Mean corpuscular hemoglobin concentration (MCHC) refers to the average concentration of hemoglobin inside a group of red blood cells. A MCHC result may be high in people with some types of anemia, liver disease, or an overactive thyroid. Other factors, such as cancer treatment, can also affect it.

MCHC refers to the average concentration of hemoglobin in a given volume of red blood cells.

A normal MCHC level for an adult is 31-37 grams per deciliter (g/dL).

MCHC values by themselves are not always a sign that a person has any underlying health problems but may prompt a doctor to do further tests.

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A CBC test may be used to diagnose high MCHC.

High MCHC is diagnosed as part of a blood test known as a complete blood count or CBC. This test provides information on the white blood cells, red blood cells, and platelets.

A doctor may order a CBC as part of a routine physical exam to help screen for a wide variety of diseases.

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

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: This is a condition in which 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.

Macrocytic anemia: 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.

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

Severe burns: 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 is damaging the red blood cells, then a person may have high MCHC.

Overactive thyroid: Thyroid problems frequently lead to changes in a person’s red blood cells.

Medications: In rare cases, high MCHC levels have been found in people taking immunosuppressive or chemotherapy drugs.

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Weakness and fatigue may be symptoms of autoimmune hemolytic anemia.

High MCHC is not a condition itself but may indicate one of the conditions mentioned above. The symptoms of these conditions vary.

Symptoms of autoimmune hemolytic anemia may include the following:

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

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

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

  • nausea
  • vomiting
  • upper right abdominal pain

People with hereditary spherocytosis may have symptoms of anemia and might also develop gallstones.

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

  • sweating
  • excess hunger
  • fatigue
  • weight loss
  • palpitations
  • restlessness
  • weakness
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Lentils are an excellent source of vitamin B-12 and folate.

Treatment for high MCHC depends on the underlying cause.

Doctors usually treat autoimmune hemolytic anemia 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.

Increasing levels of vitamin B-12 and folate can also help to 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:

  • blood transfusions
  • removing the spleen
  • removing the gallbladder

Liver disease can often be managed 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.

The outlook for a person with high MCHC varies depending on the underlying cause.

In many cases, making nutritional changes may be sufficient treatment. In some cases, a person may require a blood transfusion or even surgery.

It is essential for anyone with high MCHC to talk with their doctor about the underlying cause and what can be done to lower it.