Understanding MCHC Blood Test Results
The blood test can be helpful in diagnosing anemia.
Medically reviewed by Steffini Stalos, DO
Mean corpuscular hemoglobin concentration (MCHC) is a measurement of the amount of hemoglobin a red blood cell has relative to the cell's volume. Hemoglobin is a protein in red blood cells that carries oxygen throughout the body. Measuring hemoglobin through an MCHC blood test can help determine whether you have a medical condition; MCHC levels that are too low or high can signal several different conditions.
MCHC is a standard measurement in the diagnosis of anemia, a condition marked by low levels of red blood cells that can cause tiredness or weakness. An MCHC test is generally also performed to help diagnose and monitor other conditions, including sickle cell disease, hyperglycemia (high blood sugar), and hematology, among others.
Understanding Your Results
MCHC is one of the measurements taken during a complete blood count (CBC). A CBC is a common blood test that measures many parts of your blood. It is a routine blood test, so your healthcare provider will likely order one about once a year. They might also order one to help them diagnose or monitor certain conditions. You might hear a complete blood count be referred to as a full blood count.
Once your CBC test results are ready, you and your provider will be able to see your MCHC.
The normal range for MCHC is 32 to 36 grams per deciliter (g/dL) or 320 to 360 grams per liter (g/L). Since different laboratories might use different measurements or blood samples, you should talk with your healthcare provider about what a normal range is for you.
A low MCHC measurement is known as hypochromia. It indicates that you have a lower concentration of hemoglobin in your red blood cells. Having less hemoglobin reduces your blood's capacity to carry oxygen to your organs and tissues.
A high MCHC measurement is known as hyperchromia. It indicates that you have a higher concentration of hemoglobin in your red blood cells. This can increase your chances of developing various health complications such as blood clots.
An MCHC that is below or above the normal range can develop for a number of reasons.
Causes of Low MCHC
MCHC levels below the normal range can be a sign of iron deficiency anemia. Iron deficiency anemia develops when you don’t have enough iron in your body, which you need to make red blood cells. A lack of iron can impact the production of healthy red blood cells and, thus, your MCHC levels.
Iron deficiency anemia is the most common type of anemia. It can develop when there is:
Chronic inflammation: Conditions that cause long-lasting inflammation can make it hard for your body to use iron.
Kidney disease: With this, your kidneys don’t make enough erythropoietin, a hormone needed to make red blood cells.
Trouble absorbing iron: This can be the effect of endurance sports, digestive conditions, and certain genetic conditions.
Low MCHC can also be due to thalassemia. Thalassemia is an inherited blood disorder in which the body does not make enough hemoglobin.
It can also be due to pancytopenia, which is a combination of your body not producing enough red blood cells (anemia), white blood cells (leukopenia), and platelets (thrombocytopenia).
Causes of High MCHC
A high MCHC can also be due to anemia, depending on the type of anemia you have. Hemolytic anemia may lead to an MCHC measurement above the normal range. Hemolytic anemia develops when red blood cells break down faster than they can be replaced. This type of anemia can happen for several reasons, including:
Blood transfusion complications
Infections
Higher-than-normal MCHC results may also be attributable to hereditary spherocytosis, a rare genetic condition in which the body makes abnormally shaped red blood cells.
Editor’s Note: Even if your MCHC is within a normal range, it is still possible to have a certain type of anemia. With normocytic normochromic anemia, the circulating red blood cells are the same size (normocytic) and have a normal red color (normochromic). This type of anemia can develop for multiple reasons, including acute blood loss and kidney disease.
What to Expect When Taking an MCHC Blood Test
A healthcare provider will perform an MCHC blood test by drawing blood as part of a CBC. No preparation is needed prior to a CBC. However, if your healthcare provider has ordered other tests in addition to a CBC, you may need to fast for several hours before that test. Your provider will let you know if there are any special instructions to follow.
Using a small needle, a blood sample is taken from a vein in your arm. The small amount of blood that the needle takes is collected into a vial. As the needle goes in or out, you may feel a slight sting. The entire process usually takes less than five minutes.
After the test, you may experience bruising or mild pain where the needle was inserted. You might also feel dizzy for a brief period of time.
Related Blood Tests
MCHC is just one measurement of red blood cells included in a CBC. A CBC includes other tests to measure the size, shape, and quality of your red blood cells. Together, these measurements are called red blood cell indices. The indices can help diagnose anemia.
Besides MCHC, other red blood cell indices are:
Mean corpuscular volume (MCV): Measures of the average size of your red blood cells
Mean corpuscular hemoglobin (MCH): Measures the average amount of hemoglobin per red blood cell
Red cell distribution width (RDW): Measures differences in the volume and size of your red blood cells
Next Steps
If your MCHC is above or below the normal range, your healthcare provider will likely talk with you about potential causes and, if needed, treatment plans to address the cause. Any treatment plan would depend on what condition is causing your abnormal MCHC readings.
Anemia is usually what’s associated with abnormal MCHC levels. If anemia is the cause of your low or high MCHC levels, your healthcare provider will want to figure out what is causing your anemia and treat that cause. Treatments for anemia and the conditions that cause it may include:
Blood or bone marrow transplant
Blood transfusion
Dietary supplements
Medication
Low levels of MCHC have been shown to be associated with poorer outcomes among people hospitalized with acute heart attack or acute pulmonary embolism. Low MCHC levels may help predict the outcome of certain cases of heart attack or pulmonary embolism.
Could My MCHC Be Wrong?
It is possible that your MCHC reading was incorrect. Since your MCHC is calculated by the amount of hemoglobin in your red blood cells, anything that temporarily affects your hemoglobin levels can also alter your MCHC results. These include:
Blood transfusion: The hemoglobin levels from the blood in the transfusion may have been high, thus temporarily giving you high hemoglobin.
Hyperbilirubinemia: This is characterized by high bilirubin levels. Bilirubin is the substance that's created when your body breaks down red blood cells. High bilirubin levels could indicate liver disease, gallstones, hemolytic anemia, and Gilbert's syndrome.
Infections: Certain infections, such as cytomegalovirus and pneumonia, can cause red blood cells to clump together, which can make hemoglobin levels appear high.
Lipidemia: An excess of fat particles (lipids) in your blood can cause a mistakenly high hemoglobin measurement.
Mishandling of your blood test: It is possible (although unlikely) that your blood specimen was mishandled. This is more likely if your blood test had to be transferred to another location, prolonging its exposure to varying temperatures and delaying the processing time.
Plasma transfusion: Plasma is the liquid portion of blood, separate from red blood cells, white blood cells, and platelets. If you recently had a plasma transfusion, your plasma levels may temporarily be higher than normal, in turn lowering your hemoglobin levels.
A Quick Review
The MCHC is a measurement of the amount of hemoglobin a red blood cell has relative to the size of the cell. MCHC below or above the normal limit may be a sign of anemia, meaning you do not have enough healthy red blood cells.
MCHC is a test that is part of a CBC. Your healthcare provider may order a CBC as part of a routine exam or if you have symptoms of anemia, a family history of a blood disorder, or a diet low in iron. The test is quick and requires no preparation.
Depending on your results, your healthcare provider might talk to you about the potential cause of a high or low reading. Depending on any symptoms you may have and your past medical history, they will likely talk to you about treatment options to address your anemia.
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