According to Thuisarts, the body builds haemoglobin, the oxygen-carrying protein in the red blood cells, with iron, vitamin B12 and folate. How much haemoglobin is in the red blood cells is shown by the MCH value, which according to the NVKC is calculated from the haemoglobin and the number of red blood cells.
In anaemia, the MCH value can go two ways: according to the NVKC too low with iron deficiency and too high with a lack of vitamin B12 and/or folate. Where the MCH value lies can only be seen with a blood test.
For adults older than 18, the MCH reference value at Certe lies between 1700 and 2100 amol.
Doctor's Assessment Included
MCH is the average amount of haemoglobin, the protein that carries oxygen, in one red blood cell; it is calculated from haemoglobin and the red cell count. Certe uses 1700 to 2100 attomol for adults, equal to 1.70 to 2.10 femtomol.
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Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.
Check your own value| Laboratory | Group | Reference value (amol) | Relative scale |
|---|---|---|---|
| Certe | · Male · 18 years and older | 1700–2100 amol |
1700 2100
|
| Certe | · Female · 18 years and older | 1700–2100 amol |
1700 2100
|
Source: Certe
Each value as the laboratory itself publishes it, retrieved in 2026.
According to the NVKC, the MCH test determines how much haemoglobin is in the red blood cells, and Certe gives the result in attomole (amol).
The MCH value, according to the NVKC, is an aid in looking for the cause of anaemia, and according to Thuisarts that cause matters for the advice and the treatment.
With a tired and weak feeling, dizziness or less colour in the face, symptoms that according to Thuisarts fit anaemia, a doctor can request an MCH test according to the NVKC to find the cause of anaemia.
According to the NVKC, iron deficiency can give anaemia with a low MCH. According to Thuisarts, too little iron can come from eating very little food with iron in it for years, or from a disease that makes it harder for iron to get into the body through the gut.
According to the NVKC, too little vitamin B12 and/or folate can give anaemia with a high MCH. According to Thuisarts, food can contain too little vitamin B12 when someone eats very little, and the diabetes medicine metformin can cause too little vitamin B12. According to Thuisarts, folate is found in spinach, wholemeal bread and beans, among other foods.
Iron deficiency
A low MCH can point to anaemia from iron deficiency.
Thalassaemia
In thalassaemia, a defect of the haemoglobin protein in the red blood cells, MCH is too low.
Vitamin B12 or folate deficiency
A high MCH can point to anaemia from a lack of vitamin B12 or folate.
Fat or burst cells in the blood sample
A lot of fat in the blood sample gives a falsely high MCH, and red blood cells that burst in the tube can do the same.
An abnormal MCH value goes to the GP. With too little folate, Thuisarts advises a daily pill of 0.5 milligrams of folate, and with too little vitamin B12 a daily pill of 1000 micrograms of vitamin B12.
According to Thuisarts, a vegan diet can give too little vitamin B12, and according to the NVKC a lack of vitamin B12 can go together with anaemia and a high MCH.
Yes, according to Gulati and colleagues (Annals of Laboratory Medicine, 2022), lipaemia, a lot of fat in the blood, is not uncommon in blood samples from people with diabetes, and according to the same article that fat in the sample makes the MCH falsely high.
These panels measure values from the same category as this marker.
Red blood cells, white blood cells and platelets in one test — a broad look at your blood.
Complete blood count, iron status, vitamin B12 and vitamin D in one panel — eating a lot less also means fewer nutrients coming in.
Medical reviewer
Dr. Naimi oversees the medical standards behind our content and assessments.
Medical policyDoctor's Assessment Included
Every result includes a professional assessment from a BIG-registered doctor. For treatment decisions, discuss your results with your GP.
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