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Blood health

Mean Corpuscular Hemoglobin

Also known as: MCH blood test, Mean cell hemoglobin test

The mean corpuscular hemoglobin (MCH) test measures the average amount of hemoglobin in each red blood cell. Hemoglobin is the protein that carries oxygen from your lungs to your tissues and returns carbon dioxide for exhalation. Because oxygen delivery is fundamental to your overall health, MCH provides an important window into your red blood cell function.

MCH is calculated automatically as part of a complete blood count (CBC). While you won’t typically get an “MCH test” ordered on its own, providers review it in combination with other red blood cell indices like mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC) to better understand the cause of abnormal results.

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Key takeaways

  • Sample required: Blood (usually from a vein; sometimes a finger stick)

  • Tests for: Measures the average amount of hemoglobin per red blood cell; used to evaluate anemia type and red blood cell health.

  • Healthy range: 27 to 32 picograms (pg) per cell for adults, though ranges vary slightly by lab.

What can an MCH test tell you?

A provider may use an MCH test to:

  • Identify anemia type. MCH helps distinguish between different categories of anemia. Low MCH (hypochromic) suggests red blood cells have less hemoglobin, which is often linked to iron deficiency or the inherited blood disorder thalassemia. High MCH (hyperchromic) suggests red blood cells have more hemoglobin, which is commonly linked to vitamin B12 or folate deficiency, liver disease, or alcohol-related macrocytic anemia.

  • Support CBC interpretation. MCH adds context alongside MCV (size of red blood cells) and MCHC (concentration of hemoglobin inside red blood cells).

  • Guide further testing. Abnormal MCH typically triggers follow-up labs, including iron, vitamin B12, folate, and bone marrow testing.

Note: MCH is not diagnostic on its own — it supports a broader evaluation of anemia and blood health.

What is being tested?

MCH represents the average hemoglobin content in a red blood cell, expressed in picograms (pg). It is calculated by dividing the total hemoglobin by the red blood cell count:

MCH (pg) = Hemoglobin (g/dL) ÷ RBC count (millions/µL) × 10

Because hemoglobin carries oxygen, MCH reflects the oxygen-carrying capacity of individual red blood cells. Abnormal MCH suggests a mismatch between red blood cell size and hemoglobin content.

Where is the MCH test typically included?

MCH is automatically reported as part of the complete blood count (CBC), which looks at your overall blood health. It may also be included in an anemia panel, used to determine the cause of anemia.

MCH testing is included as part of lab testing through Hers. Discover how to improve or optimize your health with recommendations based on your results.

Who should get an MCH test?

There are no universal recommendations to order an MCH test by itself. Instead, it comes bundled in a CBC, which providers may request when:

  • Symptoms suggest anemia. Fatigue, weakness, pallor, dizziness, shortness of breath, or headaches may warrant testing.

  • Risk factors are present. This includes conditions like kidney disease, malnutrition, chronic inflammatory disease, or a family history of blood disorders.

  • Monitoring ongoing treatment. MCH may help assess how someone is responding to therapy for anemia, chemotherapy, or chronic illness.

  • Routine preventive care. Many providers include a CBC in periodic checkups, especially in older adults or those with risk factors.

How Labs by Hers works

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Not available in all 50 states. Eligibility and provider order required. Lab results alone are not intended to diagnose, treat, or cure any condition. A provider will reach out about critical results and plans include access to 24/7 provider messaging.

Images for illustrative purposes only.

Frequently asked questions

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What causes changes in MCH levels?

Mean corpuscular hemoglobin (MCH) levels can shift based on nutrient status, underlying disease, or blood loss. Increased MCH is often linked to vitamin B12 or folate deficiency, liver disease, hypothyroidism, or alcohol use disorder, and may also occur with certain medications such as antimetabolites or chemotherapy drugs.

Decreased MCH is typically caused by iron deficiency, thalassemia (a genetic disorder affecting red blood cells), lead poisoning, chronic inflammatory diseases, or significant blood loss, all of which can interfere with hemoglobin production or red cell health.

Can MCH be tested at home?

Not directly. Because it is part of the CBC, you typically need a lab draw. Some telehealth services offer mail-in kits with virtual interpretation.

Is fasting required for MCH?

No, fasting is not required. You can eat and drink normally before the test.

How long do results take?

CBC results, including MCH, are usually available within 24 hours.

How often should I get my MCH checked?

There is no set schedule. MCH is checked whenever your provider orders a CBC — during routine care or when symptoms arise.

Does insurance cover the test?

Yes. Because MCH is part of the CBC, it is almost always covered when ordered by a provider. Insurance is not required for lab testing available through the Hers platform.

What is the difference between MCH, MCV, and MCHC?

• MCH refers to the average hemoglobin per cell (weight of hemoglobin).

• MCV measures the average red blood cell size.

• MCHC is the average concentration of hemoglobin within red blood cells.

These indices work together to help classify anemia.

What tests are related to this biomarker?

• Red blood cell count (RBC)

• Hemoglobin and hematocrit

• Mean corpuscular volume (MCV)

• Mean corpuscular hemoglobin concentration (MCHC)

• Iron studies (serum iron, ferritin, transferrin)

• Vitamin B12 and folate levels

• Reticulocyte count

The information provided here is for informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always talk to a qualified healthcare provider about your specific health concerns.

Related biomarkers

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Hematocrit

Hematocrit is a test that measures the percentage of your blood that is made up of red blood cells, which carry oxygen throughout your body. Being in the healthy range means your blood cells are successfully transporting oxygen to your tissues to sustain bodily functions.

Learn more about Hematocrit

Hemoglobin

Hemoglobin is the protein inside your red blood cells that carries oxygen to your muscles and brain. Being in the healthy range means your blood cells have what they need to move oxygen to your tissues successfully.

Learn more about Hemoglobin

Mean Corpuscular Hemoglobin Concentration (MCHC)

Mean corpuscular hemoglobin concentration (MCHC) measures the average concentration of hemoglobin in your red blood cells, which reflects how effectively they carry oxygen. When MCHC is in the healthy range, it indicates that the body is likely not experiencing any red blood cell disorders or iron deficiency.

Learn more about Mean Corpuscular Hemoglobin Concentration (MCHC)

Mean Corpuscular Volume (MCV)

Mean corpuscular volume (MCV) measures the average volume of your red blood cells, which can help reveal early signs of nutrient deficiencies or other blood conditions.

Learn more about Mean Corpuscular Volume (MCV)

Mean Platelet Volume (MPV)

Mean platelet volume (MPV) measures the average volume of your blood platelets, which play an essential role in blood clotting. When your MPV is in the healthy range, it suggests that your platelet volume is normal.

Learn more about Mean Platelet Volume (MPV)

Platelet Count

Platelets are the blood cells that help your body form clots, stopping bleeding when needed. A healthy platelet count means your body generally supports normal blood clotting when necessary.

Learn more about Platelet Count

Red Blood Cell Count

Red blood cells are responsible for carrying oxygen throughout your body. Your healthy red blood cell count is helping your organs and tissues function at their best.

Learn more about Red Blood Cell Count

Red Cell Distribution Width (RDW)

Red cell distribution width (RDW) measures the variation in the size of your red blood cells, which can help detect early signs of anemia or other blood conditions. A healthy RDW suggests that your red blood cells are uniform and efficiently transporting oxygen throughout your body.

Learn more about Red Cell Distribution Width (RDW)

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Reviewed by Darragh O'Carroll, MD

Published 12/04/2025