MCH: What It Is, Low Levels, High Levels, and Treatment

Red blood cells, which are the cells in the blood that carry oxygen, transport it through the hemoglobin protein that has the ability to bind oxygen. The amount of hemoglobin is crucial for transporting enough oxygen throughout the body and for the healthy functioning of metabolism. For this reason, the MCH value, which indicates the average amount of hemoglobin in red blood cells, becomes important.

What Is MCH?

MCH, which stands for Mean Corpuscular Hemoglobin, is a type of blood test that measures the average amount of hemoglobin in a red blood cell. Since hemoglobin is a protein found in red blood cells, the MCH level indicates how much hemoglobin a person's red blood cells carry. When MCH is evaluated along with the Mean Corpuscular Volume (MCV) value, it also provides information about the size of the red blood cell. Thus, the MCH value, measured in picograms (pg), can be used in diagnosing certain blood disorders.

What Should the MCH Value Be?

The normal range for MCH (mean corpuscular hemoglobin) is considered to be 27-33 picograms (pg). However, since this range can vary depending on the laboratory or the measurement unit used, it is important to pay attention to the reference range specified by the laboratory when evaluating the MCH result. If the MCH value is found to be below or above the normal range based on the reference range indicated in the test result, a doctor should be consulted, and further tests may be necessary.

What Is Low MCH?

Low MCH in a blood test refers to the average amount of hemoglobin in red blood cells falling below the normal range. When the MCH value is 26 pg or lower, red blood cells shrink and become pale. Since low MCH can stem from various causes and may lead to significant health issues, it should be taken seriously.

What Are the Symptoms of Low MCH?

Because low MCH is related to the size and hemoglobin-carrying capacity of red blood cells, various symptoms can occur in the body when MCH is low. Symptoms of low MCH include:

• Fatigue and tiredness: Due to insufficient oxygen being transported to the body’s cells, energy levels may decrease, leading to fatigue and tiredness.
• Pale skin: The low hemoglobin levels in red blood cells cause the cells to appear paler, leading to pale skin.
• Shortness of breath: A decrease in the oxygen levels in the blood can cause respiratory problems and lead to shortness of breath.
• Dizziness: When MCH levels are low, insufficient oxygen is delivered to the brain, which can result in dizziness.
• Palpitations: When the body does not receive enough oxygen, the heart works harder to compensate, leading to palpitations.
• Numbness and tingling: When oxygen does not reach certain parts of the body, such as the hands and feet, numbness or tingling may occur.
• Concentration problems: Inadequate oxygen levels can impair cognitive function, causing problems with focus and concentration.

What Are the Causes of Low MCH?

One of the most common causes of low MCH is iron deficiency anemia, but it can also arise from various other conditions. These causes of low MCH include:

• Iron deficiency anemia: This is one of the most common types of anemia that prevents the production of sufficient hemoglobin in red blood cells. When the body does not receive enough iron, it cannot produce enough hemoglobin, leading to low MCH.
• B12 or folate deficiency: A deficiency in vitamin B12 or folate can cause red blood cells to become larger than normal, leading to a condition known as megaloblastic anemia and resulting in low MCH.
• Thalassemia: Thalassemia is an inherited blood disorder that causes the blood to contain less hemoglobin than normal. In thalassemia, red blood cells may contain less hemoglobin and be smaller in size.
• Sideroblastic anemia: Sideroblastic anemia is a bone marrow disease that prevents the body from producing enough healthy red blood cells. Since insufficient healthy red blood cells are produced, low MCH occurs.
• Chronic diseases: Certain chronic inflammatory diseases, cancers, and kidney diseases can prevent the body from producing enough healthy red blood cells, leading to low MCH.

How Is Low MCH Treated?

The treatment for low MCH depends on the underlying cause and aims to resolve the issue. In the case of iron deficiency anemia, treatment usually involves iron supplements and changes to dietary habits. If the cause is a B12 or folate deficiency, the missing vitamins can be replenished through supplements or foods rich in these vitamins. If left untreated, low MCH can lead to serious health problems, such as heart disease and breathing difficulties. Therefore, if symptoms are present, it is important to see a doctor and begin treatment as soon as possible.

What is High MCH?

High MCH (Mean Corpuscular Hemoglobin) refers to the condition where the average amount of hemoglobin in red blood cells exceeds the normal range. Since the normal MCH range is between 27-33 picograms (pg), an MCH value above 34 pg is usually considered high. High MCH can cause significant health problems and should be addressed and treated.

What are the Symptoms of High MCH? Normally, high MCH does not show significant symptoms and is often detected incidentally during a blood test. However, depending on the underlying causes, high MCH can lead to various symptoms. Some symptoms that may occur due to high MCH include:

• Vitamin Deficiency: If high MCH is caused by a B12 or folic acid deficiency, symptoms such as fatigue, tiredness, shortness of breath, dizziness, and palpitations may occur.
• Hemoglobinopathies: If high MCH is related to hemoglobinopathies (diseases caused by genetic changes in hemoglobin molecules), symptoms like anemia, fatigue, shortness of breath, and palpitations may be observed.
• Liver Disease: If high MCH is associated with liver dysfunction, symptoms like jaundice, itching, abdominal pain, weight loss, and skin rashes may appear.
• Other Diseases: High MCH caused by other blood diseases like leukemia, myeloproliferative disorders, hemolytic anemia, or thalassemia may present symptoms related to these conditions.

What Causes High MCH? The most common cause of high MCH is a deficiency in B12 or folic acid, which can also lead to low MCH. A deficiency in B12 or folic acid prevents normal red blood cell development, resulting in abnormally large red blood cells that carry more hemoglobin, causing high MCH. Some causes of high MCH include:

• B12 or Folic Acid Deficiency: A deficiency in B12 or folic acid prevents red blood cells from developing properly, which can lead to high MCH.
• Alcoholism: Chronic alcohol consumption can cause abnormal growth of red blood cells, resulting in high MCH.
• Liver Disease: Impaired liver function affects red blood cell production, leading to high MCH.
• Hemoglobinopathies: Hemoglobinopathies, caused by genetic changes in hemoglobin molecules, can increase the amount of hemoglobin in red blood cells, leading to high MCH.
• Other Diseases: High MCH can also be associated with other blood diseases like leukemia, myeloproliferative disorders, hemolytic anemia, or thalassemia.

How is High MCH Treated? Treatment for high MCH, like low MCH, is determined based on the underlying cause. If B12 or folic acid deficiency is present, vitamin supplements can be prescribed. If the cause is excessive alcohol consumption, treatment for alcoholism is recommended. If other diseases are the cause, treatment for those conditions is required to resolve the high MCH. For hereditary blood diseases like spherocytosis, treatment may include blood transfusions or surgical intervention such as a splenectomy (removal of the spleen) to prevent high MCH.

Since untreated high or low MCH can lead to serious health issues, it is important to consult a doctor and seek treatment as soon as symptoms are noticed.