What Is Low MCHC? What Does It Mean?

Medically Reviewed By William C. Lloyd III, MD, FACS
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MCHC stands for mean corpuscular hemoglobin concentration. It describes the level of hemoglobin in your red blood cells.  Having low MCHC levels could mean you have anemia. It could also signify low iron, inflammation, or hemolysis.

Symptoms of low MCHC include weakness, irregular heartbeat, and breathing problems.

Learn more about low MCHC levels, including details about typical levels, causes, symptoms, and treatment.

What is MCHC?

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Mean corpuscular hemoglobin concentration (MCHC) refers to the amount of hemoglobin in your red blood cells. MCHC is a laboratory value, not a clinical diagnosis. Many factors influence MCHC levels.

Hemoglobin is an iron-rich protein that transports oxygen around your body. It is also responsible for the red color of your blood.

Having low MCHC levels could mean you have anemia. 

Anemia is a medical condition in which you have an unusually low number of red blood cells. This reduces your body’s ability to transport oxygen to your tissues. Anemia can result from nutritional deficiencies, alcohol use, and several other factors.

What are low and dangerously low levels of MCHC?

In some cases, a person’s MCHC levels can be severely low. 

The table below lists the differences between low MCHC and severely low MCHC levels.

Low MCHCSeverely low MCHC
Test resultsA low MCHC can be slightly below the reference MCHC range of 33.4–35.5 grams per deciliter (g/dl).A severely low MCHC may be far below the reference MCHC range.
SymptomsA slightly low MCHC may show no symptoms. A severely low MCHC will cause serious anemia symptoms.
ManagementA low MCHC may improve with dietary changes.A severely low MCHC may require more aggressive treatments, such as a blood transfusion.

What can cause low MCHC levels?

Low MCHC levels commonly result from factors that cause anemia.

Several types of anemia exist, including:

  • Iron deficiency anemia: This refers to a lack of iron in your blood. It can result from intestinal malabsorption, pregnancy, and other factors.
  • Chronic low-grade blood loss over time: Common examples include lengthy menstruation and untreated peptic ulcers.
  • Aplastic anemia: This is when your bone marrow cannot make enough new blood cells for your body to work properly. It can develop from damage to the stem cells inside your bone marrow.
  • Pernicious anemia: This occurs when the intestines cannot properly absorb vitamin B12, which helps make red blood cells. Causes include a weakened stomach lining and autoimmune activity.
  • Hemolytic anemia: This is when your body destroys more red blood cells than it replaces. It has several causes, including infections and bone marrow failure.

Additional factors that can cause anemia and low MCHC include:

  • Parasitic infections: Parasites can feed on the blood, leading to a loss of iron and protein. Examples include hookworm and tapeworm infections.
  • Kidney disease: According to the National Kidney Foundation, kidney disease can reduce the hormones that tell your body how to make red blood cells.
  • Inflammatory conditions: These may prevent your body from using stored iron to produce enough healthy red blood cells. One example is Crohn’s disease.
  • Cancer and its treatments: These can damage the bone marrow cells that create red blood cells. Cancer treatments include chemotherapy and radiation therapy.
  • Liver disease: The liver helps regulate iron in the body. As such, liver disease can contribute to low iron and anemia. 
  • Chronic lead poisoning: This can increase the rate at which red blood cells disintegrate. 
  • Gastric bypass surgery: This is a type of weight loss surgery. It can affect the body’s ability to absorb iron.
  • Other conditions: Many other health issues can contribute to anemia. They include porphyria, urinary tract infection, enlarged spleen, and vasculitis.

What are the symptoms of low MCHC levels?

People with a low MCHC often experience symptoms of anemia. 

However, symptoms may not be apparent if the condition is mild.

Common symptoms include:

Report severe or persistent symptoms to your doctor for diagnosis and treatment.

Learn more about the symptoms of anemia.

How do doctors diagnose low MCHC levels?

A doctor will use the results of multiple laboratory tests to identify the cause of anemia.

An MCHC test is a standard part of a complete blood count (CBC). It measures the average amount of hemoglobin in a volume of red blood cells. It can also evaluate the type and severity of anemia. 

If a doctor needs further confirmation, they may conduct additional tests, such as:

  • Mean corpuscular volume (MCV) test: This is also part of a CBC. It measures the average size of your red blood cells.
  • Diagnostic imaging: Routine X-ray studies, ultrasound sonograms, CT scans, and MRI scans create images of your internal anatomy. Imaging can identify sources of bleeding, tumors, and many other structural abnormalities.
  • Endoscopy: This is when a doctor uses a thin, camera-fitted tube to examine the inside of your body. It can detect cancers and other causes of anemia.

What are the complications of low MCHC levels?

Having extremely low MCHC may indicate severe anemia.

Severe anemia can have serious health implications, such as:

  • myocardial infarction, which is when the heart muscle begins to die because of low blood flow
  • angina, which is a type of chest pain that results from reduced blood flow
  • heart failure
  • multiorgan failure 
  • death

Severe anemia can also cause low stamina that can affect your daily routine and productivity.

Be sure to get prompt treatment to lower your risk of complications.

Learn more about the potential complications of anemia.

What are the treatment options for low MCHC levels?

If clinicians identify a specific cause for the anemia, they will structure the treatment plan to address that problem. Otherwise, treatments for a low MCHC are similar to those for iron-deficiency anemia.

Your doctor may recommend a combination of dietary adjustments and medications.

These dietary adjustments may include:

  • eating foods high in iron, such as peas and beans
  • eating foods rich in vitamin B6, such as salmon and tuna
  • eating more fiber-rich foods, such as berries and brown rice
  • adding iron supplements to your diet 
  • moderating your intake of calcium-rich foods, such as milk and cheese
  • including more protein in your diet

Medications may include:

  • iron supplements to boost your body’s iron stores
  • birth control pills to stop heavy bleeding in females
  • intravenous or IV iron, which involves receiving iron directly into your vein to help increase your blood iron levels
  • erythropoiesis stimulating agent (ESA) to help your bone marrow make more red blood cells

If your symptoms are severe, your doctor may order a blood transfusion.

Blood transfusions may help increase the levels of red blood cells and iron in your blood.

Learn more about treatment for iron deficiency anemia.

How can I prevent low MCHC levels?

You can take some measures to lower your risk of low MCHC.

First, try to increase your intake of iron and vitamin B6.

Iron-rich foods include:

  • dried fruit, such as apricots
  • iron-fortified cereals, such as wheat biscuits
  • peas and beans
  • red meat and seafood
  • dark green leafy vegetables, such as turnip greens

Vitamin B6-rich foods include:

  • some fruits, such as bananas and oranges
  • tuna
  • salmon
  • poultry
  • chickpeas
  • beef liver

See your doctor before making these or any other dietary additions.

Learn when you should take an iron supplement.

Summary

A low MCHC could mean you have anemia. It could also indicate low iron, inflammation, or hemolysis.

Symptoms include irregular heartbeat, headache, chest pain, and a loss of stamina. 

Doctors investigate the underlying cause by ordering some diagnostic tests, including blood tests, noninvasive imaging, and endoscopy.

Treatment focuses on treating anemia. Methods include high iron and vitamin B6 foods, iron supplements, and intravenous iron. In severe cases, a doctor may also perform a blood transfusion.

Seek treatment if you have symptoms of low MCHC.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 Sep 9
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