Multiple components in the blood are analyzed as part of standard blood work panels. Some of the typical components checked are hemoglobin, red blood cells, white blood cells, and platelet count. Two less well-known components are MCH (Mean corpuscular hemoglobin) and MCHC (Mean corpuscular hemoglobin concentration).

They are commonly referred to red blood cell indices together with MCV. They determine and characterize red blood cells, specifically the shape, quality, and size. There is a direct correlation between the two and we’re going to discuss it in this article.

MCH (Mean Corpuscular Hemoglobin) Test

The amount of hemoglobin in RBCs is known as mean corpuscular hemoglobin (MCH). Between 26 to 33 picograms (pg) of hemoglobin/Red blood cells are considered normal amounts of MCH. High or low readings could signify anemia or a vitamin deficit. Calculating the quantity of hemoglobin in a single red blood cell is the goal of this laboratory test.

It can identify and categorize various kinds of anemia. When there are not enough healthy red blood cells, a disease known as anemia develops. This impairs the blood’s capacity to carry ample amounts of oxygen to supply various parts of the body, specifically tissues and organs. 

MCHC (Mean corpuscular hemoglobin concentration)Test

The ratio between hemoglobin’s average amount per single RBC is referred to as MCHC, which stands for Mean Corpuscular Hemoglobin Concentration.  This specific test, which is a part of RBC indices aims to check the traits and characteristics of red blood cells. The accuracy of this test makes it effective in categorizing and sorting out various forms of conditions and diseases.

MCH and MCHC Reference Values

MCHNormal range is between 27 picograms/cell and 31 picograms/cells.

MCHCNormal range is between 32 grams/deciliter and 36 grams/deciliter.

Anything below and above the said range warrants further laboratory investigation to detect any possible causes.

 To calculate MCH, the formula is:

Mean corpuscular hemoglobin (MCH, measured in pg/cell) = (10 × [Hb/RBC])

To calculate for MCHC, the formula is:

Mean corpuscular hemoglobin concentration (MCHC, measured in g/dL) = (100 × [Hb/Hct])

What is the difference between MCH and MCHC?

The measurement of MCHC differs from MCH in that it accounts for the size or volume of RBCs, whereas MCH does not. Both serve as markers for the condition of the blood’s hemoglobin.

Red blood cells need the blood protein hemoglobin to assist them carry oxygen to various cells and tissues in the body.


Both MCH and MCHC are vital measurements used as parameters to detect certain types of conditions and diseases. Although they are closely related, they too have differences.

MCHC reflects the hemoglobin concentration in a specific unit of packed red blood cells, whereas MCH reflects the average hemoglobin content in a single RBC.

By getting the value of MCHC, health care providers will be able to evaluate various types of diseases, especially blood-related problems like anemia and hypochromasia. 

Frequently Asked Questions

Q1. What does it mean if your MCH is low?

Low MCH levels typically result from anemia brought on by a deficiency of iron in the body.  Iron is required by your body to manufacture hemoglobin. Your iron levels may decrease as a result of pregnancy, blood loss, or weight loss surgery, which may result in anemia, specifically iron deficiency anemia leading to a significantly low level of MCH and hemoglobin.  Doctors may advise patients to increase their intake of iron and vitamin B6. Consuming foods rich in iron and foods high in vitamin C and fiber may also assist to raise MCH levels. Some of the conditions that can cause low MCH level include the following:
1. Blood loss
2. Pregnancy
3. Surgery
4. Weight loss 

Q2. What are the symptoms of low MCH secondary to anemia?

1. Easily gets tired.
2. Weakness.
3. Easily gets dizzy.
4. The skin appears pale or yellowish.
5. Having difficulty catching your breath.
6. Headache.
7. Cold clammy skin.
8. Chest pain.
9. Cold feet.
10. Irregular beating of the heart.

Q3. What does it mean if MCH is high?

MCH concentrations over 34 pg are typically regarded as excessively high.  The condition is called macrocytic anemia, a blood condition caused by the inability of the body to produce an adequate number of red blood cells. In macrocytic anemia, the red blood cells formed are larger than usual and each red blood cell has more hemoglobin. One of the reasons for high MCH level is low folic acid (vitamin B12) in the body. Other possible reasons include thyroid-related problems, infections, other forms of anemia, excessive use of medicines containing estrogen, side effects of chemotherapy, hereditary spherocytosis, and some types of leukemia.  Clinical manifestations include the following:
1. Pallor
2. Unexplained tiredness/fatigue
3. Palpitations
4. Heart complications 

Q4. What does a low MCHC mean?

Adults’ MCHC reference levels fall between 33.4 and 35.5 grams per deciliter (g/dL). Your MCHC level is considered low if it is below 33.4 grams per deciliter. It is commonly associated with iron deficiency and thalassemia. the latter is a genetic condition in which the body has a few hemoglobin and red blood cells. Hypochromic anemia is one of the main reasons for low MCHC level, which is frequently brought on by iron shortage. If you experience anemia symptoms, you may have normochromic anemia within the MCHC reference range. Aplastic anemia is a rare kind of anemia in which the body cannot create enough RBC. Other conditions associated with low MCHC levels are unexpected blood loss, having an artificial heart valve, kidney failure,

Q5. What does a high MCHC level mean?

Hyperchromic anemia, which is higher above the MCHC reference range, may be brought on by spherocytosis. It is an extremely rare hereditary condition in which the body produces irregularly shaped red blood cells. Another possible reason is red blood cell agglutination, a condition where the red blood cells cluster together in an abnormal manner. The level of MCHC is high if the value if 35.5 grams per deciliter and above.

Q6. What happens if both MCH and MCHC levels are low?

Your body is producing less hemoglobin than usual if your MCV and MCH levels are low. As a result, anemia develops because the body produces less than normal healthy red blood cells.  Although anemia typically does not result in major health issues, it can be dangerous if left untreated. Some of the conditions linked to low levels of MCH, MCHC, and MCV are the following: 
1. Genetic predisposition for Hb C
2. Chronic inflammatory disease
3. Problems in metabolizing copper
4. Sideroblastic anemia
5. Autoimmune-related disorders
6. Blood loss secondary to injury, heavy monthly period, and surgery
7. Inflammatory disease of the liver and kidneys
8. Lack of iron in your diet
9. Pregnancy or has recently given birth

Q7. What happens if both MCHC and MCH levels are high?

A high MCHC and MCH result is most likely to happen when hemoglobin inside the red blood cells is heavily condensed. Hemoglobin can also leak outside of red blood cells in conditions where RBCs get severely damaged.  Some of the conditions linked with high MCH and MCHC levels are the following:
1. Liver-related diseases
2. Hyperactive thyroid gland
3. Too much intake of alcoholic beverages
4. Complications from infections
6. Too much intake of estrogen-containing drugs for a long period of time
7. Caused by some types of cancer
8. Deficiency in B vitamins like vitamin B12 and folate
9. Heavy menstrual bleeding
10. Those who underwent gastric-related procedures
11. Those suffering from microcytic anemia and celiac disease

Q8. What is the difference between MCH and MCHC and their clinical significance?

The amount of hemoglobin in each red blood cell is measured by MCH. MCH readings typically range from 29 to 2 picograms (pg) per cell. On the other hand, MCHC pertains to the hemoglobin content per unit of volume. It links the amount of hemoglobin to the size of the cell.

Q9. What Is the Treatment for Abnormal MCH Levels?

Depending on the illness or disease that causes the abnormally high or low MCH levels, treatment varies for high and low levels. A medical professional must first ascertain the cause of your MCH levels, which could be low or excessive. For a thorough picture, they’ll probably consider the other outcomes of your complete blood count. The course of treatment usually includes diet modifications, supplements, and blood transfusion for severe cases. In some instances, a bone marrow might be necessary. 

Q10. Is it cause for concern if the MCHC is low?

Anemia, more specifically hypochromic microcytic anemia, can be indicated by low MCHC levels. It’s crucial to determine the underlying cause through more testing and assessment with a healthcare professional, even though this may raise concerns. Depending on the underlying cause, treatment options could include dietary adjustments or medical procedures. Bottomline, it is not always a cause for concern, but it is better to have yourself checked by your primary care physician. When it comes to your health, you should not be laxed. It should always be the top priority. As the line goes “better safe than sorry.”

Q11. Which is more accurate: MCH or MCHC?

Which one is a better parameter in identifying disease condition primarily depends on the type of condition or disease that the doctor is trying to rule out. For instance,  it was once believed that MCHC was a more accurate parameter than MCH for identifying hypochromasia. Plasma entrapment, which normally results in a slightly elevated hematocrit, has no effect on the MCHC, as it is now analyzed by a multichannel analyzer. Therefore, when there is hypochromasia, MCHC does not decrease.



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