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Hematology

MCV: what the average size of red blood cells says about anaemia

Red blood cells carry oxygen: according to Thuisarts they contain haemoglobin, which takes oxygen from the lungs to all the cells of the body. The MCV, short for mean corpuscular volume, is the average size of those red blood cells according to the NVKC, the Dutch society of clinical chemists. According to the NVKC, the size of the cells gives information about the cause of anaemia, which according to Thuisarts means having too few red blood cells.

According to the NVKC, a high MCV can point to anaemia from a shortage of vitamin B12 or folate, and a low MCV to anaemia from iron deficiency. Only a blood test shows whether the red blood cells are too large or too small.

According to the NVKC, the MCV in healthy adults lies roughly between 80 and 100 femtolitres (fl), and according to the NVKC these reference values can differ slightly between laboratories.

Doctor's Assessment Included

MCV is the average size of the red blood cells. According to the NVKC, a high MCV can point to a shortage of vitamin B12 or folate, a low MCV to iron deficiency.

  • Star-SHL, Unilabs, Certe and Diagnostiek voor U all four use an MCV of 80 to 100 fl for adults.
  • A US review article (American Family Physician, 2009) names alcoholism, a shortage of vitamin B12 or folate and medicines as the most common causes of an MCV above 100 fl.
  • According to a US review article (American Family Physician, 2010), anaemia from iron deficiency and thalassaemia trait are the most common causes of an MCV below 80 fl in adults.

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
fl
Low 80 Normal 100 High
Female Your group
fl
Low 80 Normal 100 High

Source: NVKC — Nederlandse Vereniging voor Klinische Chemie en Laboratoriumgeneeskunde Reference population: Healthy adults (NVKC)

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

MCV (Mean Corpuscular Volume): what Dutch laboratories use

Reference ranges by group, in fl
Star-shl · Everyone · 19 years and older 80–100 fl
80 100
Unilabs · Male · 15 years and older 80–100 fl
80 100
Unilabs · Female · 15 years and older 80–100 fl
80 100
Certe · Male · 18 years and older 80–100 fL
80 100
Certe · Female · 18 years and older 80–100 fL
80 100
Diagnostiek voor U · Male · 16 years and older 80–100 fL
80 100
Diagnostiek voor U · Female · 16 years and older 80–100 fL
80 100
75 105 fl

Source: Star-shl

Source: Unilabs

Source: Certe

Source: Diagnostiek voor U

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

MCV (Mean Corpuscular Volume): what this test measures

The MCV test measures the average size of the red blood cells, expressed in femtolitres (fl). According to the NVKC, the test is part of the complete blood count, a general test for detecting various conditions. Unilabs measures the MCV with a Sysmex XR1000 based on the impedance of the red blood cells, and Certe gives 'Berekening' (calculation) as its method of analysis.

Star-SHL, Unilabs, Certe and Diagnostiek voor U all four use an MCV of 80 to 100 fl for adults. Star-SHL and Certe give that limit for people older than 18, Unilabs and Diagnostiek voor U for people older than 15.

MCV (Mean Corpuscular Volume): why this value matters

According to the NVKC, the MCV is useful for finding the cause of anaemia, and for detecting blood disorders that involve an abnormal size of the red blood cells. According to Thuisarts, the body needs iron, vitamin B12 and folate to make haemoglobin. A US review article (American Family Physician, 2009) calls an MCV above 100 fl macrocytosis, red blood cells that are too large, and a second review in the same journal (2010) calls an MCV below 80 fl in adults microcytosis, red blood cells that are too small.

MCV (Mean Corpuscular Volume): how the blood test works

Referral
No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw
A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Which test
Vitamin & mineral checkup · €229,- · Blood count checkup · €109,- · General checkup · €199,-
Where
650+ draw sites run by independent laboratories across the Netherlands. Draw sites

MCV (Mean Corpuscular Volume): when is testing worthwhile?

According to the NVKC, a doctor can request an MCV to find the cause of anaemia, or to detect blood disorders that involve an abnormal size of the red blood cells. According to the NVKC, the MCV is usually part of the complete blood count, which is used as a general test for detecting various conditions. According to a US review article (American Family Physician, 2010), red blood cells that are too small are typically an incidental finding in people without symptoms who had a complete blood count for another reason.

MCV (Mean Corpuscular Volume): symptoms of a high or low value

Low Levels

According to the NVKC, a low MCV can point to anaemia from iron deficiency, and according to the NVKC the MCV is also too low in thalassaemia, an abnormality of the haemoglobin protein in the red blood cells. A US review article (American Family Physician, 2010) names anaemia from iron deficiency and thalassaemia trait as the most common causes of red blood cells that are too small, and besides these, among others, anaemia of chronic disease, lead poisoning and sideroblastic anaemia, a form of anaemia. According to the same article, measuring ferritin, a protein that according to the NVKC stores iron, is the first recommended laboratory test with red blood cells that are too small, and a low ferritin suggests iron deficiency.

High Levels

According to the NVKC, a high MCV can point to anaemia from a shortage of vitamin B12 or folate. A US review article (American Family Physician, 2009) names alcoholism, a shortage of vitamin B12 or folate and medicines as the most common causes of an MCV above 100 fl. According to the same article, medicines, an underactive thyroid, liver and kidney disease and COPD, a chronic lung disease, are associated with a less marked rise in the MCV. According to the article, the MCV can also rise after blood loss or breakdown of red blood cells, because the bone marrow then releases young red blood cells that are slightly larger than average. According to the article, a falsely raised MCV is uncommon, and can arise from cold agglutinins, which make red blood cells clump together, from high blood sugar or from many white blood cells.

MCV (Mean Corpuscular Volume): causes of a low or high value

What lowers the value

  • Iron deficiency

    A low MCV can point to anaemia from iron deficiency.

  • Thalassaemia

    In thalassaemia, an abnormality of the haemoglobin protein in the red blood cells, the MCV is too low.

  • Anaemia of chronic disease

    A US review article names anaemia of chronic disease as another cause of red blood cells that are too small.

What raises the value

  • Vitamin B12 or folate shortage

    A high MCV can point to anaemia from a shortage of vitamin B12 or folate.

  • Alcoholism

    A US review article names alcoholism as one of the most common causes of an MCV above 100 fl; with chronic alcohol use the MCV generally stays below 110 fl.

  • Medicines

    According to a US review article, medicines including anti-epileptic drugs, methotrexate and metformin may enlarge the red blood cells.

  • Underactive thyroid or liver disease

    According to a US review article, an underactive thyroid and liver disease are associated with a less marked rise in the MCV.

  • Blood loss or breakdown of red blood cells

    After blood loss or breakdown of red blood cells the MCV can rise, because the bone marrow releases young red blood cells that are slightly larger than average.

MCV (Mean Corpuscular Volume): lifestyle and this value

Discuss an abnormal MCV with your GP. According to Thuisarts, someone with anaemia from too little iron is given iron tablets, and with a shortage of vitamin B12 or folate tablets with vitamin B12 or folate. Thuisarts then advises having blood taken again after 4 weeks.

MCV (Mean Corpuscular Volume): frequently asked questions

What does MCV stand for?

According to the NVKC, MCV is short for mean corpuscular volume, the average size of the red blood cells. According to the NVKC, the MCV test is part of the complete blood count.

What causes a high MCV?

According to the NVKC, a high MCV can point to a shortage of vitamin B12 or folate. A US review article (American Family Physician, 2009) also names alcoholism and medicines among the most common causes of an MCV above 100 fl.

Does the normal MCV range differ between laboratories?

According to the NVKC, MCV reference values can differ slightly between laboratories, but Star-SHL, Unilabs, Certe and Diagnostiek voor U all four use 80 to 100 fl for adults. Star-SHL and Certe give that limit for people older than 18, Unilabs and Diagnostiek voor U for people older than 15.

MCV (Mean Corpuscular Volume): sources

  1. Nederlandse Vereniging voor Klinische Chemie en Laboratoriumgeneeskunde. MCV. "Bij gezonde volwassenen ligt de MCV-waarde ongeveer tussen 80 en 100 femtoliter." Tevens: "Deze referentiewaarden kunnen per laboratorium iets variëren." De bron maakt geen onderscheid tussen mannen en vrouwen. Geraadpleegd 13 augustus 2026. (retrieved 2026) allesovertesten.nl
  2. Star-shl, Labbepalingen (referentiewaarden per bepaling), star-shl.nl, geraadpleegd 2026-10-01 (retrieved 2026) star-shl.nl
  3. Unilabs, Bepalingenklapper (referentiewaarden per bepaling), bepalingenklapper.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenklapper.nl
  4. Certe, Bepalingenwijzer (referentiewaarden per bepaling), bepalingenwijzer.certe.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenwijzer.certe.nl
  5. Diagnostiek voor U, eLabgids (Referentiewaarden DvU), diagnostiek.getincontrol.eu, geraadpleegd 2026-10-01 (retrieved 2026) diagnostiek.getincontrol.eu
  6. NVKC, Alles over testen: MCV, allesovertesten.nl, geraadpleegd 2026-10-15 (retrieved 2026) allesovertesten.nl
  7. Van Vranken M. Evaluation of Microcytosis. Am Fam Physician. 2010;82(9):1117-1122 (retrieved 2026) aafp.org
  8. Kaferle J, Strzoda CE. Evaluation of Macrocytosis. Am Fam Physician. 2009;79(3):203-208 (retrieved 2026) aafp.org

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,-
General checkup

General checkup

A broad blood test covering 18 values across liver, kidneys, thyroid, heart, vitamins and blood count.

ALT (Alanine Aminotransferase) GGT (Gamma-Glutamyl Transferase) Creatinine eGFR (Estimated Glomerular Filtration Rate) TSH (Thyroid Stimulating Hormone) Total Cholesterol HDL Cholesterol LDL Cholesterol Triglycerides Glucose (Fasting) Vitamin D (25-OH) Vitamin B12 Ferritin Hemoglobin Leukocytes (WBC) Platelets (Thrombocytes) CRP (C-Reactive Protein) MCV (Mean Corpuscular Volume) Cholesterol/HDL Ratio Non-HDL Cholesterol LDL/HDL Ratio
€199,-

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Medical standards

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Medical policy
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MCV (Mean Corpuscular Volume)

€8,-