Blood WorkMCH (mean corpuscular hemoglobin) is the average amount of hemoglobin in each red blood cell. It's part of a complete blood count (CBC), and the typical range is about 27 to 33 pg. Low MCH usually travels with small cells and most often means iron deficiency or thalassemia trait; high MCH usually travels with large cells, from low B12 or folate, alcohol, liver disease or thyroid problems.
What does MCH measure?
MCH is the average weight of hemoglobin inside one red blood cell, measured in picograms (pg). It's calculated from your hemoglobin and red cell count. Because bigger cells hold more hemoglobin, MCH almost always moves in the same direction as MCV, so clinicians read the two together, with MCHC.
What is a normal MCH?
| Result | What it usually means |
|---|---|
| Below about 27 pg | Low: often small, pale red cells from iron deficiency or thalassemia trait. |
| About 27 to 33 pg | Typical adult range. |
| Above about 33 pg | High: often large red cells, from B12 or folate deficiency, alcohol, liver or thyroid causes. |
Your lab's printed range applies.
What does low MCH mean?
- Iron deficiency, the most common cause; confirmed with a ferritin test.
- Thalassemia trait, inherited and usually harmless, but worth knowing about before pregnancy.
- Anemia of chronic disease, from long-term inflammation.
In men and in women after menopause, iron deficiency usually needs a check of the stomach and colon for slow bleeding (American Gastroenterological Association).
Call 911 or go to the ER if a low result comes with chest pain, fainting or severe shortness of breath. Get care the same day for black or bloody stools.
What does high MCH mean?
- Low vitamin B12 or folate. See the vitamin deficiency guide.
- Regular alcohol use and liver disease.
- An underactive thyroid.
- Some medicines, such as methotrexate.
If your MCH is off at Passion Health
A Texas-licensed clinician reviews every result and calls you the same day about anything critical. One result outside the range is common and often harmless; we read it with the rest of your panel, your history and your medicines, and recheck when that's the sensible next step.
Low MCH leads to ferritin and iron studies; high MCH leads to B12, folate, thyroid and liver tests. The anemia and iron guide explains the full workup.
MCH test cost in Texas
Self-pay. MCH comes with every complete blood count. In Essential Blood Work ($59) it's part of 33 results with the draw and a clinician's review included; on its own, the complete blood count is $20 plus the $29 draw and review fee ($49).
With insurance. If we're in network with your plan, we bill it when the test is covered. You pay cash for a test only after we tell you the price in writing, and Medicare patients sign an Advance Beneficiary Notice first.
MCH blood test questions
What is MCH in a blood test?
MCH, mean corpuscular hemoglobin, is the average amount of hemoglobin in each red blood cell. It's part of a complete blood count, and the typical range is about 27 to 33 pg.
What does low MCH mean?
Your red cells carry less hemoglobin than usual, most often because of iron deficiency or thalassemia trait. A ferritin test is the usual next step.
What does high MCH mean?
Your red cells are carrying more hemoglobin, usually because they're larger than normal. Low B12 or folate, alcohol, liver disease and an underactive thyroid are common causes.
What is the difference between MCH and MCHC?
MCH is the amount of hemoglobin in each red cell; MCHC is how concentrated that hemoglobin is for the cell's size. MCH follows cell size (MCV), while MCHC stays fairly steady unless cells are pale or abnormally shaped.
Is a slightly abnormal MCH serious?
Usually not on its own, especially with a normal hemoglobin. Your clinician looks at MCH with MCV, hemoglobin and your symptoms, and checks iron, B12 or folate when the pattern suggests it.