How to improve low MCH and MCHC?

December 16, 2025 •

4 min read

Anemia, a condition frequently associated with low MCH and MCHC results, affects over 2 billion people worldwide. These low blood test values indicate that red blood cells contain a lower-than-normal amount of hemoglobin, the protein responsible for oxygen transport, which can lead to various symptoms and health issues.

Quick Summary

This article outlines effective strategies to raise low mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) values, focusing on dietary adjustments, targeted supplementation, and lifestyle changes.

Key Points

Identify the Root Cause: Consult a doctor to determine if low MCH and MCHC are due to nutritional deficiencies (iron, B12, folate), chronic illness, or other factors.
Eat Iron-Rich Foods: Incorporate heme iron from meat and poultry, and non-heme iron from legumes and leafy greens, into your diet.
Boost B Vitamins: Increase your intake of vitamin B12 (found in fish, dairy, eggs) and folate (in greens and citrus fruits) to support red blood cell production.
Enhance Iron Absorption: Pair iron sources with vitamin C-rich foods like oranges or bell peppers and limit coffee and tea around meals.
Consider Supplements: A doctor may prescribe iron, vitamin B12, or folate supplements, especially in cases of severe deficiency or malabsorption.
Manage Underlying Conditions: Treat underlying issues like chronic kidney disease or celiac disease, which can impair nutrient absorption and red blood cell production.

Understanding Low MCH and MCHC

Mean Corpuscular Hemoglobin (MCH) measures the average amount of hemoglobin in a single red blood cell, while Mean Corpuscular Hemoglobin Concentration (MCHC) measures the average concentration of hemoglobin in a volume of red blood cells. When these values are low, it typically points to hypochromic microcytic anemia, a condition where red blood cells are both smaller and paler than normal due to insufficient hemoglobin. Hemoglobin is a complex protein that requires specific nutrients, primarily iron, to be produced correctly. Without enough hemoglobin, red blood cells cannot effectively transport oxygen throughout the body, leading to symptoms like fatigue, weakness, and shortness of breath.

The Primary Causes of Low MCH and MCHC

Identifying the underlying cause is the crucial first step toward improvement. While nutritional deficiencies are the most common culprits, other factors must be considered.

Nutritional Deficiencies

Iron Deficiency: The most frequent cause of low MCH and MCHC, this can result from inadequate dietary intake, poor absorption (due to conditions like celiac disease or gastric surgery), or chronic blood loss (e.g., heavy menstruation or internal bleeding).
Vitamin B12 and Folate Deficiency: These B vitamins are essential for the bone marrow to produce healthy red blood cells. A deficiency, which can be diet-related (especially for vegans) or due to conditions like pernicious anemia, can also lead to issues with red blood cell development.

Other Health Conditions

Thalassemia: This is an inherited blood disorder that affects the body's ability to produce hemoglobin, leading to anemia and low MCH/MCHC.
Chronic Diseases: Long-term illnesses such as kidney disease, autoimmune disorders (like rheumatoid arthritis), or cancer can cause anemia of chronic disease, which interferes with the body's use of iron.
Lead Poisoning: Exposure to lead can interfere with hemoglobin production and result in hypochromic anemia.

Dietary Strategies to Boost MCH and MCHC

For low MCH and MCHC caused by nutritional deficits, modifying your diet is a powerful and often first-line treatment. Focus on increasing your intake of key nutrients.

Foods Rich in Iron

Heme Iron (highly absorbable): Red meat, poultry, and seafood (especially oysters, clams, and sardines).
Non-Heme Iron: Legumes (lentils, beans), leafy greens (spinach, kale), dried fruits (apricots, raisins), nuts and seeds, and iron-fortified cereals.

Foods High in Vitamin B12 and Folate

Vitamin B12: Fish, meat, dairy products (milk, cheese, yogurt), eggs, and fortified cereals.
Folate (Vitamin B9): Leafy green vegetables, broccoli, brussels sprouts, citrus fruits, avocados, and legumes.

Nutrient Absorption Boosters

Vitamin C: Enhances the absorption of non-heme iron from plant-based foods. Combine foods like spinach and legumes with citrus fruits, strawberries, or bell peppers.
Copper and Vitamin A: These support iron metabolism and hemoglobin synthesis. Good sources include nuts, seeds, whole grains (for copper) and oily fish, carrots, and sweet potatoes (for vitamin A).

A Comparison of Nutrient Sources


Nutrient	Animal-Based Sources	Plant-Based Sources	Key Advantage
Iron	Red Meat, Poultry, Oysters, Liver	Lentils, Spinach, Tofu, Fortified Cereals	Heme iron from meat is more easily absorbed
Vitamin B12	Meat, Fish, Dairy, Eggs	Fortified Cereals, Nutritional Yeast, Plant-Based Milks	Crucial for vegetarians/vegans who require supplements or fortified foods
Folate (B9)	Liver, Eggs	Leafy Greens, Legumes, Citrus Fruits, Asparagus	Easily obtained from a wide variety of vegetables
Vitamin C	Minimal	Citrus Fruits, Berries, Bell Peppers, Broccoli	Significantly increases non-heme iron absorption

Supplementation and Medical Treatment

For many, dietary changes alone are insufficient. Consulting a healthcare provider is essential for a proper diagnosis and treatment plan.

Oral and Intravenous Supplements

Oral Iron: Often prescribed, especially ferrous sulfate, to quickly replenish iron stores. Low-dose, alternate-day iron dosing may be more effective and better tolerated by some individuals.
Intravenous (IV) Iron: Used for severe iron deficiency, malabsorption issues, or when oral supplements cause intolerable side effects.
Vitamin B12 and Folate: Supplements are available in tablets or, for B12, injections, especially for those with pernicious anemia or severe deficiency.

Other Treatments

Addressing Underlying Issues: If blood loss is the cause, treating the source (e.g., ulcers or heavy periods) is necessary. In cases of chronic disease, managing the primary condition is key to improving anemia.
Blood Transfusion: Reserved for severe, symptomatic anemia to rapidly increase red blood cell count and hemoglobin levels.

Lifestyle and Absorption Tips

Beyond diet and supplements, simple changes can help optimize your body's ability to correct low MCH and MCHC.

Enhancing Nutrient Absorption

Pair Nutrients Wisely: As mentioned, consuming iron-rich foods with vitamin C-rich foods boosts absorption significantly.
Avoid Iron Blockers: Tannins in coffee and tea, as well as calcium from dairy products, can inhibit iron absorption. Time your consumption to avoid these around iron-rich meals or supplements.
Hydration: Staying well-hydrated supports overall blood health and circulation.

Conclusion

Improving low MCH and MCHC is a multi-faceted process that starts with identifying and treating the underlying cause with a healthcare provider. For many, this involves a combination of targeted dietary changes, such as increasing iron, vitamin B12, and folate intake, and taking appropriate supplements. Optimizing nutrient absorption by pairing foods correctly and avoiding inhibitors is also vital. While addressing nutritional deficiencies often resolves the issue, persistent low levels may point to other health concerns that require medical attention. Consistent effort and professional guidance are key to restoring healthy blood counts, alleviating symptoms, and enhancing your quality of life.

For more detailed clinical information on blood disorders like iron deficiency anemia, the American Society of Hematology is a valuable resource. American Society of Hematology

Frequently Asked Questions

The fastest way depends on the underlying cause. If a nutritional deficiency is diagnosed, a doctor may prescribe high-dose oral iron or vitamin supplements. In cases of severe anemia, intravenous iron or a blood transfusion may be used for rapid repletion.

For mild deficiencies, dietary adjustments can be effective. However, for significant deficiencies or malabsorption issues, diet alone is often insufficient, and supplements or other medical treatments are necessary.

You should limit or avoid foods and drinks that inhibit iron absorption, such as coffee, tea, and excessive calcium from dairy products, especially around the time you consume iron-rich foods or supplements.

With appropriate treatment, such as iron supplementation, you may start feeling better within a week, but it can take several months or longer for your levels to fully normalize and for your body's iron stores to be replenished.

While low MCH and MCHC are strong indicators of anemia, particularly hypochromic microcytic anemia, other conditions can also cause these low values. A full diagnosis from a healthcare provider is essential.

You should see a doctor if your blood test results show low MCH and MCHC, especially if you experience symptoms like persistent fatigue, dizziness, or shortness of breath. This will ensure an accurate diagnosis and treatment plan.

Yes, a vegan diet can be a risk factor if not managed carefully. Plant-based iron (non-heme) is less readily absorbed, and vitamin B12 is primarily found in animal products. Vegans should focus on fortified foods and consider supplements.