TCMH (MCHC): normal value?

MCHC in a blood test allows you to find out the average amount of hemoglobin in an erythrocyte. The index is included in the complex of a complete blood count, is determined by dividing the amount of hemoglobin in grams / 100 ml by the hematocrit, then multiplying the resulting number by 100. The Mchc-index is expressed in g / dl, reflects the concentration of hemoglobin in a single erythrocyte, serves as a reliable reflection of the amount of hemoglobin in the volume of one blood cell.

The mean corpuscular hemoglobin content (TCMH) corresponds to the average hemoglobin content contained in a red blood cell. More specifically, the mean corpuscular hemoglobin concentration (CCMH) represents the average hemoglobin concentration in a red blood cell. Hemoglobin is the protein found in red blood cells, which is responsible for carrying oxygen in the blood and delivering it to organs for proper functioning. Too low a hemoglobin level leads to anemia (iron deficiency).

Description of the analysis

The definition of mchc occurs by calculation, based on basic data, such as hematocrit, obtained from a complete blood count. This index serves as a highly sensitive test for impaired hemoglobin generation processes. The main advantage is that it is independent of the average erythrocyte volume.

In fact, mchc reflects the filling density of red blood cells with hemoglobin, and is a very stable indicator. Therefore, mchc is often used as an indicator of errors in the operation of laboratory equipment. But do not confuse MCHC with MCV, as these are different indicators.

The determination of TCMH and CCMH is carried out in case of suspicion of anemia, that is to say of a decrease in the level of hemoglobin in the blood. Anemia manifests itself by:

• shortness of breath on exertion and then at rest;
• paleness of the face;
• intense and persistent fatigue;
• headaches ;
• dizziness ;
• a feeling of weakness;
• difficulty concentrating;
• lack of motivation;
• or even a decrease in sexual desire.

When the anemia is severe, it can have repercussions on the heart and lungs.

Preparation for analysis

Direct analyzes for mchc are not done; general analysis data (OAC) are used for the calculation. For its implementation, blood is taken from a vein, the amount is up to 3 ml. In the presence of certain indicators, it is possible to take capillary blood, such an analysis is prescribed for children under the age of 3 years, patients with pathologies of the blood coagulation system.

Special preparation for a general blood test is not required. Blood sampling is performed in the morning, on an empty stomach, or at any convenient time of the day. The main condition is not to eat for at least 8 hours before the analysis. You can drink water, but not coffee, tea or sugary drinks.

To increase the reliability of the data obtained 1-2 days before blood sampling, it is recommended to avoid stress, excessive physical and psycho-emotional stress. Drinking alcohol should be avoided.

The mean corpuscular hemoglobin content (TCMH) is measured using a blood sample taken in a medical analysis laboratory. TCMH is calculated by dividing the concentration of hemoglobin in one liter of blood (TCCM) by the number of red blood cells in one liter of blood.

MCHC blood test interpretation

A normal mchc indicator is considered to be from 310 to 380 g / l. Such values ​​are considered the norm for adults of both sexes. In newborns, children, adolescents, the limits of the norm are shifted downward. For children under 1 year old, the average amount of hemoglobin in an erythrocyte at the level of 290-370 g / l is considered the norm.

After the completion of puberty, the normal concentration of iron-containing proteins stabilizes, remains throughout life within certain limits (in the absence of pathologies that can affect this indicator).

It is important to bear in mind that finding the mchc index in the range of normal values ​​does not always mean the absence of pathologies. There are anemia and other diseases that do not manifest themselves as a change in the mchc indicator in a blood test.

Other causes can be at the origin of an increase in the level of TCMH:

• folic acid deficiency;
• vitamin B12 deficiency;
• hyperchromic anemia (discoloration of red blood cells);
• taking certain medications;
• liver disease;
• a parasite;
• the pregnancy ;
• or even thyroid insufficiency.

Conversely, a TCHM that is too low can lead to hypochromic anemia: the red blood cells turn out to be abnormally white, revealing a lack of hemoglobin. Most often due to iron deficiency, this can also be indicative of an inflammatory pathology. In all cases, additional examinations will be carried out to determine the cause of these variations in the rate of TCHM.

MCHC in a blood test is elevated

A high mchc index occurs with an increase in the concentration of iron-containing proteins in red blood cells. Such conditions are usually observed in various genetic pathologies. Most often found:

• hereditary spherocytosis. This is a disease in which the formation of the erythrocyte cytoskeleton is disrupted. As a result, the surface area of ​​the cell membrane decreases, its plasticity is disturbed, and the concentration of hemoglobin in the cell increases significantly. You can learn more about hemoglobin levels here. Spherocytosis often occurs in latent, benign forms, and is detected only during screening diagnostics.
• Sickle cell anemia. One of the most common congenital disorders of the red blood cells. As a result of disturbances in the process of hemoglobin production, erythrocytes acquire an altered shape, the mchc index increases. In such patients, hemoglobin has a different structure from the norm and is less efficient at transporting oxygen. If pathological genes are transmitted from one of the parents, the disease proceeds in a latent or mild form and provides immunity from malaria. When receiving defective genes from the mother and father, sickle cell anemia is severe and can cause serious pathologies and death.
• Hemoglobinosis C. Severe hereditary pathology that develops when both parents receive defective genes that direct the synthesis of erythrocyte proteins. It manifests itself in the form of hemolytic jaundice, chronic anemia, the most common complication is cholelithiasis. Defective hemoglobin is produced by the body in significant quantities, since it carries oxygen worse than normal protein. As a result, a sharp increase in mchc index values ​​is observed.

An increase in the mchc index does not always serve as a signal for the development of pathological processes. This figure may increase during the recovery of the body after severe blood loss. In residents of highlands, an increase in hemoglobin concentration is a variant of the norm, as it serves to compensate for the low oxygen content in the air.

Therefore, professional climbers may experience a significant increase in the mchc index, which, in the absence of other pathological symptoms, should be considered normal.

MCHC low

Deciphering the mchc blood test with a decrease in the index is required much more often. In this case, there is a decrease in the concentration of iron-containing protein in erythrocytes, often so significant that, with direct microscopy, red blood cells become much less saturated in color.

This phenomenon is called blood hypochromia, and anemia that is accompanied by a decrease in this index is called hypochromic. There are quite a few reasons for a decrease in mchc in a blood test, the most common are:

• Iron-deficiency anemia. Occurs when there is a lack of foods enriched with iron in food, or a violation of its absorption in the intestine. It is often found in vegetarians, as large amounts of iron in an easily digestible form are found in meat and other animal products.
• Thalassemia. A hereditary disease associated with the transmission to a child of defective genes responsible for coding hemoglobin protein chains.
• Anemia, which is a symptom of the development of pathologies of the liver, bone marrow, kidneys and other organs.

Another specific condition for which a decrease in mchc levels is a marker is lead poisoning. This toxic metal is dangerous in any concentration, it is widely used in various industries, so the probability of poisoning with it is quite high. Acute forms of poisoning are extremely rare; in chronic forms, this toxic metal gradually accumulates in the bones, nerve tissues, and bone marrow.

Hematopoietic function is suppressed, pathologies of the nervous system develop, kidneys and liver suffer. There are practically no specific symptoms in such poisonings, therefore, if a patient has a decrease in the mchc indicator, the possibility of intoxication with this metal should be taken into account.

The treatment depends on the cause of the too high or too low level of TCMH or CCMH. Thus, in the event of macrocytic anemia, treatment is based on supplementation with folic acid and vitamin B12. The diet must also be adapted to make it possible to fill these deficiencies. Faced with hypochromic anemia, the doctor will prescribe iron tablets for a minimum of three months so that the body can replenish its reserves.