If a person is not feeling well and visited the doctor’s office or hospital, one of the tests ordered is CBC or complete blood count. It checks various components of the blood so as to give the doctor a general overview of the patient’s health. The result of the test is used as a basis for diagnosing and treating the patient’s condition.
One of the blood components measured in the routine blood check is MCH. It stands for Mean Corpuscular Hemoglobin. It measures the amount of hemoglobin present in red blood cells. It is checked to diagnosed blood and iron-related disorders. What is hemoglobin? It is a protein that stores oxygen. It enables your blood to transport oxygen throughout the body.
The mean corpuscular hemoglobin is one of the three red blood cell indices. The other two are MCV and MCHC. A special machine is used to determine the level of MCH in the blood. (1, 2, 3, 4, and 5)
Image 1: The image shows the level of MCH; a proportion of hemoglobin to red blood cells.
Picture Source: healthtestingcenters.com
How to calculate the level of MCH?
The level of MCH is calculated by multiplying the number of hemoglobin in a particular volume of blood by ten and divide by the number of red blood cells. (4)
Image 2: The formula used to calculate MCH level.
Picture Source: slidesharecdn.com
What is the Normal MCH level?
The normal MCH reading is between 27 and 31 pg per cell. The reading is low if it falls below 25 and high if it is 35 or higher. (5)
What does a low MCH mean?
If the MCH level is low, it means that the red blood cells are smaller than normal. The condition is called microcytosis. What’s even alarming is that symptoms do not show up until the condition gets severe.
If the MCH reading is lower than the usual, other blood parameters have to be checked to come up with an accurate diagnosis. Such tests include iron markers, MCV, and RDW. (4, 5, and 6)
A patient with an extremely low MCH level may experience the following:
- Easy fatigability
- Loss of stamina
- Shortness of breathe
- Tiredness even with just minimal effort
- The skin becomes pale or yellowish
- The patient gets bruised easily (5, 6, and 7)
Image 3:Anemia is one of the leading causes of low MCH reading.
Picture Source: plantbasedpharmacist.com
Image 4: Thalassemia is also linked with the decrease in MCH reading.
Picture Source: ghr.nlm.nih.gov
What are the possible reasons behind low MCH reading?
- Iron deficiency anemia – It is one of the reasons for having a low MCH. In a study made, about 82% of patients who have a low MCH have iron deficiency anemia and most of them have Celiac disease too. This condition leads to the poor absorption of iron leading to iron deficiency anemia.
- Thalassemia – It is a blood-related disorder characterized by abnormal hemoglobin in the blood causing the MCH level to go down. (6, 7, and 8)
What can you do to normalize the level of MCH?
- Watch your diet – Make sure you eat a healthy and balanced diet. Increase your intake of iron-rich foods to prevent the possibility of having iron deficiency anemia. Rich sources of iron are:
- Edible seeds
- Whole grains
- Dried fruits (3, 5)
Foods to avoid
These foods decrease the absorption of iron into the body:
2. Take iron supplements – If you are a vegetarian and you can’t include meat products in your diet, the best thing to do is to take iron supplements.
3. Blood transfusion – If the symptoms are severe such as severe blood loss, your doctor will order a blood transfusion to compensate for the blood loss. (6, 8, 9, and 10)
What does a high MCH mean?
If your MCH level is high, it means that your red blood cell is bigger than the usual. The condition is called macrocytic, which is associated with an underlying medical condition.
A high MCH level can go unnoticed for a long period of time until such time that the condition gets wore and symptoms began to appear. These include the following:
- Paleness of the skin
- Easily gets tired
- Rapid beating of the heart
- Inability to concentrate
- Nails get brittle and break easily
- Memory loss
- Digestive-related issues such as diarrhea
- Loss of appetite leading to drastic weight loss
- Nausea with or without vomiting
- Smooth/sensitive tongue (3, 5, and 9)
Image 5: MCH is dramatically high in patients with megaloblastic anemia.
Picture Source: medindia.net
What causes a high MCH level?
- Megaloblastic Anemia – It is caused by a deficiency in vitamin B 12 or folate.
- Vices – Those who have a lot of vices such as chronic smoking and heavy alcohol consumption have higher chances of having a high MCH level than those who lead a healthy lifestyle.
- Malaria infection – Infections caused by Falciparum malaria have a high MCH level. (1, 4, and 9)
How to bring down the MCH level?
- Diet – What you eat plays a vital role in normalizing the level of MCH. To bring down a high MCH level, you should increase your intake of foods rich in folate and vitamin B12 such as:
- Green leafy vegetables
- Meat products, especially chicken, beef, lamb, and turkey
- Dairy products like milk and yogurt
- Pork liver
- Live healthy – Improve your way of life.
- Reduce your intake of alcoholic beverages.
- Cut or totally stop smoking.
- Consider taking supplements such as vitamin B12 and folate. (4, 5, 9, and 10)
To determine the outlook of the patient with MCH abnormalities, the underlying condition has to be established. If it is caused by iron deficiency anemia, the outlook is good as it can be easily corrected through diet, supplement, and lifestyle modification.
If the underlying cause is thalassemia, you might need to undergo a regular blood transfusion, especially if the condition is severe. It is important to consult your primary care physician to determine the underlying cause and come up with a better solution. That way, your outlook or prognosis can be improved significantly. (4, 6, and 9)
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