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Hematology

MCH: how much haemoglobin the red blood cells hold and what a deviation means

Haemoglobin is the protein in the red blood cells that, according to Thuisarts, the patient site of the Dutch College of General Practitioners, carries oxygen from the lungs to all the cells of the body. MCH, short for 'mean corpuscular haemoglobin', says according to the NVKC, the Dutch society of clinical chemists, something about how well the red blood cells are filled with haemoglobin. According to the NVKC, the value is not measured directly but calculated from the amount of haemoglobin and the number of red blood cells.

According to the NVKC, a low MCH can point to anaemia from iron deficiency, and in thalassaemia, an abnormality of the haemoglobin protein, the MCH is too low. According to the NVKC, a high MCH can point to anaemia from a lack of vitamin B12 and/or folate. Only a blood test shows how well the red blood cells are filled.

Certe uses 1700 to 2100 amol (attomole) for women and men older than 18. The NVKC gives about 1.70 to 2.10 femtomol for healthy adults, the same limits in a different unit.

Doctor's Assessment Included

MCH is the average amount of haemoglobin, the protein that carries oxygen, in one red blood cell; it is calculated from haemoglobin and the red cell count. Certe uses 1700 to 2100 attomol for adults, equal to 1.70 to 2.10 femtomol.

  • A low MCH can fit iron deficiency or thalassaemia, a defect of the haemoglobin protein; a high MCH a lack of vitamin B12 or folate.
  • Star-SHL, Unilabs and Diagnostiek voor U publish no limit for MCH.

Reference Ranges

See the value that applies to you:

Choose male or female — this range differs by sex.

Enter your age — this range changes with age.

This range also depends on context such as cycle phase or sample material; the highlighted rows apply to your group.

Male Your group
fmol
Low 1.65 Normal 2.1 High
Female Your group
fmol
Low 1.65 Normal 2.1 High

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

Check your own value

MCH (Mean Corpuscular Hemoglobin): what Dutch laboratories use

Reference ranges by group, in amol
Certe · Male · 18 years and older 1700–2100 amol
1700 2100
Certe · Female · 18 years and older 1700–2100 amol
1700 2100
1600 2200 amol

Source: Certe

Each value as the laboratory itself publishes it, retrieved in 2026.

MCH (Mean Corpuscular Hemoglobin): what this test measures

The MCH value gives the amount of haemoglobin in the red blood cells, expressed in femtomol (fmol) or attomole (amol): Diagnostiek voor U reports MCH in fmol, Certe in amol, and 1000 amol is 1 fmol. According to the NVKC, MCH is calculated from the amount of haemoglobin and the number of red blood cells, and it is part of the complete blood count.

Star-SHL, Unilabs and Diagnostiek voor U publish no reference value for MCH; of these four laboratories, Certe is the only one with a published limit.

MCH (Mean Corpuscular Hemoglobin): why this value matters

According to the NVKC, the MCH test helps find the cause of anaemia, and a doctor can request the test to look for blood disorders that involve abnormal red blood cells. According to Thuisarts, anaemia means that someone has too few red blood cells, and to make haemoglobin the body needs iron, vitamin B12 and folate.

MCH (Mean Corpuscular Hemoglobin): how the blood test works

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Blood count checkup · €109,-
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MCH (Mean Corpuscular Hemoglobin): when is testing worthwhile?

According to the NVKC, an MCH value usually comes from the complete blood count, a general test used to look for various conditions. According to the NVKC, a doctor can also request the MCH test to find the cause of anaemia.

MCH (Mean Corpuscular Hemoglobin): symptoms of a high or low value

Low Levels

According to the NVKC, a low MCH can point to anaemia from iron deficiency, and in thalassaemia the MCH is too low. According to Thuisarts, someone with anaemia may feel tired and weak, be short of breath on stairs or during sport, feel dizzy, have a headache or have less colour in the face. According to Thuisarts, anaemia is usually caused by too little iron in the body.

High Levels

According to the NVKC, a high MCH can point to anaemia from a lack of vitamin B12 and/or folate. An MCH can also come out falsely high: according to a 2022 review in Annals of Laboratory Medicine (Gulati and colleagues), a lot of fat in the blood sample gives a falsely high MCH, and red blood cells that burst in the tube can do the same.

MCH (Mean Corpuscular Hemoglobin): causes of a low or high value

What lowers the value

  • Iron deficiency

    A low MCH can point to anaemia from iron deficiency.

  • Thalassaemia

    In thalassaemia, a defect of the haemoglobin protein in the red blood cells, MCH is too low.

What raises the value

  • Vitamin B12 or folate deficiency

    A high MCH can point to anaemia from a lack of vitamin B12 or folate.

  • Fat or burst cells in the blood sample

    A lot of fat in the blood sample gives a falsely high MCH, and red blood cells that burst in the tube can do the same.

MCH (Mean Corpuscular Hemoglobin): lifestyle and this value

An abnormal MCH value is one to discuss with your GP, who according to Thuisarts can use blood tests to find what causes anaemia. According to Thuisarts, anaemia from too little iron is treated with iron pills, and too little vitamin B12 or folate with pills of that vitamin; Thuisarts then advises having blood taken again after 4 weeks.

MCH (Mean Corpuscular Hemoglobin): frequently asked questions

Is the MCH limit the same for men and women?

Yes, Certe gives the same MCH limits for women and men older than 18: 1700 to 2100 amol. For children, Certe uses separate limits by age and sex, for example 1539 to 1874 amol for girls aged 12 to 18.

What is the difference between MCH and haemoglobin?

According to Thuisarts, haemoglobin is the substance in the red blood cells that carries oxygen, and according to the NVKC the MCH value says how well those red blood cells are filled with haemoglobin. According to the NVKC, MCH is calculated from the amount of haemoglobin and the number of red blood cells.

How is MCH calculated in picograms?

According to a 2022 review in Annals of Laboratory Medicine (Gulati and colleagues), MCH in picograms per cell is haemoglobin in g/dl times 10, divided by the number of red blood cells in millions per microlitre. Dutch laboratories such as Certe and Diagnostiek voor U report MCH in attomole or femtomol.

MCH (Mean Corpuscular Hemoglobin): sources

  1. Certe, Bepalingenwijzer (referentiewaarden per bepaling), bepalingenwijzer.certe.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenwijzer.certe.nl
  2. NVKC, Alles over testen: MCH, allesovertesten.nl, geraadpleegd 2026-10-06 (retrieved 2026) allesovertesten.nl
  3. Gulati G, Uppal G, Gong J. Unreliable Automated Complete Blood Count Results: Causes, Recognition, and Resolution. Ann Lab Med 2022;42(5):515-530. (retrieved 2026) pmc.ncbi.nlm.nih.gov

Test Products

This marker is included in the following test panels.

Blood count & immunity

Blood count checkup

A blood test with 10 values for blood count and immunity — haemoglobin, haematocrit, white cells with differential, platelets, MCV, MCH, MCHC, CRP and ESR — for insight into blood and inflammation.

Hemoglobin Hematocrit Leukocytes (WBC) Leukocyte Differential Platelets (Thrombocytes) MCV (Mean Corpuscular Volume) MCH (Mean Corpuscular Hemoglobin) MCHC (Mean Corpuscular Hemoglobin Concentration) CRP (C-Reactive Protein) Erythrocytes (RBC) Ferritin
€109,-

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