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Doctors test mean corpuscular hemoglobin (MCH) levels to diagnose various blood disorders. MCH is a protein that helps deliver oxygen around the body.
Doctors regularly order blood tests to get an idea of the overall health of their patients. Different MCH levels may cause a variety of symptoms, which will require individual treatments.

MCH stands for mean corpuscular hemoglobin.
MCH levels refer to the average amount of hemoglobin found in the red blood cells in the body. Hemoglobin is a protein in the blood that allows red blood cells to deliver oxygen to the cells and tissues in the body.
Though they are very similar, MCH levels should not be confused with MCHC levels.
MCH levels are the average amount of hemoglobin that is in each red blood cell. MCHC levels are the average weight of that hemoglobin based on the volume of red blood cells. Both are a reflection of the health of the hemoglobin in the blood.
A complete blood count test, or simply CBC test, is designed to give doctors a general overview of a person’s health. The test can help screen people for a variety of issues at once and may help diagnose conditions, such as bleeding disorders, infections, and anemia.
Regular health screenings will often include a CBC test. If the results come back normal, the person may not need another test until their next health screening. Doctors may order CBC tests if a person shows signs of any disorder that can affect the blood.
A CBC test can also be used to help monitor individuals who have blood disorders. Doctors will use them to track the progress of a treatment and determine how effective it is.
CBC tests examine all three types of cells in the blood. The test will give a total white, red, and platelet cell count.
CBC tests examine all three types of cells in the blood and will show the total number of white cells, red cells, and platelets in the blood.
MCH levels
Doctors will often order a CBC test to find out a person’s MCH levels. Normal MCH levels are around 27 to 33 picograms (pg) per cell in adults. These numbers may vary based on the machine used to carry out the test.
The numbers are different in young children. A person with a low MCH has concentrations at or below 26 pg per cell. A person with high MCH levels will have concentrations at 34 pg per cell or more.
Different types of anemia can cause low MCH levels. For example, microcytic anemia occurs when the blood cells are too small and cannot take in as much hemoglobin as they should. This can be due to malnutrition or nutritional deficiencies.
Some medical conditions can also cause anemia, even if the person eats a balanced and healthful diet.
Low amounts of iron in the blood can also cause low MCH levels. The body uses iron to make hemoglobin. If the body runs out of iron, iron deficiency anemia can cause low MCH levels. This type of anemia may be more common in vegetarians or people with poor nutritional intake.
People with other conditions may also experience low MCH levels. Celiac disease can prevent the body from properly absorbing iron, which makes it very difficult to keep the iron levels where they need to be.
Likewise, people who have had types of gastric surgery may also not be able to absorb iron as well as they need to. Women with excessive menstruation may also become anemic, as they lose more iron in the menstrual blood than they can recover.
Low MCH levels can also appear in a body that is lacking key vitamins. People who do not get enough B vitamins such as folate and B12 may show low MCH concentrations on their tests. Because a lack of vitamins can also show high MCH levels, doctors may request further lab testing and interpretation to make a definitive diagnosis.
Symptoms of low MCH levels
At first, many people with low MCH levels do not experience symptoms at all. When low MCH numbers persist or fall too low, symptoms start to appear. Symptoms of low MCH include:
- shortness of breath
- loss of regular stamina
- consistent tiredness
- dizziness
- weakness in the body
Low MCH numbers can also affect the skin. The skin may become pale or bruise very easily in someone with low MCH levels.
Anyone experiencing these symptoms should contact their doctor immediately.
High MCH scores are commonly a sign of macrocytic anemia. This condition occurs when the blood cells are too big, which can be a result of not having enough vitamin B12 or folic acid in the body.
High MCH scores may also be the result of the following:
- liver diseases
- an overactive thyroid gland
- drinking alcohol regularly
- complications from certain cancers
- complications from an infection
- taking too many medications containing estrogen
Symptoms of high MCH levels
People experiencing a high MCH caused by macrocytic anemia may experience symptoms that follow a particular pattern. People may not notice symptoms at first, but they can gradually get worse over time. Symptoms of high MCH include:
- tiredness
- very pale skin
- fast heartbeat
- nails that are brittle and easily broken
- brain fog or poor concentration
- confusion and memory loss
People with macrocytic anemia may also experience digestive issues. They may not have an appetite, lose weight, and have regular diarrhea. A person experiencing any of these symptoms should talk to their doctor as soon as possible.
How doctors treat unbalanced MCH levels can vary with every case. Treatment largely depends on treating the cause of the imbalance.
Adding more vitamin B12 and folic acid to the diet can be a good way to address high MCH levels. It is best to get these from a varied and balanced diet, but supplements may also help keep these levels where they need to be.
Low MCH levels usually occur as a result of iron deficiency that has led to anemia. Doctors may recommend that individuals add more iron and vitamin B6 to their diet. Eating vitamin C and fiber, along with foods that contain iron, may also help increase the MCH levels.
Supplements for various vitamins are available to purchase online, including vitamin B12, vitamin C, folic acid, and iron. People with an imbalance in their MCH levels should always discuss a treatment plan with their doctors before taking any supplement or making drastic changes to their diet.
Most people can improve their MCH levels by making changes to their diet. Iron injections may be necessary for people with disorders that prevent iron absorption. Other people may require regular transfusions with iron-rich blood.
People should be open with their doctor about what they eat and drink during the testing process to make diagnosis and treatment as smooth as possible.