A high MCH (mean corpuscular hemoglobin) level can be caused by conditions such as megaloblastic anemia, side effects from medications, hypothyroidism, alcoholism, or liver disease.
MCH is considered high when values exceed 32 pg in a complete blood count (CBC). This indicates that the red blood cells are unusually large and contain higher-than-normal amounts of hemoglobin.
When MCH levels are high, it’s important to see a primary care provider for an accurate diagnosis and appropriate treatment, which may include medications, oral supplements, dietary changes, or, in some cases, surgery.
Main causes
The main causes of high MCH are:
1. Megaloblastic anemia
High MCH may indicate megaloblastic anemia, a type of anemia usually caused by a deficiency in vitamin B12 or vitamin B9 (folate).
These vitamins are essential for producing healthy red blood cells, and when levels are low, the cells become larger and contain excess hemoglobin.
What to do: If megaloblastic anemia is suspected, consult a doctor for proper diagnosis and treatment. Treatment may involve daily vitamin B12 injections or oral supplementation with vitamin B9 (folic acid) or vitamin B12.
A doctor or nutritionist may also recommend eating more foods rich in vitamin B12 and B9, such as fish, cheese, milk, spinach, broccoli, nuts, beans, and nutritional yeast.
2. Side effects of medications or treatments
High MCH levels may also result from side effects of certain medications, such as zidovudine, stavudine, or lamivudine, or from chemotherapy treatments.
What to do: Talk with the healthcare provider who prescribed these medications or treatments. The provider will evaluate whether the dosage can be adjusted or the medication changed if needed.
3. Alcohol use disorder
Alcohol use disorder (alcoholism) is one of the most common causes of high MCH, as alcohol can lead to deficiencies in folate and vitamin B12.
In addition, alcohol has a toxic effect on erythroid precursor cells in the bone marrow, cells that develop and mature into red blood cells.
What to do: If alcohol use disorder is confirmed, a doctor may prescribe medications such as disulfiram, naltrexone, or acamprosate to help reduce alcohol cravings.
The doctor may also recommend counseling sessions and participation in support groups to encourage behavior change and support recovery.
4. Hypothyroidism
High MCH can also be caused by hypothyroidism, a condition in which the thyroid gland produces insufficient amounts of the hormones T3 and T4. This affects cell production and bone marrow activity, which can interfere with red blood cell formation.
Common symptoms of hypothyroidism include fatigue, weakness, dry or rough skin, hair loss, and weight gain.
What to do: If you have symptoms that may suggest hypothyroidism, consult an endocrinologist or primary care provider for evaluation and diagnosis.
When hypothyroidism is confirmed, treatment usually involves levothyroxine to replace the missing thyroid hormones.
Lifestyle changes can also help, including eating a diet rich in fiber, antioxidants, and healthy fats.
5. Liver disease
Liver disease can also cause high MCH levels. This happens because cholesterol levels increase in the outer membrane of red blood cells, expanding their surface area and raising MCH.
What to do: If liver disease is diagnosed, treatment will depend on the specific type and severity. A doctor may recommend a healthy diet, medications, or supplements.
In more serious cases, treatment may include a livertransplant.
How to know if MCH is high
To confirm if MCH levels are high, you should consult a primary care provider, who may order a complete blood count (CBC). This test provides detailed information about red blood cells, including their size and hemoglobin content.
Also recommended: MCH Blood Test (What Low or High MCH Levels Mean) tuasaude.com/en/mch-blood-testFrequently asked questions
Some frequently asked questions about high MCH include:
1. What does high MCV and MCH mean?
High MCV (mean corpuscular volume) and high MCH can indicate conditions such as folate or vitamin B12 deficiency, alcohol use disorder, thyroid problems, or liver disease.
However, high MCV and MCH results on their own are not necessarily a cause for concern. A doctor or other healthcare provider will interpret the CBC results in combination with the person’s medical history to determine if further testing or treatment is needed.
2. Does high MCH cause symptoms?
High MCH itself does not cause symptoms directly. However, it is often associated with underlying conditions such as megaloblastic anemia, which can lead to fatigue, pale skin, and muscle pain.
Therefore, the symptoms related to high MCH depend on the underlying condition causing the abnormal result.