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Causes of increases and decreases in the average hemoglobin content of the erythrocyte

Alexey Kryvenko, medical expert
Last reviewed: 06.07.2025

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This indicator reflects the degree of saturation of the erythrocyte with hemoglobin, it can be calculated using the formula: Hb (g/l)/RBC (10 ¹² /l). MCH has no independent value and is always related to MCV, color index and MCHC. Based on these indicators, anemia can be divided into normo-, hypo- and hyperchromic.

A decrease in MCH (i.e. hypochromia) is characteristic of hypochromic and microcytic anemias, including iron deficiency, anemia of chronic diseases, thalassemia; some hemoglobinopathies, lead poisoning; and impaired porphyrin synthesis.

Increased MCH is a marker of macrocytosis and hyperchromia. Therefore, increased MCH is detected in megaloblastic anemia, anemia after acute blood loss, many chronic hemolytic anemias, hypoplastic anemia, hypothyroidism, liver diseases, metastases of malignant diseases; when taking cytostatics, oral contraceptives, anticonvulsants.