Mean Corpuscular Hemoglobin (MCH), Mean Cell Hemoglobin

September 5, 2026Hematology Lab Tests

Table of Contents

Mean Corpuscular Hemoglobin (MCH)

What sample is needed for Mean Corpuscular Hemoglobin (MCH)?

This test is done on blood in EDTA (anticoagulant).

What are the indications for Mean Corpuscular Hemoglobin (MCH)?

It is done as part of blood indices.
It is done to diagnose anemia. It has limited value in diagnosing anemia.

What are the precautions for Mean Corpuscular Hemoglobin (MCH)?

Remember that an abnormal RBC size may affect the value.
The presence of cold agglutinins can cause a falsely elevated value.
A raised WBC count also affects the value.

How will you define Mean corpuscular hemoglobin (MCH)?

It is the average amount of hemoglobin inside one RBC.
Mean corpuscular hemoglobin (MCH) is obtained by dividing hemoglobin by RBC count.
It represents the average hemoglobin content per RBC.

Mean corpuscular hemoglobin (MCH) calculation

What is the significance of the Mean Corpuscular Hemoglobin (MCH)?

This is the mean weight of hemoglobin in one RBC.

Mean corpuscular hemoglobin (MCH) formula

MCH and MCHC values determine the hemoglobin content in the RBCs.
MCH adds very little value to other blood indices.
The RBC size influences MCH.
A large RBC with normal hemoglobin will contain a greater weight of hemoglobin than a small RBC with normal hemoglobin.
MCH also depends upon the amount of hemoglobin in relation to the size of the RBC; for example, hypochromic RBCs have less hemoglobin than normochromic RBCs.
In short, macrocytosis leads to increased MCH, and microcytosis and hypochromia decrease MCH.

What is the normal value of MCH?

Source 1

Age	pg/cell
Fetal blood
18 to 20 weeks	43.14 ± 2.7
21 to 22 weeks	41.39 ± 3.32
23 to 25 weeks	40.48 ± 2.88
26 to 30 weeks	37.04 ± 3.67
Infants and Child
Cord blood	31 to 37
0.5 month	30 to 37
0ne month	29 to 36
2 month	27 to 34
4 month	25 to 32
6 month	24 to 30
9 month	25 to 30
12 month	24 to 30
1 to 2 years	22 to 30
3 to 5 years	25 to 31
6 to 8 years	25 to 31
9 to 11 years	26 to 32
Adult/Children	Male	Female
12 to 14 years	26 to 32	26 to 32
15 to 17 years	27 to 32	26 to 34
18 to 44 years	27 to 37	27 to 34
45 to 64 years	27 to 35	27 to 34
65 to 74 years	27to 34	27 to 35

Source 2

Adult = 27 to 31 pg (picograms).
Newborn = 32 to 34 pg (picogram)

Another source

26 to 34 pg

How will you interpret MCH values?

MCH	MCH value
Normal	27 to 31 pg/RBC
Low	<27 pg/RBC
High	>30 pg/RBC

What conditions will interfere with estimating Mean Corpuscular Hemoglobin (MCH)?

Lipemia.
Cold agglutinins.
Increased white blood cells (Leucocytosis = >50,000/cmm).
In vivo hemolysis.
In case of high heparin concentration.
Monoclonal proteins in the blood.

What are the causes of increased Mean corpuscular hemoglobin (MCH)?

Macrocytic anemia and in newborns.
Vitamin B12 deficiency.
Infants and newborns.

Macrocytosis seen in megaloblastic anemia

What are the causes of decreased Mean Corpuscular Hemoglobin (MCH)?

Microcytic anemia (iron deficiency anemia).
Hypochromic anemia.
Thalassemia.
Some chronic diseases.

Microcytic hypochromic RBC indicating low MCH

Questions and answers:

Question 1: What is the value of MCH for the diagnosis of anemia?

Question 2: What is an effect of hemolysis on MCH?

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