What Is Mean Corpuscular Hemoglobin?
Hemoglobin is the protein that gives the red color to the blood and carries oxygen from the lungs to all cells and tissues of your body.
Mean Corpuscular Hemoglobin (MCH) refers to the average amount of hemoglobin present in each of your red blood cells. MCH levels are determined by blood tests and indicate several health issues that range from nutrient deficiencies to chronic diseases.
The MCH levels in blood, either high or low, can cause concern. Your doctor will recommend testing your blood to see if you have adequate amounts of vitamin B12, folate, and iron that are linked to an imbalance in MCH levels. Based on the report, you would be given an appropriate treatment plan for normalizing MCH levels.
[Also Read: Folate blood test]
The MCH value is linked to two other values, Mean Corpuscular Hemoglobin Concentration (MCHC) and Mean Corpuscular Volume (MCV). All 3 values (MCH, MCHC, and MCV,) are sometimes described as red blood cell indices.
MCHC is a measure like MCH and refers to the average amount of hemoglobin in a group of red blood cells and considers the size or volume of the red blood cells.
MCV is a measure of the average size of a single red blood cell. High MCV and MCH levels refer to abnormally large, or macrocytic red blood cells caused by vitamin B12 or folic acid deficiency.
How To Test MCH Levels In Blood?
The MCH levels in blood are determined as a component of the Complete Blood Count (CBC). CBC is a blood test used to evaluate the overall health; to determine the number of red blood cells, white blood cells, and platelets; and detect a wide range of infections, and disorders such as anemia, or leukemia. MCH, the average amount of hemoglobin per red blood cell, is calculated by dividing the total measure of hemoglobin by the number of red blood cells in the given volume of blood.
MCH Levels Normal Range
On average, the normal range of MCH levels is between 27.5 to 33.2 picograms (pg) per red blood cell. MCH levels may be low in women compared to men because women lose blood during menstruation. Also, the numbers seem to be different in young children.
Normal – 27.5 to 33.2 picograms (pg) per red blood cell
Low MCH – At or below 26 pg per red blood cell
High MCH levels – At or above 34 pg per red blood cell
Symptoms Of High MCH In Blood
High MCH levels indicate that your red blood cells are not dividing properly. The resulting low number of red blood cells causes anemia. The symptoms of high MCH levels are like those of low MCH levels, with the most common symptom being tiredness. Other symptoms include brittle nails that easily break, poor concentration, and pale skin.
With anemia caused by vitamin B12 deficiency, you may experience symptoms that include;
- Tingling or “pins and needles” sensation or numbness in your hands or feet
- Stomach problems such as bloating and gas
- Mood problems such as depression
- Confusion or memory loss
With anemia caused by folate deficiency, you could experience a few additional symptoms that include;
- Loss of appetite
- A swollen and sensitive tongue that is smooth and red
Causes Of High MCH Levels In Blood
High MCH levels usually indicate macrocytic anemia, a condition that occurs when the red blood cells are too big. This can result from vitamin B12 or folic acid deficiency in the body.
High MCH levels can also occur because of;
- Liver diseases
- Hyperthyroidism (an overactive thyroid gland that produces too much hormone called thyroxine)
- Regular alcohol intake
- Complications resulting from certain infections and cancers
- Over-use of estrogen-containing medications
Treatment For High MCH Levels
Treatment for high MCH levels depends on the cause of anemia. If you have anemia caused by vitamin B-12 deficiency or folate deficiencies, the treatment may include;
- Consuming foods rich in vitamin B12 and folic acid
- Vitamin B12 pills or injections
- Folic acid pills
You may feel better within a few days of treatment for low vitamin B12 but check with your doctor until your vitamin B12 levels return to normal. If severe vitamin B12 Deficiency persists for long, you may develop the risk of stomach cancer and damage to your heart, brain, nerves, and bones.
Symptoms Of Low MCH In Blood
At the onset, many people may not experience any symptoms of low MCH levels. When the low MCH levels persist for long or the levels become too low, you may start developing symptoms.
The symptoms of low MCH include;
- Difficulty in breathing
- Loss of normal stamina
- Weakness or fatigue
- Faster heartbeat
- Pale or yellowish skin
- Chest pain
- Hair loss
- Weak nails
Low MCH levels may also affect the skin, making it pale and bruise easily.
If these symptoms appear, seek medical attention immediately.
Causes Of Low MCH Levels In Blood
Causes of low MCH levels are;
1. Different Types Of Anemia
- Microcytic Anemia – This condition occurs when the red blood cells are too small, pale, and do not contain enough hemoglobin. This can occur because of malnutrition or nutritional deficiencies.
- Iron Deficiency Anemia – Iron plays an essential role in making hemoglobin for the red blood cells. Hence, iron deficiency can cause a low level of MCH. This commonly occurs in vegetarians, and in people with poor nutritional intake.
2. Medical Conditions
Certain medical conditions can cause anemia, even if the person eats a well-balanced, healthy diet.
3. Celiac Disease
A condition that prevents the absorption of iron in the body lowers the iron levels causing low MCH levels.
4. Surgical Procedure
People who have undergone gastric surgery may also experience iron deficiency because of poor iron absorption resulting from the structural changes made during the surgery.
Women with heavy periods can also become anemic, because of losing more iron in the menstrual blood than they can recuperate.
This is a genetic condition that causes low MCH levels where the production of hemoglobin is affected, decreasing the number of red blood cells circulating in your bloodstream.
Treatment For Low MCH Levels
The treatment depends on the cause of low MCH levels.
With mild iron deficiency, the treatment includes;
- Eating iron-rich foods
- Taking iron pills
- Consuming foods containing vitamin C that help in the absorption of iron
- Quitting black tea as it lowers iron absorption
In case of severe iron deficiency, the treatment includes;
- Intravenous (IV) iron therapy that involves infusing iron medication into a vein
- A blood transfusion that involves infusing someone else’s blood into your vein
Treatment may not be required for mild thalassemia. But severe conditions may require;
- Blood transfusions
- Folic acid pills
- Iron Chelation Therapy – That removes excess iron from the body through medication that can be swallowed or received through IV, which is required if the iron content becomes high because of many transfusions
Iron supplements should not be considered for low levels of iron as they can cause damage to your organs.
How to Maintain Normal MCH Levels In Blood?
Treating unbalanced MCH levels can vary with every case and as it depends on the cause of the imbalance.
High MCH Levels
Including more vitamin B12 and folic acid foods to the diet is a good way to address high MCH levels. A varied and balanced diet and supplements help to keep the MCH levels normal.
Low MCH Levels
Including more iron and vitamin B6 containing foods to the diet helps to address low MCH levels caused by iron deficiency that has led to anemia. Besides foods containing iron, eating vitamin C and fiber-rich foods also help to increase the MCH levels bringing them to normal.
Supplements for vitamin B12, vitamin C, folic acid, and iron are available. With an imbalance in your MCH levels in blood, consider discussing a treatment plan with your doctor before taking supplements or making drastic dietary changes.
Vasavi Attada specializes in creating content for Medical/healthcare domain. She has written articles for Indian Health Organization (IHO), American Diabetes Association, and for magazines such as India Today and Dignity Dialogue.
Vasavi Attada holds a Master’s degree in Microbiology from Bangalore University.