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Low mean corpuscular hemoglobin concentration (MCHC) usually indicates anemia. Other, more serious causes like cancer are rare.
MCHC is the average concentration of hemoglobin in your red blood cells. Hemoglobin is the protein molecule that allows red blood cells to carry oxygen to tissues within your body.
Your MCHC can fall into low, normal, and high ranges, even if your red blood cell count is normal.
There are a number of symptoms that people with low MCHC levels often have. These symptoms are generally tied to anemia. They include:
- fatigue and chronic tiredness
- shortness of breath
- pale skin
- easy bruising
- loss of stamina
People with slightly or recently low MCHC levels may not notice any symptoms at all.
The most common cause of low MCHC is anemia. Hypochromic microcytic anemia commonly results in low MCHC. This condition means your red blood cells are smaller than usual and have a decreased level of hemoglobin.
This type of microcytic anemia can be caused by:
- lack of iron
- the inability of your body to absorb iron, which can be caused by conditions like celiac disease, Crohn’s disease, and gastric bypass surgery
- chronic low-grade blood loss over time from a long menstrual cycle or peptic ulcers
- hemolysis, or the premature destruction of red blood cells over time
In rarer cases, low MCHC and hypochromic microcytic anemia can be caused by:
If your doctor suspects that you have a low MCHC, they may order several blood tests, including:
- a blood test that will examine your MCHC levels
- a mean corpuscular volume (MCV) test, which measures the average volume of your red blood cells
These tests may be included in a complete blood count (CBC). A CBC measures whether you have normal ranges of red and white blood cells.
Through the results of the tests they order, your doctor should be able to determine exactly what type of anemia you have, making it easier to find the underlying cause. This can help them create a course of treatment.
Your doctor may check your iron levels and iron-binding capacity, which measures whether your body absorbs iron the way it’s supposed to. All of this can be done from the same blood draw used for your CBC, and these two tests can help your doctor determine the cause of the anemia.
If blood loss is thought to be the cause of your low MCHC score, your doctor will look for the source of the blood loss. The easiest to detect is abnormally long, frequent, or heavy menstrual cycles, as women can self-report this.
Your doctor may order diagnostic tests for other conditions, including:
- An endoscopy, during which a lighted camera is moved through the upper part of your gastrointestinal (GI) tract. This can help show ulcers or cancer. Also, a biopsy performed during this procedure tests most reliably for celiac disease.
- X-rays of your upper GI, which involves drinking a thick liquid containing barium. This substance makes it possible for some ulcers to show up on the X-ray of your stomach and small intestine.
- Additional blood tests, which can provide some screening indicators for celiac or Crohn’s disease.
The most common complication of living with low MCHC levels is lack of energy and decreased stamina. This can limit your activities.
In severe cases, anemic hypoxia can occur as a result of low MCHC levels. When MCHC levels are very low, your body could struggle to provide enough oxygen to all its tissues.
As a result, these tissues are deprived of oxygen and unable to get rid of carbon dioxide. This can actually become life threatening.
Common symptoms of anemic hypoxia include:
Once your doctor is able to detect the underlying cause of your low MCHC levels, they’ll come up with a plan of treatment.
The most common cause of low MCHC is iron deficiency anemia. To treat this, your doctor may recommend the following:
- Increase iron in your diet.
- Take iron supplements.
- Get more vitamin B6, which is necessary for proper absorption of iron.
- Add more fiber to your diet, which can help improve the intestinal absorption of iron.
- Take no more than the daily requirement of calcium, as too much can make it difficult for your body to absorb iron.
The best way to prevent a low MCHC level is to prevent iron deficiency anemia. To do this, try to make sure you’re getting enough iron and vitamin B6 in your diet.
Keep in mind that the iron in spinach is not as readily absorbed because of its oxalic acid content. This can be improved by consuming it with things like vitamin c/citric acid, beef, poultry, or fish.
Foods rich in iron include:
- spinach (best if cooked to reduce the oxalic acid content)
- red meat, pork, and poultry
Foods rich in vitamin B6 include: