What is MCH?

Mean Corpuscular Hemoglobin, referred to as MCH, is a crucial parameter in a Complete Blood Count (CBC). It calculates the average amount of hemoglobin present in each red blood cell. Hemoglobin is a vital protein responsible for transporting oxygen from the lungs to body tissues and eliminating carbon dioxide. An MCH test is commonly employed to evaluate the size and hemoglobin content of red blood cells, aiding in the diagnosis and monitoring of various health conditions.

Causes of Low MCH

Low MCH levels, medically known as hypochromia, can be attributed to several underlying factors. Here are some prevalent causes:

1. Iron Deficiency:

Iron deficiency is the most common cause of low MCH. Iron serves as an essential component in the synthesis of hemoglobin. When iron stores are depleted, red blood cells become smaller in size and have lower hemoglobin content, leading to decreased MCH levels. Iron deficiency can result from inadequate dietary intake, impaired iron absorption, or blood loss.

2. Thalassemia:

Thalassemia is an inherited blood disorder characterized by reduced or absent production of one or more globin chains, the building blocks of hemoglobin. This abnormality leads to the formation of defective hemoglobin and smaller red blood cells with decreased hemoglobin content, resulting in low MCH levels.

3. Sideroblastic Anemia:

Sideroblastic anemia is a group of disorders characterized by defective heme synthesis, the iron-containing component of hemoglobin. This defect leads to the accumulation of iron within red blood cell precursors, hindering the production of functional hemoglobin. Consequently, red blood cells become hypochromic and microcytic, resulting in low MCH levels.

4. Lead Poisoning:

Lead poisoning, primarily caused by high levels of lead in the body, can interfere with hemoglobin synthesis. Lead inhibits the production of heme and can damage developing red blood cells, leading to decreased hemoglobin content and reduced MCH levels.

5. Chronic Diseases:

Certain chronic diseases, such as chronic kidney disease, inflammatory bowel disease, and rheumatoid arthritis, can disrupt red blood cell production and metabolism. These conditions may result in low MCH levels due to impaired hemoglobin synthesis or increased red blood cell destruction.

Symptoms of Low MCH

Individuals with low MCH may experience a range of symptoms, including:

1. Fatigue:

Decreased hemoglobin levels can impair oxygen delivery to body tissues, leading to fatigue, weakness, and shortness of breath, especially during physical exertion.

2. Pale Skin and Mucous Membranes:

The reduced hemoglobin content in red blood cells can manifest as pale skin, lips, nail beds, and mucous membranes, indicating anemia.

3. Brittle Nails:

Low MCH levels can contribute to brittle and spoon-shaped nails, known as koilonychia.

4. Cold Hands and Feet:

Poor oxygen circulation due to low hemoglobin levels can cause cold hands and feet.

5. Difficulty Concentrating:

Reduced oxygen delivery to the brain can affect cognitive function, leading to difficulty concentrating, impaired memory, and decreased attention span.

Treatment for Low MCH

The treatment for low MCH primarily focuses on addressing the underlying cause:

1. Iron Deficiency:

For iron deficiency, iron supplements are prescribed to replenish iron stores and promote hemoglobin production. Dietary modifications to increase iron intake through iron-rich foods, such as red meat, poultry, fish, and leafy green vegetables, are also recommended.

2. Thalassemia:

Treatment for thalassemia varies depending on the severity of the condition. Regular blood transfusions may be necessary to maintain adequate hemoglobin levels. In some cases, bone marrow transplantation may be considered.

3. Sideroblastic Anemia:

Treatment for sideroblastic anemia may involve medications to stimulate red blood cell production or blood transfusions to manage severe anemia.

4. Lead Poisoning:

In cases of lead poisoning, the primary aim is to eliminate the source of lead exposure. Medications may be used to remove lead from the body, and supportive care is provided to manage symptoms and complications.

5. Chronic Diseases:

For chronic diseases associated with low MCH, treatment focuses on managing the underlying condition and mitigating its impact on red blood cell production.


Low MCH levels can be caused by various underlying factors, ranging from iron deficiency to chronic diseases. Understanding the cause of low MCH is crucial for appropriate treatment and management. If you have concerns about your MCH levels or experience symptoms suggestive of anemia, consult your healthcare provider for a comprehensive evaluation and tailored treatment plan.

Frequently Asked Questions

1. Can low MCH cause hair loss?

While low MCH can be associated with fatigue and brittle nails, hair loss is not a typical symptom.

2. How quickly can low MCH be corrected?

The rate of correction depends on the underlying cause. Iron deficiency can be corrected within a few weeks with iron supplements, while other causes may require longer-term treatment.

3. Can low MCH be prevented?

Preventing low MCH involves maintaining a healthy diet rich in iron and other essential nutrients, avoiding exposure to lead, and managing underlying chronic conditions.

4. What is the normal range for MCH?

The normal range for MCH typically falls between 27 and 31 picograms per cell.

5. What are the potential complications of low MCH?

Untreated low MCH can lead to chronic fatigue, heart problems, and delayed growth and development in children.



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