MCH Blood Test: High & Low Levels + Normal Range

What Are Red Blood Cell Indices?

MCH Blood Test: High & Low Levels + Normal Range

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If you are looking at your red blood cell count on a complete blood count (CBC), you may see a number of different initials included along with the total count. The red blood cell indices, called MCHC, MCV, MCH, and RDW give further information about your red blood cells and can be helpful in determining the cause of anemia and other medical conditions.

Let's take a look at the information contained in your CBC) including your red blood cell count, and then discuss the meaning and importance of each of these indices.

The complete blood count (CBC) is a blood test ordered by your doctor to evaluate the composition and quality of the blood cells in your body. These blood cells include:

  • White blood cells (leukocytes) which help fight infection
  • Red blood cells (erythrocytes) which distribute oxygen throughout the body
  • Platelets (thrombocytes) which clot blood

The red blood cell count (RBC) is the number of red blood cells that are found in your blood. A normal RBC count depends on age and gender:

  • For women, 4.2 – 5.4 million/mcL
  • For men, 4.7 – 6.1 million/mcL
  • For children 4.1 – 5.5 million/mcL

A low red blood cell count is referred to as anemia. There are many different causes of anemia, of which iron deficiency is only one. Red blood cell indices are very helpful in distinguishing these different causes.

An elevated red blood cell count is called erythrocytosis or polycythemia.

Causes may include dehydration (in which the level isn't actually high, but appears that way due to less fluid volume in the blood), a need for greater oxygen-carrying capacity of the blood, such as living at high altitudes, COPD, or heart failure, and an increased production of red cells in the bone marrow due to conditions such as polycythemia vera.

While looking at the total RBC count can tell you if your number of red blood cells is low, normal, or high, it doesn't tell you why the count is abnormal. Hence the need for further evaluation of these cells. Even if the RBC count is normal, looking at the RBC indices can sometimes give important clues in diagnosing medical conditions.

Along with the total RBC count, the RBC indices provide information about the size and quality of your red blood cells. This can be used to diagnose the cause and severity of anemia and provide vital clues about other health conditions you may have.

The RBC indices are comprised of four different components known as the mean corpuscular hemoglobin concentration (MCHC), the mean corpuscular volume (MCV), the mean corpuscular hemoglobin (MCH), and the red cell distribution width (RDW).

The mean corpuscular hemoglobin concentration (MCHC) is the average concentration of hemoglobin in red blood cells.

Hemoglobin is the iron-carrying protein in red blood cells whose function it is to carry oxygen. It is also the element that gives red blood cells their color. Any alternation in concentration can cause the cells to appear more or less red.

The MCHC basically tells you whether a person's red blood cells have more or less hemoglobin than what would be expected. A normal range for MCHC is between 32 and 36 grams per deciliter in adults. Any value outside of the reference range is defined as follows:

When the MCHC is high, the red cells are referred to as being hyperchromic. Possible causes of a high MCHC (which is uncommon) include:

  • Autoimmune hemolytic anemia, a condition in which the bodies immune system attacks its own red blood cells
  • Hereditary spherocytosis, a genetic condition characterized by anemia and gallstones

When the MCHC is low, the cells are referred to as being hypochromic. Possible causes include:

Whether hyperchromic or hypochromic, treatment is primarily focused on treating the underlying condition.

Iron supplementation and the increased dietary of intake of iron can help treat iron deficiency anemia, but an iron supplement is not recommended for people who are not iron deficient (excess iron can be stored in the liver and heart). Blood transfusions may be used in more severe cases.

Mean corpuscular volume (MCV) measures the average red blood cell volume, meaning the actual size of the cells themselves.

A normal range for MCV is between 80 and 96 femtoliters per cell.

A low MCV indicates that the red blood cells are small, or microcytic. Possible causes include:

  • Iron deficiency
  • Lead poisoning
  • Thalassemia (the thalassemias are genetic disorders characterized by abnormal hemoglobin)

A high MCV implies the red blood cells are larger than normal, or macrocytic. Causes of macrocytic anemia include:

  • Vitamin B12 deficiency
  • Folate deficiency (both vitamin B12 deficiency and folate deficiencies are also called megaloblastic anemia, due to the macrocytic RBCs)
  • Liver disease
  • Alcoholism
  • Hypothyroidism
  • Medications such as chemotherapy drugs and retroviral therapies for HIV

It's important to note that a person can have anemia and have a normal MCV. This is called a normocytic anemia. Causes may include:

  • Sudden blood loss
  • Kidney failure
  • Hemolytic anemia
  • Nutritional deficiencies
  • Anemia of chronic disease
  • Rheumatoid arthritis
  • Giant cell arteritis

Mean corpuscular hemoglobin (MCH) is the average amount of hemoglobin per red blood cell in a sample of blood. A normal range for MCH is between 27 and 32 picograms per cell.

The MCH value directly parallels the MCV value, and some physicians find that the test is redundant. As such, if the size of the red blood cells is large (as measured by the MCV), the amount of hemoglobin per red blood cells will be high (as measured by the MCH), and vice versa.

While the MCH can be used alone to determine if the anemia is hyper-, hypo-, or normocytic, the MCV has to be considered along with the MCH since the cell volume directly affects the content of hemoglobin per cell.

Red cell distribution width (RDW) is a test which reflects the variability in size of the red blood cells (and is proportionate the standard deviation of the MCV). A normal RDW would mean that the red blood cells are all similar in size, whereas a higher RDW means that there is more variability in size of the red blood cells.

Some physicians believe that RDW is one of the most helpful red cell indices in making diagnoses.

Aside from its role in helping to diagnose anemia, an elevated RDW may predict the presence of coronary artery disease in people with high blood pressure.

 It also provides clues to an early nutritional deficiency which may not be noted with the other tests alone. Finally, it a good test for determining if further testing is needed, such as a peripheral blood smear.

A normal range for RDW is 11.5 to 14.5 percent.

RDW is most helpful when evaluated along with MCV. An example of some causes include:

High RDW and low MCV (microcytic):

  • Iron deficiency anemia
  • Sickle cell anemia

High RDW and normal MCV (normocytic):

  • Iron deficiency anemia
  • Combined anemias
  • Hemorrhage (a few days later)
  • Hemoglobin variants

High RDW and high MCV (macrocytic):

  • Vitamin B12 deficiency
  • Folate deficiency
  • Cold agglutinin disease
  • Myelodysplastic syndrome
  • Immune hemolytic anemia
  • Liver disease (chronic)
  • Aplastic anemia
  • Alcohol-related
  • Anemia of chronic disease
  • Some types of thalassemia
  • Some abnormal hemoglobins

It's important to note that these are only a few examples, and there are many possibilities.

A CBC is a standard blood test and includes the red blood cell count in addition to white blood cell count and platelets. The red blood cell count can tell doctors about the number of red blood cells you have but says little about the reason for any abnormalities.

RBC indices, by looking at the characteristics of red blood cells, are helpful in not only figuring out the cause of anemia but in diagnosing medical conditions even when the red blood cell count is normal.

The combination of these indices also gives important clues in narrowing down anemia. The examples given above are only a few of the possible causes, and determining the precise cause of anemia is sometimes very challenging. These blood tests are best used in combination with a careful history, a thorough physical exam, and any imaging tests which are indicated.

Learning about these blood tests can help you ask your doctor questions so that you thoroughly understand either a diagnosis she has made, or further testing she is recommending.

Increasingly, people are being called on to be an active participant in their health care, and learning how to make informed decisions about their health.

Taking the time to learn about your lab values can help you be empowered in making the choices that are best for you alone.

Source: https://www.verywellhealth.com/mean-corpuscular-hemoglobin-concentration-797200

What is MCH blood test and What does it mean

MCH Blood Test: High & Low Levels + Normal Range

If a person is not feeling well and visited the doctor’s office or hospital, one of the tests ordered is CBC or complete blood count. It checks various components of the blood so as to give the doctor a general overview of the patient’s health. The result of the test is used as a basis for diagnosing and treating the patient’s condition.

One of the blood components measured in the routine blood check is MCH. It stands for Mean Corpuscular Hemoglobin. It measures the amount of hemoglobin present in red blood cells. It is checked to diagnosed blood and iron-related disorders. What is hemoglobin? It is a protein that stores oxygen. It enables your blood to transport oxygen throughout the body.

The mean corpuscular hemoglobin is one of the three red blood cell indices. The other two are MCV and MCHC. A special machine is used to determine the level of MCH in the blood. (1, 2, 3, 4, and 5)

Image 1: The image shows the level of MCH; a proportion of hemoglobin to red blood cells.
Picture Source: healthtestingcenters.com

How to calculate the level of MCH?

The level of MCH is calculated by multiplying the number of hemoglobin in a particular volume of blood by ten and divide by the number of red blood cells. (4)

Image 2: The formula used to calculate MCH level.
Picture Source: slidesharecdn.com

What is the Normal MCH level?

The normal MCH reading is between 27 and 31 pg per cell. The reading is low if it falls below 25 and high if it is 35 or higher. (5)

What does a low MCH mean?

If the MCH level is low, it means that the red blood cells are smaller than normal. The condition is called microcytosis. What’s even alarming is that symptoms do not show up until the condition gets severe.

If the MCH reading is lower than the usual, other blood parameters have to be checked to come up with an accurate diagnosis. Such tests include iron markers, MCV, and RDW. (4, 5, and 6)

A patient with an extremely low MCH level may experience the following:

  • Easy fatigability
  • Loss of stamina
  • Shortness of breathe
  • Dizziness
  • Tiredness even with just minimal effort
  • Weakness
  • The skin becomes pale or yellowish
  • The patient gets bruised easily (5, 6, and 7)

Image 3:Anemia is one of the leading causes of low MCH reading.
Picture Source: 
plantbasedpharmacist.com

Image 4: Thalassemia is also linked with the decrease in MCH reading.
Picture Source: 
ghr.nlm.nih.gov

What are the possible reasons behind low MCH reading?

  1. Iron deficiency anemia – It is one of the reasons for having a low MCH. In a study made, about 82% of patients who have a low MCH have iron deficiency anemia and most of them have Celiac disease too.

    This condition leads to the poor absorption of iron leading to iron deficiency anemia.

  2. Thalassemia – It is a blood-related disorder characterized by abnormal hemoglobin in the blood causing the MCH level to go down.

    (6, 7, and 8)

What can you do to normalize the level of MCH?

  1. Watch your diet – Make sure you eat a healthy and balanced diet. Increase your intake of iron-rich foods to prevent the possibility of having iron deficiency anemia. Rich sources of iron are:
    1. Eggs
    2. Meat
    3. Liver
    4. Nuts
    5. Edible seeds
    6. Tofu
    7. Whole grains
    8. Dried fruits (3, 5)

Foods to avoid

These foods decrease the absorption of iron into the body:

2. Take iron supplements – If you are a vegetarian and you can’t include meat products in your diet, the best thing to do is to take iron supplements.

3. Blood transfusion – If the symptoms are severe such as severe blood loss, your doctor will order a blood transfusion to compensate for the blood loss. (6, 8, 9, and 10)

What does a high MCH mean?

If your MCH level is high, it means that your red blood cell is bigger than the usual. The condition is called macrocytic, which is associated with an underlying medical condition.

A high MCH level can go unnoticed for a long period of time until such time that the condition gets wore and symptoms began to appear. These include the following:

  • Paleness of the skin
  • Easily gets tired
  • Rapid beating of the heart
  • Confusion
  • Inability to concentrate
  • Nails get brittle and break easily
  • Memory loss
  • Digestive-related issues such as diarrhea
  • Loss of appetite leading to drastic weight loss
  • Nausea with or without vomiting
  • Smooth/sensitive tongue (3, 5, and 9)

Image 5: MCH is dramatically high in patients with megaloblastic anemia.
Picture Source: 
medindia.net

What causes a high MCH level?

  1. Megaloblastic Anemia – It is caused by a deficiency in vitamin B 12 or folate.
  2. Vices – Those who have a lot of vices such as chronic smoking and heavy alcohol consumption have higher chances of having a high MCH level than those who lead a healthy lifestyle.
  3. Malaria infection – Infections caused by Falciparum malaria have a high MCH level. (1, 4, and 9)

How to bring down  the MCH level?

  • Diet – What you eat plays a vital role in normalizing the level of MCH. To bring down a high MCH level, you should increase your intake of foods rich in folate and vitamin B12 such as:
    • Green leafy vegetables
    • Meat products, especially chicken, beef, lamb, and turkey
    • Dairy products milk and yogurt
    • Pork liver
  • Live healthy – Improve your way of life.
    • Reduce your intake of alcoholic beverages.
    • Cut or totally stop smoking.
    • Consider taking supplements such as vitamin B12 and folate. (4, 5, 9, and 10)

Outlook

To determine the outlook of the patient with MCH abnormalities, the underlying condition has to be established. If it is caused by iron deficiency anemia, the outlook is good as it can be easily corrected through diet, supplement, and lifestyle modification.

If the underlying cause is thalassemia, you might need to undergo a regular blood transfusion, especially if the condition is severe. It is important to consult your primary care physician to determine the underlying cause and come up with a better solution. That way, your outlook or prognosis can be improved significantly. (4, 6, and 9)

References

  • What is Anisocytosis ? Causes, Types and Vs Poikilocytosis
  • RDW Blood Test – Normal Range, Causes and what does it mean when it is high and low
  • MPV Blood Test – Normal range, Results, Interpretation (High and Low)
  • Target Cells – Causes, Examples and Images
  • Variations in Red Blood Cell Morphology : Size, Shape, Color and Inclusion Bodies

Source: https://laboratoryinfo.com/mch-blood-test/

MCV (Mean Corpuscular Volume): MedlinePlus Lab Test Information

MCH Blood Test: High & Low Levels + Normal Range
URL of this page: https://medlineplus.gov/lab-tests/mcv-mean-corpuscular-volume/

MCV stands for mean corpuscular volume. There are three main types of corpuscles (blood cells) in your blood–red blood cells, white blood cells, and platelets.

An MCV blood test measures the average size of your red blood cells, also known as erythrocytes. Red blood cells move oxygen from your lungs to every cell in your body. Your cells need oxygen to grow, reproduce, and stay healthy.

If your red blood cells are too small or too large, it could be a sign of a blood disorder such as anemia, a vitamin deficiency, or other medical condition.

Other names: CBC with differential

An MCV blood test is often part of a complete blood count (CBC), a routine screening test that measures many different components of your blood, including red cells. It may also be used to diagnose or monitor certain blood disorders.

Your health care provider may have ordered a complete blood count, which includes an MCV test, as part of your regular checkup or if you have symptoms of a blood disorder. These symptoms include:

  • Fatigue
  • Unusual bleeding or bruising
  • Cold hands and feet
  • Pale skin

During the test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

You don't need any special preparations for an MCV blood test. If your health care provider has ordered more tests on your blood sample, you may need to fast (not eat or drink) for several hours before the test. Your health care provider will let you know if there are any special instructions to follow.

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

If your results show that your red blood cells are smaller than normal, it may indicate:

  • Iron-deficiency anemia or other types of anemia
    • Anemia is a condition in which your blood has a lower than normal amount of red blood cells. Iron-deficiency anemia is the most common form of anemia.
  • Thalassemia, an inherited disease that can cause severe anemia

If your results show that your red blood cells are larger than normal, it may indicate:

If your MCV levels are not in the normal range, it doesn't necessarily mean that you have a medical problem needing treatment. Diet, activity level, medicines, a women's menstrual cycle, and other considerations can affect the results. Talk to your health care provider to learn what your results mean.

If your health care provider suspects you have anemia or another blood disorder, he or she may order additional tests of your red blood cells. These include a red blood cell count and measurements of hemoglobin.

  1. American Society of Hematology [Internet]. Washington D.C.: American Society of Hematology; c2017. Anemia [cited 2017 Mar 28]; [about 3 screens]. Available from: http://www.hematology.org/Patients/Anemia 
  2. Bawane V, Chavan RJ. Effect of Low Count of Leukocytes In The Rural People. International Journal of Innovative Research & Development [Internet]. 2013 Oct [cited 2017 Mar 28]; 10(2):111–16. Available from: www.ijird.com/index.php/ijird/article/download/39419/31539  
  3. Hinkle J, Cheever K. Brunner & Suddarth’s Handbook of Laboratory and Diagnostic Tests. 2nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Red Cell Indices; 451 p.
  4. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2017. Anemia [updated 2016 Jun 18; cited 2017 Mar 28]; [about 2 screens]. Available from: https://labtestsonline.org/understanding/conditions/anemia/start/4
  5. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2017. Complete Blood Count: The Test [updated 2015 Jun 25; cited 2017 Mar 28]; [about 4 screens]. Available from: https://labtestsonline.org/understanding/analytes/cbc/tab/test
  6. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2017. Complete Blood Count: The Test Sample [updated 2015 Jun 25; cited 2017 Mar 28]; [about 3 screens]. Available from: https://labtestsonline.org/understanding/analytes/cbc/tab/sample
  7. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; How Are Thalessemias Diagnosed? [updated 2012 Jul 3; cited 2017 Mar 28]; [about 7 screens]. Available from: https://www.nhlbi.nih.gov/health/health-topics/topics/thalassemia/diagnosis 
  8. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; How is Anemia Diagnosed? [updated 2012 May 18; cited 2017 Mar 28]; [about 7 screens]. Available from: https://www.nhlbi.nih.gov/health/health-topics/topics/anemia/diagnosis 
  9. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Types of Blood Tests [updated 2012 Jan 6; cited 2017 Mar 28]; [about 2 screens]. Available from: https://www.nhlbi.nih.gov/health/health-topics/topics/bdt/types 
  10. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; What Are Thalessemias? [updated 2012 Jul 3; cited 2017 Mar 28]; [about 3 screens]. Available from: https://www.nhlbi.nih.gov/health/health-topics/topics/thalassemia 
  11. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; What Are the Risks of Blood Tests? [updated 2012 Jan 6; cited 2017 Mar 28]; [about 5 screens]. Available from: https://www.nhlbi.nih.gov/health/health-topics/topics/bdt/risks 
  12. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; What is Iron Deficiency Anemia? [updated 2014 Mar 16; cited 2017 Mar 28]; [about 2 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/topics/ida 
  13. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; What Do Blood Tests Show? [updated 2012 Jan 6; cited 2017 Mar 28]; [about 6 screens]. Available from: http://www.nhlbi.nih.gov/health/health-topics/topics/bdt/show
  14. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; What To Expect with Blood Tests [updated 2012 Jan 6; cited 2017 Mar 28; [about 4 screens]. Available from: https://www.nhlbi.nih.gov/health/health-topics/topics/bdt/with
  15. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2017. Health Encyclopedia: Complete Blood Count with Differential [cited 2017 Mar 28]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=complete_blood_count_w_differentia 

Source: https://medlineplus.gov/lab-tests/mcv-mean-corpuscular-volume/

Understanding Blood Counts | Leukemia and Lymphoma Society of Canada

MCH Blood Test: High & Low Levels + Normal Range

Blood cell counts give your doctor important clues about the state of your health before, during and after treatment. Blood counts alone can't determine whether you have a blood cancer, but they can alert your doctor if further testing is needed.

Your blood count (the number and types of cells circulating in your blood) is measured using laboratory tests that require a small blood sample.

Blood is composed of several types of cells:

  • Red cells, sometimes referred to as erythrocytes, pick up oxygen as blood passes through the lungs and release it to the cells in the body.
  • White cells, sometimes referred to as leukocytes, help fight bacteria and viruses.
  • Platelets help your blood clot in response to a cut or a wound.

A CBC also tests hemoglobin and hematocrit:

  • Hemoglobin is a protein used by red cells to distribute oxygen to other tissues and cells in the body.
  • Hematocrit refers to the amount of your blood that's occupied by red cells.

Normal Blood Counts

Normal blood counts fall within a range established by testing healthy men and women of all ages. The cell counts are compared to those of healthy individuals of similar age and sex. Nearly all lab reports include a “normal” range or high and low “values” to help you understand test results.

  Red Blood Cells  (per litre tera/L) White Blood Cells  (per litre of blood giga/L) Platelets  (per litre of blood giga/L) Hematocrit1; (% of blood composed of red cells) Hemoglobin1 (Substance in red blood cells that carries oxygen) (grams per litre of blood g/gL)  
Men4.7 to 6.1 million5.0 to 10150 to 40042% to 52%140 to 180
Women24.2 to 5.4 million4.5 to 11.0150 to 40037% to 47%140 to 180
Children34.5 to 5.0 million5.0 to 10.0150 to 40032% to 44%95 to 55

1The ratio of hematocrit to hemoglobin is about 3 to 1.
2Normal ranges for women who are pregnant differ from these ranges.
3These ranges are for children from infancy to adolescence; speak with your doctor to find out specific values for infants and young children.

White Cell Differential

Differential count, sometimes referred to as a “diff,” is a breakdown of the different types of white cells. A white cell (WBC) differential also checks whether white cells appear normal. The five types of white cells and the approximate percentage they make up in the blood are:

  • Neutrophils (55% to 70%)
  • Band neutrophils (0% to 3%)
  • Lymphocytes (20% to 40%)
  • Monocytes (2% to 8%)
  • Eosinophils (1% to 4%)
  • Basophils (0.5% to 1%)

Until children are more than 4 years old, they have a higher percentage of lymphocytes in their blood than adults do.

How Blood Cancers Affect Blood Counts

Blood cancers can affect blood cell counts in a number of ways, either lowering or increasing measurements. If you're currently receiving cancer treatment such as chemotherapy, drug therapy or radiation, your blood counts will be affected. Blood counts usually return to normal after treatment is complete.

Should You Keep Track of Your Blood Counts?

Some people want to know the results of their blood count tests so they can take preventive measures to protect their health or to what's causing their symptoms. For example:

  • If you have anemia as a result of low red cell counts, you'll understand why you have low energy levels or are unable to carry out everyday tasks.
  • If you have low white cell counts and develop a fever, you'll know to contact your doctor promptly.
  • If your platelet counts are too low, you can bleed or bruise easily, so you may choose to avoid activities that have a risk of injury.

Noncancerous Conditions

About 5 percent of healthy people will have test results outside of the “normal” range. If one or more of your blood cell counts is higher or lower than normal, your doctor will try to find out why. Many noncancerous conditions can contribute to low or high blood cell counts, such as those in the table below.

  Red Cells White Cells Platelets
High counts
  • Smoking
  • Carbon monoxide exposure
  • Chronic lung disease
  • Kidney disease
  • Certain forms of heart disease
  • Alcoholism
  • Liver disease
  • Conditions that affect the body's fluid level
  • Infection
  • Inflammation
  • Severe physical or emotional stress (such as fever, injury or surgery)
  • Burns
  • Kidney failure
  • Lupus
  • Rheumatoid arthritis
  • Malnutrition, thyroid problems
  • Certain medicines
  • Bleeding
  • Mild to moderate iron deficiency
  • Problems with bone marrow function
Low counts
  • Anemia from too little iron, folic acid or vitamin B12
  • Bleeding
  • Inflammatory bowel disease
  • Other diseases that might cause malnutrition
  • Certain drugs
  • Infection
  • Chemotherapy and other medicines
  • Malaria
  • Alcoholism
  • AIDS
  • Lupus
  • Enlarged spleen
  • Pregnancy
  • Idiopathic thrombocytopenic purpura
  • Thrombotic thrombocytopenic purpura
  • Hemolytic uremic syndrome
  • Autoimmune diseases

Source: https://www.llscanada.org/managing-your-cancer/lab-and-imaging-tests/understanding-blood-counts

RBC Indices

MCH Blood Test: High & Low Levels + Normal Range

Red blood cell (RBC) indices are part of the complete blood count (CBC) test. They are used to help diagnose the cause of anemia, a condition in which there are too few red blood cells.

The indices include:

  • Average red blood cell size (MCV)
  • Hemoglobin amount per red blood cell (MCH)
  • The amount of hemoglobin relative to the size of the cell (hemoglobin concentration) per red blood cell (MCHC)

Alternative Names

Erythrocyte indices; Blood indices; Mean corpuscular hemoglobin (MCH); Mean corpuscular hemoglobin concentration (MCHC); Mean corpuscular volume (MCV); Red blood cell indices

How the Test will Feel

When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or a slight bruise. This soon goes away.

Why the Test is Performed

Hemoglobin transports oxygen. RBCs carry hemoglobin and oxygen to our body's cells. The RBC indices test measures how well the RBCs do this. The results are used to diagnose different types of anemia.

Normal Results

These test results are in the normal range:

  • MCV: 80 to 100 femtoliter
  • MCH: 27 to 31 picograms/cell
  • MCHC: 32 to 36 grams/deciliter (g/dL) or 320 to 360 grams per liter (g/L)

The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or may test different samples. Talk to your health care provider about the meaning of your specific test results.

What Abnormal Results Mean

These test results indicate the type of anemia:

  • MCV below normal. Microcytic anemia (may be due to low iron levels, lead poisoning, or thalassemia).
  • MCV normal. Normocytic anemia (may be due to sudden blood loss, long-term diseases, kidney failure, aplastic anemia, or man-made heart valves).
  • MCV above normal. Macrocytic anemia (may be due to low folate or B12 levels, or chemotherapy).
  • MCH below normal. Hypochromic anemia (often due to low iron levels).
  • MCH normal. Normochromic anemia (may be due to sudden blood loss, long-term diseases, kidney failure, aplastic anemia, or man-made heart valves).
  • MCH above normal. Hyperchromic anemia (may be due to low folate or B12 levels, or chemotherapy).

Risks

There is little risk involved with having your blood taken.Veins and arteries vary in size from one person to another, and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight, but may include:

  • Excessive bleeding
  • Fainting or feeling lightheaded
  • Multiple punctures to locate veins
  • Hematoma (blood buildup under the skin)
  • Infection (a slight risk any time the skin is broken)

References

Bunn HF. Approach to the anemias. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 158.

Chernecky CC, Berger BJ. Blood indices – blood. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. Philadelphia, PA: Elsevier; 2013:217-219.

Vajpayee N, Graham SS, Bem S. Basic examination of blood and bone marrow. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St Louis, MO: Elsevier; 2017:chap 30.

Review Date: 02/18/2018

Source: https://www.ucsfhealth.org/medical-tests/003648

MCH Blood Test: High & Low Levels + Normal Range

MCH Blood Test: High & Low Levels + Normal Range

Mean corpuscular hemoglobin (MCH) measures the amount of hemoglobin in your red blood cells. It can be used to help diagnose blood and iron-related disorders. Keep reading to learn more about the causes of low and high MCH and what you can do to address abnormal levels.

What is Mean Corpuscular Hemoglobin (MCH)?

Mean corpuscular hemoglobin (MCH) is a measure of the average amount of hemoglobin in your red blood cells. Hemoglobin is the protein that stores (binds) oxygen, which is what allows your blood to transport oxygen throughout your body [1, 2].

MCH is normally part of a complete blood count, which measures your hemoglobin, hematocrit, and red blood cell count. Doctors can use MCH to help diagnose different types of anemia [1, 2].

MCH values usually (but not always) parallel those of mean corpuscular volume (MCV), which is a measure of the size of your red blood cells. This means that when your red blood cells increase, MCH usually follows [1]. This makes sense because bigger red blood cells can fit in more hemoglobin.

Normal Range of MCH

The normal range of MCH is usually from 27 – 31 pg [1].

However, what your labs report as a normal range may differ slightly. Some lab-to-lab variability occurs due to differences in equipment, techniques, and chemicals used.

If your value is normal, that doesn’t mean you don’t have a condition such as anemia. There are anemias in which red blood cell size and hemoglobin content are normal (normocytic anemia) [3]. Your doctor will interpret your results in conjunction with your medical history and other test results.

Low MCH

A low mean corpuscular hemoglobin (MCH) means that your red blood cells contain less hemoglobin than normal. This usually also means they are smaller than normal (microcytic) [1].

People with small red blood cells (microcytosis) often do not show any symptoms unless their anemia is severe. Other blood tests can help your doctor determine the cause of microcytosis, such as MCV, RDW, and iron markers [4].

Causes of Low MCH

Causes shown below are commonly associated with low MCH. Work with your doctor or other health care professional to get an accurate diagnosis of the underlying cause.

1) Iron Deficiency

Iron deficiency is one of the most common causes of low MCH [5, 6, 7].

In a study of 830 subjects, 82% of the people who were iron deficient also had low MCH [8].

Iron deficiency is usually due to [5, 6, 9, 10]:

  • Dietary deficiency
  • Gut disorders that decrease nutrient absorption (including that of iron)
  • Toxins that interfere with iron absorption, such as lead

2) Thalassemia

Thalassemia, an inherited blood disorder with abnormal hemoglobin in the blood, also causes low MCH [11, 12].

Increasing MCH

Work with your doctor to determine and treat the cause of low MCH. Attempting to raise MCH artificially may not address underlying health conditions and ultimately may do more harm than good.

If you have a low MCH, your doctor may order additional tests and/or use this result to help make a diagnosis and determine an appropriate course of action, which may or may not include the strategies below.

Diet

Check your iron levels. Make sure you are eating a healthy and nutritious diet in order to prevent iron deficiency.

The foods rich in iron include liver, meat, fish, eggs, tofu, beans, nuts, seeds, whole grains, and dried fruits [5, 6, 13].

However, remember that nutrient deficiencies can also have non-dietary causes, such as bleeding or gut issues (malabsorption), in which case they can’t be corrected by simple dietary adjustments.

Coffee and tea can lower hemoglobin levels by decreasing the absorption of iron into the body. If you have low MCH, you may choose to reduce your intake of caffeine [14, 15].

Finally, vitamin C can significantly increase the absorption of iron from foods. If your iron is low, it’s a good strategy to combine your iron-rich meals with vitamin C sources such as lemon or orange juice. In addition, you can sprinkle lemon juice on your meat and salads [16].

High MCH

A high mean corpuscular hemoglobin (MCH) means that your red blood cells contain more hemoglobin than normal. This usually also means that they are larger than normal (macrocytic) [1].

By themselves, large red blood cells (macrocytosis) don’t seem to cause any symptoms. However, a diagnosis of macrocytosis can help provide information about underlying health conditions that may require treatment [17].

Causes of High MCH

Causes shown below are commonly associated with high MCH. Work with your doctor or other health care professional for an accurate diagnosis of the underlying cause.

1) Anemia due to Vitamin B12 or Folate Deficiency

One of the most common causes of high MCH is megaloblastic anemia. Megaloblastic anemia is often caused by folate (vitamin B9) or vitamin B12 deficiency and may be treated with supplements of the deficient nutrient [1, 18].

2) Heavy Alcohol Intake

Heavy alcohol intake increases MCH levels. Chronic alcohol users have significantly higher MCH levels than non-drinkers [19, 20, 17].

Decreasing MCH

Work with your doctor to determine and treat the cause of high MCH. Attempting to lower MCH artificially may not address underlying health conditions and ultimately do more harm than good.

If you have high MCH, your doctor may order additional tests and/or use this result to help make a diagnosis and determine an appropriate course of action, which may or may not include the strategies below.

Lifestyle

Reducing your alcohol intake can prevent your MCH from becoming too high. Heavy alcohol consumption can decrease folate and vitamin B12 levels. But alcohol can also be toxic to red blood cells in its own right [19, 20, 23, 24].

Smoking has also been linked to lower B12 and folate levels, which in turn are linked to megaloblastic anemia. Smoking is generally very bad for your health, and it may contribute to or aggravate low MCH as well [25, 26].

Supplements

If you are deficient in vitamin B12 or folate, taking supplements can increase your vitamin levels. Doctors often recommend these supplements to patients with megaloblastic anemia; talk to yours before supplementing [27, 28].

Source: https://selfhacked.com/blog/mch-blood-test-high-low-levels-normal-range/

RBC indices

MCH Blood Test: High & Low Levels + Normal Range

Red blood cell (RBC) indices are part of the complete blood count (CBC) test. They are used to help diagnose the cause of anemia, a condition in which there are too few red blood cells.

The indices include:

  • Average red blood cell size (MCV)
  • Hemoglobin amount per red blood cell (MCH)
  • The amount of hemoglobin relative to the size of the cell (hemoglobin concentration) per red blood cell (MCHC)
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