the MCH value doesn’t.

How to determine the MCH level

Your complete blood count (CBC) panel is necessary to determine your MCH level. Your healthcare professional will order a CBC panel to screen for various conditions, such as infection and anaemia.

The CBC panel checks the red blood cells, white blood cells and platelets. The red blood analysis helps to calculate MCH.

MCH calculation is the amount of haemoglobin in a volume of blood divided by the number of red blood cells.

Normal range

MCH in a healthy person should be between 27.5 and 33.2 picograms (pg).

An MCH level is low if it is below 27.5 pg, meaning the amount of haemoglobin per red blood cell is low.

Causes of low MCH

Low MCH values usually indicate iron deficiency anaemia. Iron is vital for haemoglobin production, and your body absorbs small amounts of iron from the food you eat to produce haemoglobin.

The common causes of iron deficiency include blood loss, trauma, major surgery, and a diet low in iron. In rare cases, low MCH results from a genetic condition called thalassemia. This condition causes limited haemoglobin production, meaning few red blood cells are circulating in your bloodstream.

Symptoms of low MCH

A low MCH value may cause the following symptoms:

High MCH

An MCH value is high if it is above 33.2 pg. This result means a larger amount of haemoglobin is in each red blood cell.

Causes of high MCH values

A high MCH value is usually due to B vitamin deficiency, particularly folate and vitamin B12. These vitamins are essential for red blood cell production in the body. These types of anaemia may develop if B vitamins aren’t enough in your diet or your body doesn’t absorb folate or vitamin B12 properly.

Symptoms of high MCH values

You may experience these symptoms if your MCH value is low.

If your anaemia results from vitamin B12 deficiency, the following symptoms may occur:

If folate deficiency causes anaemia, you will experience these additional symptoms.

Treatment for low MCH

The treatment for low MCH resulting from iron deficiency may include eating iron-rich food and taking iron supplements. In rare cases, when the symptoms are severe, or blood loss occurs, a blood transfusion may be necessary.

Those with mild thalassemia do not need treatment, but blood transfusions may be necessary if the symptoms are severe.

Treatment for high MCH

The treatment for folate or vitamin B12 deficiency-induced anaemia is lifestyle changes such as including foods rich in folate and vitamin B12 in your diet. Your doctor may also recommend taking supplements to boost your folate and vitamin B12 levels. If absorbing these vitamins is the problem, you may get B12 injections.

If you experience symptoms of high or low MCH levels, you can have your MCH test, including a CBC panel. Our healthcare professionals will ensure you get accurate results. Visit us or call 02071830244 to book your CBC panel, including the MCH level check.