Blood count and blood group · Blood

MCHC

The hemoglobin concentration in the red blood cells; mainly a control value, low in longer-standing iron deficiency.

At a glance

Measured in blood
In 11 test panels
No special preparation

Explanation

MCHC: what is measured?

MCHC (mean corpuscular hemoglobin concentration) is the average concentration of hemoglobin in the red blood cells: how much hemoglobin there is per volume of cell. The value is calculated from the hemoglobin and the hematocrit. Unlike MCV and MCH, the MCHC changes little in most forms of anemia; it mainly falls in longer-standing iron deficiency and thalassemia, and a truly raised value is rare. Laboratories also use the MCHC as a check on the quality of the measurement.

What can it detect?

Longer-standing iron deficiency or thalassemia (low MCHC, pale cells)
Rare conditions with abnormally shaped red blood cells, such as hereditary spherocytosis (high MCHC)
Measurement interference in the blood sample (strongly abnormal MCHC)

Result

What does the result mean?

MCHC too high

A raised MCHC is unusual, because a red blood cell can only hold a limited amount of hemoglobin. It is usually due to measurement interference: clumping of cells caused by cold antibodies, a cloudy (fatty) sample or a blood sample that was in transit for too long. A truly raised MCHC fits hereditary spherocytosis, a rare inherited condition with sphere-shaped red blood cells that are broken down faster; symptoms are then anemia, jaundice and gallstones. With severe dehydration the value can also come out slightly higher. According to the Dutch Society for Clinical Chemistry (NVKC), the MCHC can be raised with a deficiency of vitamin B12 or folic acid, but it usually stays normal; the MCV and the MCH are then clearly raised.

MCHC too low

A low MCHC means that the red blood cells contain relatively little hemoglobin (hypochromic). This fits anemia due to iron deficiency that has existed for a longer time, and thalassemia. With a slightly low MCHC and a normal hemoglobin, MCV and ferritin, there is usually nothing wrong; the value naturally fluctuates somewhat. As the NVKC points out, the MCHC should always be looked at together with the hemoglobin and the MCV; if in doubt, the GP has the ferritin measured.

After an abnormal result

The GP only assesses the MCHC together with hemoglobin, MCV and ferritin, following the Dutch GP guideline (NHG) on anemia. With an unexplained, strongly raised MCHC, the measurement is usually repeated and, if needed, the blood is examined under the microscope; if faster breakdown of red blood cells is suspected, the GP refers to an internist (specialist in internal medicine) or hematologist.

Reliability

How reliable is the test?

The MCHC is a calculated value and on its own the least informative of the red blood cell values: it changes little in most forms of anemia and is mainly used by laboratories as an internal check. The cause of anemia is determined with the MCV and the ferritin, which change earlier and more clearly. A normal MCHC therefore does not rule out iron deficiency.

What can affect the result?

A blood sample stored too long or too warm makes the cells swell and lowers the MCHC; clumping due to cold antibodies or a fatty sample raises it.
The MCHC only changes late in iron deficiency; the MCV and especially the ferritin respond earlier.
Reference values and units (mmol/l or g/dl) differ between laboratories.

Who it is for

Who is the test useful for?

Useful for

Only useful as part of a complete blood count. As a single test, the MCHC has no value for the client; it is a calculated value that supports the other red blood cell values and helps the laboratory check the measurement.

How common is it?

Anemia due to iron deficiency, the main cause of a low MCHC, is diagnosed in general practice in about 4 in 1000 people per year, mainly in women between 15 and 50 years. Hereditary spherocytosis, the best-known cause of a truly raised MCHC, is rare.

Dutch GP guideline (NHG) on anemia (M76)

Drawbacks and risks

A slightly abnormal MCHC with otherwise normal values almost never has meaning, but is flagged as abnormal in result lists; this can cause unnecessary worry.

Get tested

MCHC: test panels

MCHC is part of these test panels. You order online and have your blood drawn at a collection point or collect the sample at home.

Blood draw
General Health Checkup
With this General Health Check-up, you gain detailed insight into your overall health and well-being.
€ 125,00
Blood draw
Blood Count
Blood Count; complete analysis of blood cells for detection of anemia and infections.
€ 19,00
Blood draw
Complete Blood Count (CBC)
Complete Blood Count Extended; standard blood count plus detailed white blood cell analysis.
€ 27,00
Blood draw
InsideTracker
InsideTracker Blood Analysis: analyze 48 biomarkers for complete health optimization and personalized recommendations.
€ 335,00
Blood draw
Endurance Sports
Complete blood count, iron status (ferritin, transferrin), kidney function, liver function, testosterone, and hs-CRP. For athletes and endurance sport participants.
€ 203,00
Blood draw
Comprehensive Fatigue Test
Vitamin D, B12, TSH, fT4, glucose, MCV, ferritin, ESR and complete blood count. For persistent fatigue with inflammation check.
€ 152,00
Blood draw
Extended Cholesterol Test
Comprehensive cholesterol test with vitamin D, B12, and blood count. Combines heart health with a fatigue check in one package.
€ 98,00
Blood draw
Supplemental: Testosterone Replacement Therapy (TRT)
Complete hormonal analysis with testosterone, DHEA-S, thyroid, blood count, liver function, kidney function, lipids, glucose, HbA1c, insulin, hs-CRP, vitamin D and ferritin.
€ 335,00
Blood draw
Whoop (Advanced Labs)
Comprehensive blood analysis with biomarkers that integrates directly with your WHOOP wearable for optimal performance and recovery.
€ 385,00

How reliable is the test?

MCHC