Mean corpuscular hemoglobin concentration (MCHC) refers to the average concentration of hemoglobin inside a group of red blood cells. Causes of high MCHC include some types of anemia, liver disease, and overactive thyroid. Other factors, such as cancer treatment, can also affect it.

A normal MCHC level for an adult is 32–36 grams per deciliter (g/dL). MCHC values over 36 g/dL are high.

MCHC values alone do not always indicate that a person has any underlying health problems but may prompt further tests.

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There are several potential causes of high MCHC. It often occurs in people with conditions that cause the red blood cells to be fragile or easily destroyed.

Causes of high MCHC include:

Autoimmune hemolytic anemia (AIHA)

In AIHA, the body’s immune system mistakenly attacks its own red blood cells. Sometimes, high MCHC develops on its own, but it can also occur alongside lupus or lymphoma. It can also happen as a result of taking certain medications.

Symptoms of autoimmune hemolytic anemia may include the following:

  • fatigue
  • jaundice
  • weakness
  • paleness
  • abdominal discomfort
  • enlarged spleen
  • rapid heartbeat
  • fainting

Learn more about AIHA

Macrocytic anemia

Macrocytic anemia is a type of blood disorder where some of the red blood cells are much larger than usual. Sometimes a B-12 deficiency can cause macrocytic anemia.

Symptoms of macrocytic anemia are similar to those of hemolytic anemia, but also include:

  • weight loss
  • loss of appetite
  • brittle hair and nails
  • diarrhea
  • trouble concentrating
  • memory problems

Learn more about macrocytic anemia.

Hereditary spherocytosis

Hereditary spherocytosis is a genetic mutation that makes the membranes of red blood cells fragile. This condition typically passes from a parent to a child.

Learn more about hereditary spherocytosis.

Severe burns

Blood loss from severe burns may cause a person to have hemolytic anemia and high MCHC.

Liver disease

The liver stores and processes hemoglobin, so people with liver disease often have some form of anemia. If their liver damages the red blood cells, a person may have high MCHC.

Symptoms of liver disease often include common symptoms of anemia, in addition to:

  • nausea
  • vomiting
  • upper right abdominal pain

Learn more about liver disease.

Overactive thyroid

An overactive thyroid, or hyperthyroidism, may lead to changes in a person’s red blood cells.

People with high MCHC due to an overactive thyroid may experience:

  • sweating
  • excess hunger
  • fatigue
  • weight loss
  • palpitations
  • restlessness
  • weakness

Learn more about hyperthyroidism.

A blood test known as a complete blood count or CBC includes MCHC values. This test provides information on the white blood cells, red blood cells, and platelets in a person’s blood.

A doctor may order a CBC as part of a routine physical exam to help screen for various conditions.

A doctor may also order a CBC to monitor how an existing condition responds to treatment.

Learn about low MCHC in blood tests.

Treatment for high MCHC depends on the underlying cause.

Doctors usually treat AIHA with corticosteroids, such as Prednisone. Initially, doctors will prescribe a high dose and then lower it over time. In severe cases of hemolytic anemia, doctors may recommend removing the spleen.

Doctors may prescribe immunosuppressant medications when other treatments are unsuccessful and for relapsing AIHA.

Increasing levels of vitamin B-12 and folate can also help treat people with macrocytic anemia. People with hereditary spherocytosis can also benefit from increasing their intake of these nutrients.

Dietary sources of vitamin B-12 and folate include:

  • poultry
  • eggs
  • red meat
  • shellfish
  • lentils
  • dark, leafy greens
  • fortified grains and cereals
  • nutritional yeast

If a person has hereditary spherocytosis, a doctor may also recommend:

People can often manage liver disease with lifestyle modifications. However, a doctor may also prescribe medications or recommend surgery to remove part of the liver.

People with severe burns will require treatment in the hospital to prevent infection and shock if necessary. If severe burns cause high MCHC, doctors will likely order blood transfusions.

Can infection cause high MCHC?

Infection does not cause high MCHC. It is most likely to occur in people with conditions that weaken the red blood cells, such as autoimmune hemolytic anemia, macrocytic anemia, and liver disease.

When should I be worried about MCHC?

A normal level of MCHC for an adult is 32–36 grams per deciliter (g/dL). Higher or lower values may indicate an underlying condition, and a person should discuss this with a doctor. The doctor may order further tests to help with diagnosis.

MCHC levels indicate the concentration of hemoglobin in a specific volume of red blood cells. Doctors consider an MCHC value over 36 g/dL as high.

High MCHC can have many causes, including some types of anemia, liver disease, and overactive thyroid, which cause varying symptoms.

In many cases, making dietary changes to include more vitamin B-12 and folate may be sufficient treatment. Sometimes, a person may require a blood transfusion or even surgery.