Mean Corpuscular Hemoglobin (MCH)

MCH and mean corpuscular hemoglobin concentration (MCHC) increase and decrease along with mean corpuscular volume (MCV). ​Changes in the MCH and MCHC are significant findings in the diagnosis of cobalamin (vitamin B12), folate (vitamin B9), iron, copper, and pyridoxine (vitamin B6) deficiencies. MCV, MCH, and MCHC should be viewed together. 

MCH Testing

The mean corpuscular hemoglobin (MCH) test measures the average amount of hemoglobin in a single red blood cell. The MCH value is calculated by dividing the blood's hemoglobin amount by the number of red blood cells.

MCH = Total Hemoglobin/Total RBC

It is an essential component of a complete blood count (CBC).​

There is limited research into normal ranges for MCH, outside of overt disease.

MCH in Pregnancy

MCH levels increase slightly throughout pregnancy, reaching a peak between 30 to 34 weeks. This is explained by increased production and release into circulation of immature red blood cells, which are larger and contain more hemoglobin than older RBCs. This change should coincide with slight differences in MCV and MCHC. 

​After childbirth, there is a physiological adjustment known as postpartum diuresis, where the body eliminates excess fluid. This can result in a transient increase in hemoglobin concentration, including MCH levels, as the blood becomes more concentrated. Excessive bleeding during delivery may contribute to a drop in hemoglobin and MCH levels.

High MCH in Pregnancy

There is limited data on the application of this indice in pregnancy.

Most Common Causes of High MCH in Pregnancy 

• Vitamin B12 (Cobalamin) Deficiency
• Vitamin B9 (Folate) Deficiency
• Hypothyroidism
• Hypoxia
• Sleep Apnea
• Dehydration
• Myeloproliferative Diseases (Polycythemia)

Low MCH in Pregnancy

There is limited data on the application of this indice in pregnancy.

Most Common Causes of Low MCH in Pregnancy

• Iron Deficiency
• Vitamin B6 (Pyridoxine) Deficiency
• Vitamin C Deficiency
• Heavy Metal Exposure
• Environmental Chemical Exposure
• IBD Conditions (Celiac Disease, Crohn's Disease, Ulcerative Colitis) w/Bleeding
• Gut Pathogens/Parasites
• Hypothyroidism
• Rheumatoid Arthritis

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Medical Disclaimer:
This content is for educational purposes only and is intended for licensed medical professionals. It is based on current research, subject to change, and not intended to diagnose, treat, or prevent any medical condition. This information does not replace consultation with a qualified healthcare provider. Seek professional medical evaluation and treatment from a licensed provider. Use of this information is at your own risk.​

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