MCHC

Introduction

As a nurse practitioner with an autonomous practice in Florida, I frequently encounter patients who are eager to understand the nuances of their blood test results. One such important marker that often comes up in conversations is the Mean Corpuscular Hemoglobin Concentration (MCHC). This biomarker offers valuable insights into your red blood cells’ health and can guide us in diagnosing and monitoring various conditions, particularly anemias. In this article, we will explore the background of MCHC, its clinical implications, optimal ranges, interfering factors, and how medications can affect its levels.

What is MCHC?

MCHC stands for Mean Corpuscular Hemoglobin Concentration. It is a calculated measure that indicates the average concentration of hemoglobin in a person’s red blood cells. Hemoglobin is the protein in red blood cells responsible for carrying oxygen throughout the body. By calculating MCHC, we can assess whether your red blood cells have a sufficient amount of hemoglobin, which is crucial for efficient oxygen transport.

How is MCHC Calculated?

MCHC is calculated using two of the most accurate hematological determinations: hematocrit (HCT) and hemoglobin (HGB). The formula is as follows:

\text{MCHC} = \left( \frac{\text{Hemoglobin (g/dL)}}{\text{Hematocrit (%)}} \right) \times 100

This calculation gives us an insight into whether the concentration of hemoglobin within the red blood cells is within the expected range.

MCHC Ranges and Their Clinical Implications

Standard and Optimal Ranges

The standard range for MCHC in U.S. units is 32.00 – 36.00 g/dL. An optimal range is slightly narrower, from 34.00 – 36.00 g/dL. It’s important to note that MCHC values seldom exceed 37 g/dL because red blood cells cannot accommodate more than this concentration of hemoglobin.

Clinical Implications of Low MCHC

A decreased MCHC level can indicate several underlying health issues:

1. Vitamin C Need: Often associated with low MCHC, a need for vitamin C may also correlate with decreased albumin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), hematocrit, hemoglobin, and serum iron, and increased alkaline phosphatase and fibrinogen.
   
2. Vitamin B6 Deficiency Anemia: Marked by decreased MCV, MCH, MCHC, hemoglobin, and hematocrit, with increased or normal serum iron and/or ferritin levels.
   
3. Iron Deficiency Anemia: Characterized by decreased MCH, MCV, MCHC, hematocrit, and hemoglobin, along with decreased ferritin, transferrin saturation, and increased red cell distribution width (RDW) and total iron-binding capacity (TIBC).
   
4. Heavy Metal Body Burden: Toxic elements like lead, aluminum, and cadmium can decrease MCH and MCHC—often confirmed via heavy metals testing.
   
   

Clinical Implications of High MCHC

1. Vitamin B12 and/or Folic Acid Deficiency Anemia: Leads to larger red blood cells and is characterized by increased MCHC, MCH, MCV, RDW, and LDH, with decreased uric acid levels. Measurement of methylmalonic acid and homocysteine helps confirm this diagnosis.
   
2. Hypochlorhydria: Low stomach acid may present with increased MCHC and MCH, low serum iron, and altered globulin levels.
   
   

Interfering Factors

Some factors can lead to falsely increased or decreased MCHC readings:

• Falsely Increased Levels: Hyperlipidemia, rouleaux formation (stacking of red blood cells), and high heparin concentrations can falsely elevate MCHC.
  
• Falsely Decreased Levels: No prominent interferents have been noted for decreased MCHC.
  
  

Drug Associations

Certain medications can influence MCHC levels, leading to either decreased or increased readings:

• Drugs Causing Decreased Levels: Immunosuppressants and some chemotherapy agents can reduce hemoglobin concentration in red cells.
  
  
• Drugs Causing Increased Levels: Some agents that alter red cell membrane integrity or hemoglobin binding may artificially raise MCHC readings.
  
  

When is MCHC Testing Recommended?

MCHC testing is particularly valuable when monitoring anemia therapy, as it relies on the most accurate hematological determinations (HCT and HGB). It provides a reliable measure to assess the effectiveness of treatment for anemia and related conditions.

Functional Medicine Perspective

In my practice, I adopt a functional medicine approach, emphasizing the root causes of imbalances. By addressing dietary inadequacies, absorption issues, and potential toxic exposures, we develop a comprehensive strategy to restore balance and improve health.

In conclusion, a comprehensive evaluation by a functional medicine in Florida facilitates identification of cellular-level and molecular imbalances driving hematologic dysfunction. By integrating evidence-based therapies with IV therapy services—where nutrient repletion and anemia management often intersect—we offer patients a preventive framework to restore balance and optimize wellness. Call (904) 799-2531 or schedule online to request your personalized hematologic health assessment.

Further Reading

• Mean corpuscular hemoglobin concentration: an anemia parameter and predictor of nonatherosclerotic CVD. J Nephrol. 2021;34(3):915–922. https://pubmed.ncbi.nlm.nih.gov/34213761/
  
• The relationship between mean corpuscular hemoglobin concentration and mortality in hypertensive individuals: A population-based cohort study. PLoS One. 2024;19(5):e0301903. https://pubmed.ncbi.nlm.nih.gov/38722884/
• The Association Between Mean Corpuscular Hemoglobin Concentration and Prognosis in Patients with Acute Pulmonary Embolism: A Retrospective Cohort Study. Clin Appl Thromb Hemost. 2022;28:10760296221103867. https://pubmed.ncbi.nlm.nih.gov/35642292/