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Low MCH: Understanding Its Causes and Research-Based Insights 

By PharmEasy Medical Board +2 more

Key Highlights: 

  • MCH (Mean Corpuscular Haemoglobin) measures the amount of haemoglobin in red blood cells. 
  • MCH levels are determined using a CBC (complete blood count) test. 
  • Low MCH levels often indicate anaemia caused by iron deficiency, vitamin deficiencies, or blood loss. 
  • High MCH levels are commonly associated with vitamin deficiencies, liver diseases, etc. 
  • Management for low MCH could include dietary changes, supplements, and medical therapy. 

Introduction 

The health of your blood can greatly impact your overall health. One of the critical factors that doctors look out for in your blood report is the Mean Corpuscular Haemoglobin (MCH) level. MCH is a measure of the average amount of haemoglobin present in your red blood cells. Haemoglobin is the protein responsible for transporting oxygen to tissues all around your body. 

This article, is designed to be your guide to understanding the causes of low MCH levels, their implications on your health, and the research-based insights available to address them.  

low mch

Determining MCH Levels 

MCH Ranges 

  • Normal MCH values 

For people with good health, MCH values fall between 27-31 picograms (pg) per cell. 

  • Low MCH values 

If MCH drops below 27 pg/cell, it’s seen as too low. This is usually a sign of anaemia or other health problems. 

  • High MCH values 

On the flip side, MCH over 31 pg/cell is too high. Certain health issues could cause this. 

CBC Test 

A CBC (complete blood count) test is a routine test that checks MCH levels, among other things. It aids your healthcare provider in diagnosing anaemia or other blood disorders. 

  • Purpose of a CBC test 

The reasons could be many. Monitoring general health, screening for anaemia, and detecting infections are some. This test looks at red and white blood cells and platelets. 

  • Procedure and diagnosis 

During the CBC, blood is drawn, often from the arm, and sent to a laboratory. The MCH value is calculated by dividing the haemoglobin amount by the number of red blood cells. 

Causes and Symptoms of Low MCH 

Causes of Low MCH 

  • Iron deficiency: Iron shortage from blood loss, poor diet, or poor iron absorption can lower MCH levels. 
  • Vitamin deficiencies: Lack of vital vitamins such as B12 or folic acid can lead to anaemia and bring down MCH levels. 
  • Blood loss: Blood loss can lower MCH levels. Blood loss could be internal, external, or due to heavy menstrual bleeding. 

Symptoms of Low MCH 

The symptoms related to low MCH levels are as follows. 

  • Fatigue: A feeling of tiredness all the time.  
  • Weakness: Loss of muscle strength and energy could be another sign of low MCH levels. 
  • Paleness: A shortage of MCH can cause the skin to become pale. Reducing blood flow or lack of haemoglobin is generally the reason. 
  • Other associated symptoms: Dizziness, cold hands and feet, breathlessness, and chest pain are some other signs linked to low MCH levels. 

Addressing Low MCH: Management Measures 

1. Diet Changes 

Changing your diet may improve your MCH levels. The following foods are to be incorporated in one’s diet.  

  • Iron-rich foods 

By adding more iron-rich foods like red meat, poultry, spinach, and beans to your diet, MCH levels may increase. 

  • Vitamin-rich foods 

Increasing the intake of B12 and folic acid from foods may help raise MCH levels. Fish, eggs, and fortified cereals are great choices. 

2. Supplements 

Supplements might improve your MCH levels. Always incorporate them in your daily routine following your doctor’s advice.  

  • Iron supplements 

To boost your blood’s iron content, your healthcare provider may suggest iron supplements. 

  • Vitamin supplements 

Vitamin B12, folic acid, or vitamin C supplements may also help improve MCH levels. 

3. Medical  therapy 

At times, handling low MCH levels calls for medical therapy which may include the following. 

  • Addressing underlying conditions 

Handling the root cause such as anaemia or other health issues is key to normalizing MCH levels. 

  • Blood transfusions 

In dangerous cases, a person may need blood transfusions if their MCH levels are critically low. 

In my experience, a low haemoglobin concentration, low hematocrit, or low MCH are all considered forms of anaemia. Anaemia during pregnancy is defined as having a haemoglobin concentration of less than 11.0 g/dL during the first trimester and, depending on the guideline used, less than 10.5 or 11.0 g/dL during the second or third trimester.

Dr. Siddharth Gupta, B.A.M.S, M.D

High MCH Levels 

Causes of High MCH 

High MCH levels, too, have different causes which are as follows.  

  • Vitamin deficiencies: A deficiency of vitamins like B12 or folic acid can elevate MCH levels. 
  • Liver diseases: Liver problems such as hepatitis and cirrhosis can also make MCH levels rise.
  • Other factors: It might surprise you, but certain drugs, alcohol intake, and kidney disease can increase MCH levels too. 

Symptoms of High MCH 

Symptoms linked with high MCH levels are as follows.  

  • Fatigue: Tiredness can be a sign of high MCH levels. 
  • Weakness: Muscle weakness along with low energy can indicate high MCH levels. 
  • Other associated symptoms: Troubles like blurred vision, dizziness, or memory loss could be due to high MCH levels. 

Outlook and Managing Abnormal MCH Levels 

Understanding MCH results: Low vs. Normal 

Your doctor is best suited to explain your MCH results and outline the next steps, taking into account your overall health state. 

Complications of abnormal MCH levels 

Both low and high MCH levels can lead to problems. For one, your energy and strength can suffer. In severe cases, low MCH may even result in anaemic hypoxia. This risky condition hampers oxygen delivery to the body tissues. 

When to be concerned about MCH levels? 

When you experience constant fatigue, weakness, or breathlessness it’s time to speak to your doctor. They can detect the cause and map out a sound management plan. 

In my experience, the levels of red blood cells and MCH are notably reduced in malaria patients. This could be because the parasite’s main target is red blood cells (RBCs), which causes the breakdown of RBCs and malfunctioning bone marrow to remove parasitized and non-parasited RBCs more quickly.

Dr. Rajeev Singh, BAMS

Conclusion 

MCH levels are a crucial aspect of understanding your overall health and evaluating the risk of  anaemia. Whether you have low or high MCH levels, it’s essential to work closely with your healthcare provider to determine the root cause and develop an appropriate management plan. Remember, addressing nutritional deficiencies and making positive lifestyle changes which may significantly impact both your MCH levels and overall well-being. 

Frequently Asked Questions (FAQs) 

What does it mean if my MCH is low? 

Low MCH could be due to  anaemia from iron deficiency, lack of vitamins, or blood loss. It’s vital to speak with your healthcare provider to figure out the reason and the right  management. 

What does it mean if my MCH is high? 

 High MCH might be because of vitamin  deficiencies, liver diseases, or other factors like kidney disease or certain drugs. Discussing your test results with your doctor and forming a proper management plan is key. 

How do you treat low haemoglobin? 

 Diet changes, iron, and vitamin supplements, or medical therapy may help fix low haemoglobin levels. It depends on what’s causing the low levels. Your healthcare provider can craft a suitable management plan. 

Should I worry if my MCH is low? 

If you are worried about your low MCH, talk to your doctor. They can identify the cause and decide the best course of action. 

Can low MCH cause fatigue? 

 Yes, low MCH can lead to fatigue. This is because less haemoglobin in red blood cells reduces the oxygen supply to body tissues, leading to tiredness. 

Can MCHC be low without anaemia? 

 Low MCHC usually points to anaemia, but not always. Some people might show low MCHC without meeting the criteria for anaemia. It’s crucial to speak to your healthcare provider to understand your health status and discuss concerns. 

References: 

  1. National Center for Biotechnology Information (NCBI). Macrocytosis [Internet]. [cited 2024 Feb 13]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560908 
  1. National Health Service (NHS). Iron – Vitamins and minerals [Internet]. [cited 2024 Feb 13]. Available from: https://www.nhs.uk/conditions/vitamins-and-minerals/iron 
  1. National Center for Biotechnology Information (NCBI). Successful Treatment of Severe Anaemia using Erythropoietin in a Jehovah Witness with Non-Hodgkin Lymphoma – PMC [Internet]. [cited 2024 Feb 13]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274479 
  1. National Health Service (NHS). Iron deficiency anaemia [Internet]. [cited 2024 Feb 13]. Available from: https://www.nhs.uk/conditions/iron-deficiency-anaemia 
  1. PubMed. Red Cell Indices [Internet]. [cited 2024 Feb 13]. Available from: https://pubmed.ncbi.nlm.nih.gov/21250103 
  1. National Center for Biotechnology Information (NCBI). Iron Deficiency Anaemia [Internet]. [cited 2024 Feb 13]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448065 

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