MCH · high result
What does a high MCH mean?
Short answer
A high MCH means each red cell carries more hemoglobin than average, which almost always goes with a high MCV — large cells. The usual causes are vitamin B12 or folate deficiency, alcohol use, liver disease, hypothyroidism and some medications (methotrexate, hydroxyurea, anticonvulsants). MCH is read with MCV and MCHC; on its own it rarely changes management.
Medically reviewed by Youmna DiStefano, MD · Last reviewed September 2026
What is the normal range for MCH?
- age 18+: 27.0 – 33.0 pg
Full reference table, citations and testing options: MCH biomarker page.
What are the common causes of high MCH?
- Vitamin B12 or folate deficiency
- Alcohol use, liver disease
- Hypothyroidism
- Medications: methotrexate, hydroxyurea, zidovudine, some anticonvulsants
- Reticulocytosis (young red cells are larger), myelodysplasia (less common)
- Cold agglutinins or high lipids in the sample (false high)
What symptoms go with high MCH?
- None from MCH itself
- Fatigue, tingling, sore tongue and memory change with B12 deficiency
What do clinicians usually check next?
- B12, folate, TSH, liver panel
- Peripheral smear and reticulocyte count
- Alcohol and medication review
Follow-up tests available at TestWell: TSH (Thyroid Stimulating Hormone) ($26.99), TSH + Free T4 ($27.99), Folate (Vitamin B9) ($32.99).
How do you recheck MCH?
Prices are cash-pay; every order adds one $6 lab processing fee. Physician authorization is included; no insurance or referral needed.
| Test or panel | Type | Price | Fasting | Results |
|---|---|---|---|---|
| General Wellness Panel | Panel · 4 tests | $89.99 | Yes | 1–3 business days |
| Blood Clotting Panel | Panel · 4 tests | $149.99 | No | 3–7 business days |
| Baseline Anemia Panel | Panel · 5 tests | $74.99 | Yes | 2–4 business days |
| CBC with Differential | Test · 14 biomarkers | $21.99 | No | 1–3 business days |
Common questions
Is high MCH the same as high MCV?
They usually rise together — bigger cells hold more hemoglobin. MCV is the primary index; MCH adds little unless MCHC is also abnormal.
Educational content, not a diagnosis. Lab results are one input; a clinician interprets them with your history and exam.