Mean Corpuscular Haemoglobin Concentration (MCHC)

July 21, 2020

What is Mean Cell Haemoglobin Concentration (MCHC)?

Mean cell haemoglobin concentration (MCHC) is the mean haemoglobin concentration in a specific volume of red blood cells. The MCHC is usually taken as part of a full blood count. The measurement can be used alongside other red cell indices such as mean corpuscular volume and mean corpuscular haemoglobin to diagnose red cell disorders and different types of anaemia.

Why take a Mean Cell Haemoglobin Concentration blood test?

Haemoglobin is a protein found in red blood cells and is responsible for carrying oxygen to the cells and tissues of the body. Measuring how much haemoglobin is present in red blood cells gives a good indication of how efficiently the cells are working.[1]

A low haemoglobin level can indicate anaemia and an MCHC may help to determine the underlying cause. A high MCHC can be caused by other forms of anaemia or disease.

As part of a full blood count, mean cell haemoglobin concentration is measured with mean cell volume, mean cell haemoglobin and red cell distribution width. These measurements reflect the volume, size and haemoglobin content of red blood cells.[2]

You can check your level of haemoglobin together with other red blood cells within Forth’s Vitality and Ultimate blood tests.

What function does Mean Cell Haemoglobin Concentration have in the body?

Mean cell haemoglobin measures the amount of haemoglobin in each red blood cell. Haemoglobin is a vital protein in the human body and has an important function. The main role of haemoglobin is to transport oxygen from the lungs to all cells and tissues in the body. Approximately 96% of the dry weight of red blood cells is haemoglobin. The structure of haemoglobin consists of four heme molecules each of which contains an iron ion. Each of the iron ions can bind to one molecule of oxygen forming oxyhaemoglobin. When oxyhaemoglobin reaches a cell which requires oxygen, the oxygen dissociates from the haemoglobin and enters the cell.[3]

Haemoglobin is also responsible for transporting carbon dioxide from the tissues to the lungs where it can be removed from the body. Carbon dioxide is a waste product of respiration, 80% of which is transported in the plasma. Unlike oxygen, carbon dioxide doesn’t bind to the oxygen binding site, instead, it attaches to the protein structure. The removal of carbon dioxide helps to keep the pH of the blood at a constant 7.4.

How do changes in Mean Cell Haemoglobin Concentration affect health and wellbeing?

A low haemoglobin count can signify anaemia, particularly iron deficiency. Iron deficiency and other types of anaemia can cause some uncomfortable symptoms, but it can also negatively affect our physical and mental performance. Anaemia occurs when the body doesn’t have enough red blood cells to meet its needs and so can cause the symptoms which interrupt everyday life.

A high mean cell haemoglobin concentration, on the other hand, can be a sign of autoimmune haemolytic anaemia, a condition where red cells are destroyed at a faster rate than they are made. As a result, the body produces antibodies which attack its own red blood cells causing them to burst which reduces the number of red cells in circulation.

If you are worried about your haemoglobin level or just want to check where you fall on the range, you can test your level with a simple at-home blood test.

What can cause Mean Cell Haemoglobin Concentration to change?

Dehydration can cause abnormally high haemoglobin levels. Dehydration occurs when the body loses more water than it’s taking in resulting in some unpleasant symptoms. For example, the condition can reduce your energy levels and make you feel fatigued which can affect your ability to carry out your daily activities.

Some of the causes of low haemoglobin levels include:

  • Iron deficiency anaemia
    • Caused by an iron deficient diet or the body’s inability to absorb iron
  • Pernicious anaemia
    • Caused by eating a diet deficient in vitamin B12
  • Haemolytic anaemia
    • Where red blood cells are prematurely removed from circulation faster than they are replaced

Increased MCHC levels can be caused by:

  • Autoimmune haemolytic anaemia
    • Where the body’s own immune system attacks its red blood cells
  • Macrocytic anaemia
    • Where red blood cells are larger than usual
  • Severe burns
  • Overactive thyroid
  • Liver disease
  • Certain medications


What are the most common symptoms of anaemia?

Anaemia may or may not cause symptoms. However, as the condition progresses you may notice symptoms, such as:

  • Pale skin
  • Feeling tired and weak most of the time
  • Dizziness
  • Not able to complete as much exercise as you usually would
  • Feeling like you are short of breath after exercise
  • Experience heart palpitations[5]

Autoimmune haemolytic anaemia can cause symptoms such as:

  • Weakness
  • Dizziness
  • Jaundice
  • Dark urine
  • Pale skin

How to keep Mean Cell Haemoglobin Concentration in the healthy range

A nutrient which is essential for red blood cell health is iron. A good source of iron is red meat and liver. It is recommended that red meat is consumed once per week to help keep iron levels within normal parameters. Women who are of menstruating age need to keep their iron intake increased particularly around the time of their periods. Individuals who follow a vegan or vegetarian diet will need to get their iron from plant-based sources.

Good food sources of iron are:

  • red meat
  • liver
  • green leafy vegetables e.g. spinach
  • dried fruit
  • pulses
  • nuts
  • seeds

The absorption of iron from plant-based sources is better when vitamin C is present.[4] For example, fortified breakfast cereals paired with a glass of orange juice. Tea, on the other hand, can affect the absorption of iron, so you should refrain from drinking tea with your meals and switch to drinking it between meals instead. [5]

Iron levels can be influenced by too much or too little exercise. Not having enough iron can affect your muscles ability to recover following exercise.

Dehydration may result in an increased mean cell haemoglobin concentration. This is because blood plasma volume is reduced, as water is distributed around the body to the cells and tissues which need it most. You should aim to drink little and often throughout the day. Thirst is an early sign of dehydration, so you should try to avoid getting thirsty. You may need to drink more if you are exposed to increased temperatures, are exercising or experiencing diarrhoea and vomiting.


[1] Lab Tests Online UK. (2018). Haemoglobin.

[2] Lab Tests Online UK. (2015). Red Cell Indices.

[3] Panawala, L. (2017). What is the Function of Hemoglobin in the Human Body? Pedia.

[4] Lane, D, J, R and Richardson, D, R. (2014). The Active Role of Vitamin C in Mammalian Iron Metabolism: Much More than Just Enhanced Iron Absorption. Free Radical Biology and Medicine: 75, pp 69-83.

[5] Zijp, I, M., Korver, O and Tijburg, L, B, M. (2000). Effect of Tea and Other Dietary Factors on Iron Absorption. Critical Reviews in Food Science and Nutrition: 40(5), pp 371-398.

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This information has been medically reviewed by Dr Nicky Keay

Nicola has extensive clinical and research experience in the fields of endocrinology and sport and exercise medicine. Nicky is a member of the Royal College of Physicians, Honorary Fellow in the Department of Sport and Exercise Sciences at Durham University and former Research Fellow at St. Thomas' Hospital.

Dr Nicky Keay

Dr Nicky Keay

BA, MA (Cantab), MB, BChir, MRCP.