Mean Corpuscular Hemoglobin (MCH) is a measurement in a routine complete blood count (CBC) that indicates the average amount of hemoglobin in each red blood cell. Hemoglobin is the protein within red blood cells responsible for transporting oxygen from the lungs to the body’s tissues. An elevated MCH level suggests red blood cells are larger than typical and carry more hemoglobin than normal-sized cells. This finding can signal various underlying health conditions.
Common Causes of High MCH
High MCH levels are associated with macrocytic anemia, where the body produces abnormally large red blood cells. The most common reasons are deficiencies in vitamin B12 and folate (vitamin B9). These B vitamins are essential for proper maturation and DNA synthesis of red blood cells. When insufficient, red blood cells continue to grow without dividing properly, resulting in larger, immature cells that contain more hemoglobin.
Beyond nutritional deficiencies, other factors can contribute to elevated MCH. Chronic alcohol consumption is a cause, as it can impair bone marrow function and interfere with the absorption of vitamin B12 and folate. Studies indicate MCH levels tend to be higher with increased alcohol intake. Liver diseases, such as cirrhosis or hepatitis, can also lead to elevated MCH by affecting red blood cell metabolism and leading to enlarged red blood cells.
An underactive thyroid gland (hypothyroidism) can increase MCH levels by slowing the body’s metabolism, including red blood cell production. Certain medications, such as chemotherapy drugs, antiepileptics, antivirals, and estrogen-containing medications, can cause high MCH. Some blood cancers and infections can also lead to elevated MCH levels.
Practical Steps to Lower MCH Levels
Addressing high MCH levels often involves targeting the underlying cause, frequently through dietary and lifestyle modifications. If a vitamin B12 deficiency is suspected, increasing intake of B12-rich foods helps. Excellent sources include meat, fish, eggs, dairy products, and fortified breakfast cereals. For individuals following vegetarian or vegan diets, fortified foods or supplements are important as B12 is primarily found in animal products.
For folate deficiency, incorporating more folate-rich foods into the diet can normalize MCH levels. Good sources include leafy green vegetables like spinach, kale, and broccoli, legumes (peas, chickpeas, kidney beans), citrus fruits, and fortified grains. Regular consumption of these foods supports healthy red blood cell production.
Reducing alcohol consumption is important, especially if chronic alcohol use contributes to high MCH. Excessive alcohol intake impacts red blood cell development and nutrient absorption, and MCH levels often improve with abstinence. Maintaining a balanced diet with nutrient-rich foods supports overall blood health. Dietary adjustments alone may not be sufficient for all cases, and these general recommendations are not a substitute for professional medical advice.
When to Consult a Healthcare Professional
While understanding potential causes and general lifestyle adjustments is helpful, consulting a healthcare professional is important for anyone with elevated MCH levels. A medical diagnosis is necessary to accurately identify the underlying cause, as self-diagnosis and self-treatment are not recommended. The doctor will consider MCH results alongside other complete blood count components for a comprehensive picture of red blood cell health.
Further diagnostic tests may be ordered to pinpoint the reason for elevated MCH. These can include vitamin B12 and folate level assessments, liver function tests, and thyroid function studies. Depending on the diagnosis, a personalized treatment plan will be developed, which may involve targeted vitamin supplements, medication, or management of an underlying medical condition. For instance, if a deficiency is severe or absorption is an issue, B12 injections might be prescribed. Regular monitoring of MCH levels and overall blood health is part of ongoing care to ensure treatment effectiveness and prevent complications.