Blood Health
MCH
What This Marker Tells Us
Measures the average amount of hemoglobin contained in each red blood cell, reflecting how much oxygen-carrying capacity each cell possesses.
Why It Matters
MCH parallels MCV because larger cells generally contain more hemoglobin while smaller cells contain less. Low MCH indicates hypochromic (pale) cells with insufficient hemoglobin, typically from iron deficiency, thalassemia, or chronic disease; these cells can't carry as much oxygen. High MCH occurs with macrocytic cells in B12 or folate deficiency. MCH is less commonly used than MCV for classification because it provides similar information, but abnormal MCH confirms that cell size changes are accompanied by proportional hemoglobin changes. MCH helps distinguish iron deficiency (low MCH) from thalassemia trait (low MCV but relatively normal MCH) and confirms hemoglobin content matches cell size.
How to Interpret Your Trends
Normal MCH is approximately 27-33 picograms per cell. Low MCH (below 27 pg) indicates iron deficiency or thalassemia, producing pale cells with reduced oxygen-carrying capacity. This typically accompanies low MCV and suggests the same conditions. High MCH (above 33 pg) indicates macrocytic cells typically from B12 or folate deficiency, accompanying elevated MCV. Normal MCH with abnormal MCV is unusual but can occur in thalassemia trait (low MCV, borderline MCH) or mixed deficiencies. MCH should parallel MCV changes.
What Influences This Marker
MCH decreases with iron deficiency, thalassemia, chronic inflammation, and any condition producing microcytic anemia. MCH increases with B12 deficiency, folate deficiency, and conditions causing macrocytosis. The same factors affecting MCV generally affect MCH proportionally because cell size and hemoglobin content typically change together. Iron deficiency progressively lowers both MCV and MCH as cells become smaller and paler.
How Your Team Uses It
Your coach addresses the underlying nutritional pattern suggested by MCH, implementing the same iron or B12/folate strategies indicated by MCV since these markers move together.
Related Signals We Also Review
MCV, MCHC, hemoglobin, RDW, ferritin, iron saturation, B12, and folate for comprehensive RBC morphology assessment.