Mean Corpuscular Hemoglobin (MCH) is one of the blood test parameters that measures the average amount of hemoglobin within red blood cells, and may also be known as mean globular hemoglobin (HGM).
The HCM, as well as the VCM, are requested in a blood count in order to identify the type of anemia the person has, hyperchromic, normochromic or hypochromic.
Changes in HCM levels can occur due to alcohol consumption, changes in the thyroid and anemia, and it is important that a doctor is consulted so that the cause of high or low HCM can be identified and the most appropriate treatment can be initiated, if necessary.

HCM reference values
Normal values for mean corpuscular hemoglobin in picograms per red blood cell are:
- Newborn: 27 – 31
- 1 to 11 months: 25 – 29
- 1 to 2 years: 25 – 29
- 3 to 10 years: 26 – 29
- 10 to 15 years: 26 – 29
- Man: 26 – 34
- Woman: 26 – 34
These values indicate the color that the blood cell has, so when the values are low, the center of the cell becomes whitish and when the values are increased, the cell becomes darker than normal.
Do you have questions about your exam results?
How to know if HCM is normal
To find out if the HCM is normal, insert your test result into the following calculator:
What does the result mean
The main changes to HCM are:
1. HCM alto
When values are above 34 picograms in adults, this indicates hyperchromia, so that the red blood cell is darker than normal due to the large amount of hemoglobin per red blood cell, which can happen due to high alcohol consumption, use of some medications or thyroid changes.
It is also common for red blood cells to be larger than normal, which may be indicative of megaloblastic anemia, which occurs due to a deficiency of vitamin B12 and folic acid.
2. HCM goes down
When values are below 26 picograms in adults, it is indicative of hypochromia, in which the red blood cell is lighter in color than normal due to the lower concentration of hemoglobin per red blood cell, which may be due to iron deficiency anemia due to lack of iron, and thalassemia, which is a type of genetic anemia.
It is also common to notice red blood cells that are smaller than normal, known as microcytic red blood cells, and it is important to evaluate the other parameters of the blood count and the results of other tests that may have been indicated so that the cause of hypochromia and microcytosis can be identified.
Bibliography
- BUTTARELLO, M. Laboratory diagnosis of anemia: are the old and new red cell parameters useful in classification and treatment, how?. Int J Lab Hematol. 38. Suppl 1; 123-32, 2016
- YAMAGUCHI, S.; et al. Mean corpuscular hemoglobin concentration: an anemia parameter predicting cardiovascular disease in incident dialysis patients. J Nephrol. 35. 2; 535-544, 2022
- TANAKA, M.; et al. Combined effect of hemoglobin and mean corpuscular volume levels on incident metabolic syndrome: A population-based cohort study. Clin Nutr ESPEN. 40. 314-319, 2020
- GU, H.; et al. Effectiveness of Using Mean Corpuscular Volume and Mean Corpuscular Hemoglobin for Beta-thalassemia Carrier Screening in the Guangdong Population of China. Biomed Environ Sci. 34. 8; 667-671, 2021
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