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MCH is an indicator that measures the average hemoglobin content in the blood cell. MCH is measured as part of the blood count, and its result reflects the hemoglobin content of erythrocytes, i.e. red blood cells. When is the MCH blood test performed? What is it and what can a low MCH or too high MCH mean?
MCH – Mean Corpuscular Hemoglobin or Mean Cell Hemoglobin, which translates into Polish as mean hemoglobin mass – it is an important indicator determined in the morphological examination. It determines the average weight of hemoglobin in the red blood cell, i.e. the erythrocyte.
For this reason, MCH, sometimes also referred to as SWH, is included in red cell markers (also called red blood cells or red blood cells).
Red blood cells are classified into normochromic (those with normal MCH levels), hypochromic (low MCH), and hyperchromic (when MCH is too high).
MCH, that is average hemoglobin mass in the red blood cell, tells you how much hemoglobin is in one erythrocyte. The MCH blood test is carried out in parallel with other analyzes that make up the blood count. MCH requires prior determination of the level of hematocrit and hemoglobin in the test blood sample. In order to determine the value of MCH, it is necessary to divide the hemoglobin mass in a given blood volume by the number of blood cells (MCH-Hgb / RBC).
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MCH blood results are expressed in picograms (1 pg is about 10-12 g). Importantly, the MCH index should be interpreted together with the MCHC index. Thanks to their combination, it is possible to accurately determine the amount of hemoglobin in red blood cells.
Unlike the MCV test, MCH does not depend on age or gender – the norm is a result in the range of 27-32 pg. However, it is important to be aware that pregnancy and menstruation can affect MCH results in women.
Do you need interpretation of test results? Are you worried about your symptoms? Contact your doctor. Make an online teleconsultation with your family doctor at haloDoctor.pl to get answers to your questions.
Also read: What is low hematocrit associated with?
MCH blood test – preparation
MCH is a parameter that is determined during a routine blood count. Together with other indicators, it is used for the initial diagnosis of general health. Samples for morphology are taken from the ulnar vein. The patient should come to the test on an empty stomach, so you should refrain from eating for at least 8 hours before the test.
What can falsify the results of the MCH test? In addition to the already mentioned pregnancy and menstruation, changes in blood parameters can also induce sudden significant changes in diet or taking certain medications. So it’s best to ask your doctor if we should stop taking medications and dietary supplements a few days before the MCH test.
Before the test, it is also worth having a good rest and stopping alcohol and cigarettes for a few days. Usually, the waiting time for the morphology result is no longer than a day.
The actual MCH blood result may vary slightly from lab to lab. This is usually because different parameter determination techniques and equipment are used. Therefore, it is important to consult your doctor about the test result.
Also check: Morphology – when is it worth doing?
When an MCH result is below normal, it is said to be microcytosis or hyponormic red blood cells. Low average weight of hemoglobin in the red blood cell can be a harbinger of various health problems – most often there are several conditions at stake.
- Iron deficiency anemia. With an insufficient amount of iron in the body, the erythrocytes produced are too small and contain less hemoglobin – hence low MCH. It is the most common cause of anemia (80% of cases).
- Microcytic anemia accompanying chronic diseases. As a result of the underlying disease, the production of erythrocytes is significantly reduced, and the concentration of iron and transferrin (a protein that transports iron ions to tissues) drops significantly. This type of anemia accompanies various diseases, including cancer, inflammatory diseases or eating disorders.
- Acquired haemolytic anemia. It is a condition caused by autoantibodies against your own red blood cells. This disease may be secondary or idiopathic.
- Water and electrolyte disturbances – e.g. hypotonic overhydration, i.e. excess water in the body with a simultaneous reduced level of sodium in the blood.
- Thalassemia. It is an inherited disease of the nature of haemolytic anemia. In patients with thalassemia, the problem is the incorrect synthesis of globin chains in the hemoglobin molecule. As a result, red blood cells are not formed properly and contain less hemoglobin, and many of them break down in the marrow or in the spleen. So they transport much less oxygen in the body.
MCH lowered it may also result, for example, from long-term use of certain medications (e.g. chloramphenicol) or from alcohol abuse. In the elderly, low MCH may be associated with diseases of the digestive system.
Other erythrocyte blood count indices and the relationships between them also turn out to be important in the diagnosis and differentiation of anemia. In addition to the MCH, the hemoglobin concentration, mean red blood cell volume (MCV), mean erythrocyte hemoglobin concentration (MCHC), red blood cell volume distribution (RDW) and reticulocytes, i.e. the number of immature red blood cells, are also tested.
He will also read: MCHC – mean concentration of hemoglobin in the red blood cell
Elevated MCH, also known as macrocytosis or hypernormic red blood cells, is a condition commonly seen in newborns and infants. In adults, MCH above normal may mean the development of the disease.
- Macrocytic anemia – in the course of macrocytic anemia, red blood cells become too large. This anemia especially occurs in people who are missing vitamin B12 and folic acid. The cause of such deficiencies is sometimes a vegetarian diet: plant products are not always able to meet the full need for these substances. Another cause is (congenital or acquired) problems with the absorption of vitamin B12 in the digestive tract ..
- Congenital spherocytosis (haemolytic anemia). This condition is genetically inherited and is characterized by a mutation in the skeletal proteins that build red blood cells. This changes the shape of the blood cells into spherical ones and weakens the stability of their membranes, which reduces their susceptibility to deformation. The consequence of such a situation is the difficult passage of erythrocytes through the capillaries, which leads to their premature destruction in the spleen.
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Macrocytic anemia accompanied by elevated MCH may also be present:
- w hypothyroidism,
- in people who abuse alcohol,
- at liver problems., such as cirrhosis of the liver.
Although abnormal MCH blood results may indicate various conditions, the interpretation of the results remains the responsibility of the ordering physician.
Even if we perform a laboratory test on our own, we should still go to a doctor’s appointment with the results. The doctor – based on both the results of the morphology and the diagnostic interview – will assess whether everything is okay. If necessary, he will also order additional tests or propose appropriate treatment.
Read also: Reticulocytes – norm, function, diseases