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If a blood test shows you have low mean corpuscular hemoglobin concentration (MCHC), it may be a sign of anemia. In rare cases there may be a more serious cause, such as cancer.
If a doctor suspects low MCHC levels, they may order a blood test. They may also do other tests to rule out any underlying conditions.
Here, find out what causes low MCHC levels, how to recognize it, what an MCHC blood test involves, and what to do if your levels are low.
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.
What are the symptoms of low MCHC?
There are a number of symptoms that people with low MCHC levels often have.
They generally relate to iron deficiency anemia and 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.
What causes low MCHC?
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 will order a complete blood count (CBC).
This is a collection of tests that includes a blood test to examine your MCHC levels and a mean corpuscular volume (MCV) test, which measures the average volume of your red blood cells.
They will also check for:
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 your doctor suspects blood loss, they will look for the source. The easiest to detect is unusually long, frequent, or heavy menstrual cycles, as women can self-report this.
The results of the test will enable your doctor to determine what type of anemia you have, which will help pinpoint the underlying cause. They can then create a course of treatment.
Typically, there is no preparation to do before a CBC.
However, if you are afraid of needles or injections, it might be a good idea to tell the healthcare professional, who may be able to make adjustments to help you with this.
During the test
During the test, you can expect
A healthcare professional will:
- Find a vein in your arm, hand, or elsewhere from which to draw blood.
- Clean the area with an alcohol wipe.
- Place a band around your arm above the intended site to make the vein easier to see.
- Insert the needle in your vein, at which point you may feel a pinch or a little pain.
- Attach a blood sample tube to the needle.
- Wait for the tube to fill with blood, which may take a few minutes.
After the test
After the test, the healthcare professional will remove the needle, wipe the area clean, and place a dressing on it. They may ask you to press on the injection site for a few minutes to ensure it does not bleed.
You may need to stay seated for a few minutes to ensure it is safe for you to walk or drive.
Before leaving, be sure to ask when and how you can expect to hear the results.
Your doctor may also 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.
A typical MCHC result is
A healthcare professional will advise you on your individual result.
The most common complication of living with low MCHC levels is lack of energy and decreased stamina. This can limit your activities.
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.
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:
When should I be concerned about low MCHC?
Anything below or above the normal MCHC range can mean you have anemia. Common signs and symptoms include low stamina, tiredness, and difficulty breathing.
What level of MCHC is concerning?
A typical MCHC result is 32–36 grams/deciliter (g/dL) or 320–360 grams per liter (g/L), although this may vary depending on the lab.
Can MCHC be low without anemia?
Low MCHC concentrations in the blood may point to iron-deficiency anemia. You can also be deficient in iron without having iron-deficiency anemia, for example, due to heavy menstrual bleeding. Other causes of low MCHC
MCHC refers to the average concentration of hemoglobin in your red blood cells. Hemoglobin is the protein that enables red blood cells to carry oxygen throughout the body.
A low result in an MCHC blood test may indicate iron-deficiency anemia. In some cases, it may be a sign of an underlying condition, such as celiac disease or cancer.
Dietary measures and supplements can often help treat anemia. The results of an MCHC test will help your doctor decide on the most appropriate treatment.