Mean Cell Haemoglobin (MCH)

What it is

Mean Cell Haemoglobin, often shortened to MCH, is a measurement found within a Full Blood Count (FBC) blood test. It tells us the average amount of haemoglobin found inside each of your red blood cells. Haemoglobin is the protein in red blood cells responsible for carrying oxygen from your lungs to the rest of your body. Think of red blood cells as tiny delivery trucks, and haemoglobin as the oxygen cargo they carry. MCH is essentially a measure of how much cargo, on average, each truck is carrying.

This measurement is usually given in picograms (pg), which is a very small unit of weight. The typical range for MCH in adults in the UK is between 27 and 32 pg.

Why it matters

The MCH level can provide valuable clues about the health of your red blood cells and your body's ability to produce them.

If your MCH is consistently outside the typical range, it might suggest that your red blood cells are not carrying the optimal amount of haemoglobin. This can have implications for how effectively your body receives oxygen. For example, if red blood cells are carrying less haemoglobin than usual, your body might not be getting enough oxygen, which can lead to symptoms like tiredness or breathlessness. Conversely, if they are carrying too much, it could also indicate an underlying issue.

Therefore, MCH is often looked at alongside other FBC results, such as the red blood cell count, haemoglobin level, and Mean Cell Haemoglobin Concentration (MCHC), to get a complete picture of red blood cell health.

What can cause it to be high or low

Several factors can influence your MCH levels, leading to them being higher or lower than the usual range.

Higher than normal MCH (often referred to as 'high MCH') can sometimes be seen in certain types of anaemia, particularly megaloblastic anaemia. This type of anaemia is often associated with deficiencies in vitamin B12 or folate. In these cases, red blood cells may be larger than normal and contain more haemoglobin than average.

Lower than normal MCH (often referred to as 'low MCH') is commonly associated with iron deficiency anaemia. Iron is a crucial component of haemoglobin, so if your body doesn't have enough iron, it can't produce as much haemoglobin. This can result in red blood cells that are smaller than usual and contain less haemoglobin. Other conditions that can lead to low MCH include thalassaemia, a group of inherited blood disorders.

It's important to remember that MCH is just one piece of the puzzle. Your doctor will consider your MCH result alongside your symptoms, medical history, and other blood test results to understand what might be causing any deviation from the normal range.

Lifestyle factors that may help

Certain lifestyle choices can play a role in maintaining healthy red blood cell production and, consequently, influencing your MCH levels.

A balanced diet is fundamental. Ensuring your diet includes sufficient iron, vitamin B12, and folate is crucial for the production of healthy red blood cells. Foods rich in iron include red meat, leafy green vegetables, and fortified cereals. Vitamin B12 is found in animal products like meat, fish, eggs, and dairy, while folate is abundant in leafy green vegetables, legumes, and fortified grains.

Regular physical activity can also contribute to overall health, including the efficiency of your circulatory system. However, it's always a good idea to discuss any new exercise plans with your GP, especially if you have any underlying health conditions.

Managing stress levels and ensuring adequate sleep are also important aspects of general well-being that can indirectly support your body's functions, including blood cell production.

Questions to discuss with your GP

If your MCH result is outside the typical range, or if you have concerns about your red blood cell health, here are some questions you might consider discussing with your GP:

• What might be causing my MCH level to be higher or lower than the normal range?
• Are there any specific dietary changes you would recommend to support my red blood cell health?
• Could my current symptoms be related to my MCH level?
• Are there any other tests that might be helpful to understand my red blood cell status better?
• What are the potential long-term implications of my MCH result?
• Are there any lifestyle adjustments you would suggest for me to consider?