What Is MCH?

Mean corpuscular hemoglobin (MCH) is indeed a measurement that provides information about the average amount of hemoglobin in each red blood cell. Hemoglobin is a vital protein responsible for carrying oxygen to the body’s tissues and removing carbon dioxide.

When your MCH level is lower or higher than the normal range, it can suggest certain underlying conditions.

What Does Low MCH Mean?

An MCH level below the normal range can indeed be indicative of hypochromic anemia, which occurs when there is an insufficient amount of hemoglobin in the blood.

The most common cause of hypochromic anemia in the United States is iron deficiency. Iron is essential for the production of hemoglobin, and without enough iron, hemoglobin levels decrease. This condition is commonly referred to as iron-deficiency anemia.

Iron-deficiency anemia can develop due to various factors, including:

• Blood loss: Heavy menstrual periods, gastrointestinal bleeding (caused by conditions like inflammatory bowel disease), surgery, or traumatic injuries can result in significant blood loss, leading to a depletion of iron stores and subsequent iron deficiency.
• Problems absorbing iron: Certain genetic conditions, engaging in endurance sports, gastrointestinal and digestive disorders, and surgeries affecting the stomach or intestines can interfere with the absorption of iron from the diet. This impaired absorption hinders the body’s ability to acquire sufficient iron, contributing to iron deficiency.
• Kidney disease: In some cases of kidney disease, the kidneys may produce lower levels of erythropoietin, a hormone necessary for the production of red blood cells. Insufficient erythropoietin production can hinder the development of new red blood cells, leading to decreased hemoglobin levels and iron-deficiency anemia.
• Chronic inflammatory conditions: Certain chronic conditions characterized by persistent inflammation, such as autoimmune disorders or chronic infections, can disrupt iron utilization within the body. Chronic inflammation can impair the body’s ability to effectively absorb, transport, and utilize iron, resulting in iron-deficiency anemia.
• Inadequate dietary iron intake: While less common in the United States, insufficient iron intake can occur, particularly in specific age groups such as children between 9 months and 1 year of age who may have limited access to iron-rich foods. Inadequate dietary intake of iron can lead to depleted iron stores and subsequently contribute to iron-deficiency anemia.
• Pregnancy and breastfeeding: During pregnancy, the body requires increased amounts of iron to support the growing fetus and placenta. If the dietary iron intake is insufficient or the body’s iron stores are depleted, iron-deficiency anemia can occur. Breastfeeding also places additional demands on iron stores, increasing the risk of anemia if the mother’s iron intake is inadequate.
• Rapid growth periods: Infants, children, and adolescents undergo rapid periods of growth, which require an increased supply of iron to support the production of new red blood cells. Inadequate dietary iron intake during these critical growth phases can result in iron-deficiency anemia.
• Vegetarian or vegan diets: Individuals who follow strict vegetarian or vegan diets may have a higher risk of iron deficiency due to the absence or limited availability of heme iron, which is predominantly found in animal-based foods. Plant-based sources of iron, such as legumes, fortified grains, and leafy greens, are non-heme iron, which is less readily absorbed by the body. Proper planning and inclusion of iron-rich plant-based foods or supplementation are essential to prevent iron-deficiency anemia in these dietary choices.
• Chronic gastrointestinal conditions: Conditions that affect the gastrointestinal tract, such as celiac disease, Crohn’s disease, or gastric bypass surgery, can impair the absorption of nutrients, including iron. Malabsorption of iron in these conditions can lead to iron-deficiency anemia if not properly managed.
• Menstruation: Women of reproductive age experience monthly menstrual bleeding, which can result in regular iron loss. Heavy or prolonged menstrual periods, in particular, can increase the risk of iron deficiency over time, especially if dietary iron intake is insufficient to compensate for the loss.
• Medications and medical treatments: Certain medications, such as proton pump inhibitors (used to treat acid reflux) or anticoagulants (blood thinners), can interfere with iron absorption or increase the risk of gastrointestinal bleeding, contributing to iron-deficiency anemia. Additionally, individuals undergoing frequent blood transfusions or those receiving chemotherapy or radiation therapy for cancer may experience decreased red blood cell production, leading to anemia.
• Genetic disorders: Inherited conditions, such as thalassemia or hereditary spherocytosis, can affect the normal production or function of red blood cells, increasing the risk of developing iron-deficiency anemia.

Symptoms of Low MCH

In cases of iron deficiency anemia associated with a low MCH level, some individuals may not experience noticeable symptoms. However, if symptoms are present, they can include:

• Tiredness or fatigue: Feeling excessively tired or lacking energy, even with adequate rest.
• Shortness of breath: Difficulty breathing or a sensation of breathlessness, especially during physical activity or exertion.
• Chest pain: Discomfort or pain in the chest, which may be a result of reduced oxygen supply to the heart muscles.
• Dizziness or lightheadedness: Feeling dizzy or lightheaded, often upon standing up or during sudden movements.
• Cold hands and feet: Decreased blood flow to the extremities can cause a sensation of coldness in the hands and feet.
• Pale skin: A paler complexion than usual, often noticeable in the face, lips, and nail beds.

What Does High MCH Mean?

An MCH level above normal levels may indicate the presence of anemia due to low folate or vitamin B12 levels. Folate-deficiency anemia can develop when there is an insufficient intake of folate in the diet, long-term heavy alcohol use, or the use of certain medications. On the other hand, vitamin B12 deficiency anemia can occur when the body is unable to properly absorb vitamin B12 due to factors such as a lack of intrinsic factor, heavy alcohol use, certain medications, certain medical conditions, or inadequate dietary intake of vitamin B12.

Chemotherapy can also cause high MCH levels as a side effect. Additionally, falsely high MCH levels may be observed in individuals with high cholesterol.

If you have anemia due to low folate or B12 levels, you may experience symptoms such as fatigue, weakness, pale skin, shortness of breath, and lightheadedness.

Symptoms of High MCH

If you have high MCH due to anemia, such as folate-deficiency anemia or vitamin B12 deficiency anemia, you may experience symptoms associated with the anemia itself. These symptoms can include fatigue, weakness, headache, and paleness.

In the case of folate-deficiency anemia, additional symptoms may include a sore mouth and tongue.

Vitamin B12 is essential for proper brain and nerve function, so if you have vitamin B12 deficiency anemia, you may also experience problems with walking, movement, thinking, smell, taste, and vision.

How Are Abnormal MCH Levels Treated?

When treating abnormal MCH levels, the approach will depend on the underlying cause and severity of the condition. Once it is determined that anemia is the cause of the abnormal MCH levels, further investigation is needed to identify the specific cause of the anemia. Treatment options may include:

• Medication: Certain medications may be prescribed to address the underlying cause of anemia, such as medications for nutritional deficiencies or medications to manage chronic conditions.
• Supplements: Iron supplements, vitamin B12 supplements, or folate supplements may be recommended to address deficiencies and improve hemoglobin levels.
• Blood transfusion: In severe cases of anemia or when immediate intervention is required, a blood transfusion may be performed to replenish red blood cell levels and improve oxygenation.
• Blood and bone marrow transplant: In certain cases, such as severe and refractory anemia, a blood and bone marrow transplant may be considered as a treatment option.
• Surgery: Surgical interventions may be necessary to address underlying causes of anemia, such as removing tumors or repairing bleeding blood vessels.
• Dietary changes: In cases where nutritional deficiencies contribute to anemia, healthcare providers may recommend dietary modifications to increase the intake of essential nutrients like iron, vitamin B12, or folate.
• Lifestyle modifications: Making lifestyle changes can help improve overall health and manage certain causes of anemia. This may involve adopting a balanced diet rich in iron, vitamin B12, and folate, as well as incorporating regular exercise and stress management techniques.
• Management of chronic conditions: If an underlying chronic condition, such as kidney disease or inflammatory bowel disease, is contributing to anemia, treatment and management of the underlying condition may be necessary. This can include medication, lifestyle modifications, and regular monitoring.
• Hormone therapy: In cases where hormonal imbalances contribute to anemia, hormone replacement therapy or other hormonal interventions may be recommended.
• Erythropoiesis-stimulating agents: In certain cases, such as chronic kidney disease-related anemia, erythropoiesis-stimulating agents (ESAs) may be prescribed to stimulate the production of red blood cells.
• Management of bleeding disorders: For individuals with bleeding disorders, treating the underlying bleeding condition or addressing any deficiencies in blood clotting factors may help manage anemia.
• Addressing nutritional deficiencies: In cases where nutritional deficiencies are causing anemia, a comprehensive approach involving dietary changes, nutritional counseling, and appropriate supplementation may be recommended.
• Supportive care: Alongside specific treatments, supportive care measures can help manage anemia symptoms and improve quality of life. This may include pain management, fatigue management strategies, and psychological support.

A Quick Review

MCH, or mean corpuscular hemoglobin, is a measurement that provides information about the average amount of hemoglobin in each red blood cell. Hemoglobin is a protein responsible for carrying oxygen from the lungs to various tissues in the body. MCH is obtained as part of a complete blood count (CBC), which is a common blood test that assesses various parameters of red blood cells.

The normal range for MCH is typically between 27 and 31 picograms per cell. Values above or below this range can indicate certain underlying conditions, often related to different types of anemia. Low MCH levels may suggest iron-deficiency anemia, which occurs when there is insufficient iron to produce an adequate amount of hemoglobin. On the other hand, high MCH levels may indicate anemia caused by low levels of folic acid or vitamin B12, which are necessary for the production of healthy red blood cells.

When abnormal MCH levels are detected, a healthcare provider will investigate the underlying cause. This typically involves conducting further tests and evaluations to determine the specific type of anemia and its root cause. Once the cause is identified, appropriate management strategies can be implemented to address the underlying condition and restore MCH levels to within the normal range.

The treatment approach for abnormal MCH levels depends on the specific type of anemia and the factors contributing to it. It may involve interventions such as iron supplementation, dietary adjustments, vitamin supplementation, or other targeted therapies aimed at addressing the underlying deficiency or condition.

Working closely with a healthcare provider is crucial for accurate diagnosis, tailored treatment, and ongoing monitoring to ensure optimal management of abnormal MCH levels and associated anemia.