MCH: What It Says About Your Red Blood Cells

MCH is the average amount of haemoglobin in one red blood cell, calculated from your haemoglobin and red cell count. A low value often points to iron deficiency, a high value to a B12 or folate shortage. Learn what your MCH can mean.

Doctor's Assessment Included

Reference Ranges

See the value that applies to you:

Choose male or female — this range differs by sex.

Enter your age — this range changes with age.

This range also depends on context such as cycle phase or sample material; the highlighted rows apply to your group.

Male Your group

fmol

Low 1.65 Normal 2.1 High

Female Your group

fmol

Low 1.65 Normal 2.1 High

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

MCH (Mean Corpuscular Hemoglobin): what this test measures

MCH stands for mean corpuscular haemoglobin: the average amount of haemoglobin in a single red blood cell. It is not a separate measurement but a number calculated from your haemoglobin and your red blood cell count.

Haemoglobin is the protein that carries oxygen around your body. MCH shows how much of it an average red blood cell contains, expressed in femtomoles.

The value is always assessed together with your MCV and your haemoglobin. Those three numbers together say more about the cause of anaemia than any one of them alone.

MCH (Mean Corpuscular Hemoglobin): why this value matters

MCH helps distinguish between different forms of anaemia. A low haemoglobin shows that something is going on; MCH helps establish what.

A low MCH means your red blood cells carry less haemoglobin than usual. That often fits iron deficiency, and sometimes an inherited trait such as thalassaemia.

A high MCH fits larger red blood cells and can be linked to a shortage of vitamin B12 or folate, or to long-term alcohol use. Your doctor always assesses the value alongside your other blood results.

MCH (Mean Corpuscular Hemoglobin): when is testing worthwhile?

MCH is included automatically in a full blood count. That is often done for complaints such as fatigue, pallor, breathlessness or dizziness, and during a general health check.

It is also a routine check when monitoring anaemia, or a course of iron, vitamin B12 or folate.

You do not need to fast for it. The value comes from the same tube of blood as the rest of your blood count.

MCH (Mean Corpuscular Hemoglobin): symptoms of a high or low value

Low Levels

A low MCH causes no symptoms by itself. What you notice comes from the anaemia underneath it: fatigue, pallor, cold hands and feet, breathlessness on exertion or headaches. With iron deficiency, brittle nails and hair loss also occur. Discuss a low value with your doctor, who will judge whether further investigation is needed.

High Levels

A high MCH causes no symptoms by itself and is usually found by chance. When a shortage of vitamin B12 or folate lies behind it, fatigue, a smooth or sore tongue, tingling in the hands or feet and difficulty concentrating can occur. These complaints develop gradually, which is why they are often noticed late.

MCH (Mean Corpuscular Hemoglobin): lifestyle and this value

What you can do through lifestyle depends on the cause. For a low MCH from iron deficiency, iron-rich food helps: meat, pulses, wholegrain products and green vegetables. Vitamin C with a meal improves absorption, while tea and coffee close to a meal reduce it.

For a high MCH the issue is more often vitamin B12 or folate. B12 is found mainly in animal products, folate in green vegetables, pulses and wholegrain. People eating a vegetarian or vegan diet have a higher chance of B12 deficiency.

Do not start iron or vitamin supplements on your own initiative because of an abnormal value. Too much iron is harmful, and supplements can mask the underlying cause. Discuss the result with your doctor first.

MCH (Mean Corpuscular Hemoglobin): frequently asked questions

What does MCH mean in a blood test?

MCH stands for mean corpuscular haemoglobin: the average amount of haemoglobin in a single red blood cell. It is calculated from your haemoglobin and your red blood cell count, not measured separately.

What is a normal MCH value?

In the Netherlands MCH is reported in femtomoles, with a usual adult range of roughly 1.65 to 2.10 fmol. The range is the same for men and women. Always check the reference range printed on your own result.

What does a low MCH mean?

A low MCH means your red blood cells contain less haemoglobin than usual. Iron deficiency is the most common reason, and an inherited trait such as thalassaemia is another. Your doctor will look at your MCV, ferritin and haemoglobin alongside it.

What does a high MCH mean?

A high MCH fits larger red blood cells and is often linked to a shortage of vitamin B12 or folate. Long-term alcohol use and some thyroid and liver conditions can also raise it. It is assessed together with your MCV.

Do I need to fast for an MCH test?

No. MCH comes from your full blood count, which does not require fasting. If other tests in the same appointment need a fasting sample, follow the instructions provided with your test.

How is MCH calculated?

Your haemoglobin is divided by your red blood cell count. Because Dutch laboratories report haemoglobin in mmol/l and red cells in 10^12/l, the result comes out directly in femtomoles.