Article updated on 9 December 2023
Tests and blood tests: low MCHC
Sometimes the MCH is confused with the MCHC, but they are two values that indicate two different things. The MCH expresses the average hemoglobin content expressed in terms of weight, which is measured in picograms (pg), while the MCHC expresses the average hemoglobin content in a given concentrated volume of red blood cells and is measured in grams per deciliter of blood.
What is MCHC
The MCHC is a very important value that is used to diagnose hemoglobin dysfunctions and/or alterations and can be measured simply by undergoing a complete blood count. MCHC values also allow diagnosis of possible anemia. This parameter, together with the other corpuscular indices and the quantity of total hemoglobin, becomes very important when cataloging erythrocytes in relation to their hemoglobin concentration. If the MCHC value is low or high, different alterations occur in blood cells.
What does a low MCHC indicate
Typically, red blood cells are normochromic cells with a normal shape with a small area in the center that is slightly lighter than the rest. This happens when you have a normal hemoglobin concentration but when the MCHC values are below the threshold, you have a too low amount of hemoglobin. In this case we speak of hypochromic cells to indicate that under the microscope the lighter area of the red blood cell is much larger than normal.
I symptoms of MCHC low are the classic ones that are found in case of anemia. It is therefore pallor of the face, chronic tiredness and fatigue, difficulty concentrating, shortness of breath, dyspnoea, pain in the left side near the spleen, low body temperature. If you experience these symptoms you should contact your doctor who will prescribe a complete examination to evaluate hemoglobin levels, corpuscular indices and oxygen saturation. There are no specific symptoms for low or high MCHC, but they are always related to the reduction in circulating hemoglobin levels.
The root cause of low MCHC it is a genetic alteration but, in addition to this, the reduction in the production of red blood cells and hemoglobin which can be caused by a lack of intake of substances essential for the synthesis of hemoglobin such as vitamina B12, iron and folic acid. A deficiency of these substances can lead to a significant reduction in red blood cells and therefore to a condition of anemia. Another cause of low MCHC, even if transient, can be pregnancy and it is for this reason that it is recommended to take the right quantities of iron and folic acid during pregnancy.
What to do
In the event that a low MCHC level, in addition to the treatments prescribed by your doctor, it is a good idea to integrate foods and foods that contain iron into your diet, which is one of the most difficult minerals to assimilate, especially for women who lose a lot of blood with menstruation every month. Also to be integrated into the daily diet are foods that contain high levels of vitamin B12, whose assimilation, however, depends on the presence of the intrinsic factor that allows its absorption at the intestinal level.
MCH is counted by dividing the total mass of hemoglobin (in the laboratory report it can be found with the acronym HB) for the number of red blood cells present in a given blood sample (HCT). Having introduced this, let us remember that in a healthy individual the MCH value is generally between 27 and 31 picograms (pg)/cell. However, it is possible that the values are different and, more frequently, lower than this ordinariness range.
If the MCH value is low, i.e. lower than the minimum limit indicated above in 27 pg, it means that your red blood cells are small and can contain little hemoglobin. The result is a condition of microcytic hypochromic anemia, i.e. small red blood cells (microcitica) and not very colorful (hypochromic).
The cause Of these values così bassi can be traced back to numerous determinants. For example, the reason can be one iron deficiency determined following excessive blood loss due to bleeding peptic ulcers, hemorrhoids, intestinal parasites, or even to a situation of sideroblastic anemia, thalassemia or other disorders affecting hemoglobin protein synthesis. Naturally, the MCH value alone cannot however allow us to reach a diagnosis of any pathologies affecting the blood cells. It is therefore useful to integrate this value with other corpuscular indices such as MCV, MCHC.
Therefore, in the hypothesis of low MCH values, what you need to do is, intuitively, contact your trusted doctor with the report issued by the analysis laboratory. It is possible, on the basis of what we have anticipated above, that the doctor will not be able to provide you with particular indications, considering that the low MCH value alone is not a discriminant for the diagnosis of a pathology or alteration affecting the red blood cells. However, he will certainly be able to advise you on any further analyzes to be carried out and, above all, on the cross-reference with other hematocrit values, such as the quantity of total hemoglobin, the number of red blood cells, their shape, and so on.
Unfortunately, the list of determinants that can influence low MCH values it’s pretty broad. It is enough to remember, for example, that a copious loss of blood such as a wound or a heavy menstrual cycle can contribute to a drop in your MCH value. And it is equally understandable that in these conditions it is certainly not possible to talk about a situation of anemia. Finally, remember that often a very low MCH value can also be due to a lack of iron, a mineral which – especially in women – is considered difficult to assimilate, especially for those who are still going through the menstrual cycle and, therefore, are subjected to periodic blood loss.
To find out more, we invite you to contact your doctor and identify with him what to do to restore adequate levels of MCH.
Sources and bibliography
Color Atlas of Clinical Hematology. A. Victor Hoffbrand, Paresh Vyas, Elias Campo, Torsten Haferlach, Keith Gomez; Ed. John Wiley & Sons Inc; 2019
Wintrobe’s Clinical Hematology. John P. Greer, Daniel A. Arber, George M. Rodgers, Bertil E. Glader, Robert T. Means, Alan F. List; Ed. Wolters Kluwer; 2018
Diagnosis of iron-deficient states. Natasha M. Archer, Carlo Brugnar; Critical Reviews in Clinical Laboratory Sciences ; 2015