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Hematology

MCH in men: what a low or high level can mean

According to Thuisarts, every red blood cell contains haemoglobin, the substance that carries oxygen from the lungs to the rest of the body. According to the NVKC, the MCH value is calculated from the amount of haemoglobin and the number of red blood cells, and it reflects the degree to which the red blood cells are filled with haemoglobin.

According to the NVKC, the MCH value can be too low in anaemia from iron deficiency and too high in anaemia from a lack of vitamin B12 and/or folate. Only a blood test shows how the MCH value comes out.

Certe uses 1700 to 2100 amol for men older than 18, and those limits are the same for men and women older than 18. According to Thuisarts, in people older than 50, anaemia is often caused by small amounts of blood loss through the stomach or gut over a longer time.

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.

  • A low MCH can fit iron deficiency or thalassaemia, a defect of the haemoglobin protein; a high MCH a lack of vitamin B12 or folate.
  • Star-SHL, Unilabs and Diagnostiek voor U publish no limit for MCH.

Reference Ranges

Male
fmol
Low 1.65 Normal 2.1 High

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

MCH (Mean Corpuscular Hemoglobin): what Dutch laboratories use

Reference ranges by group, in amol
Certe · Male · 18 years and older 1700–2100 amol
1700 2100
1600 2200 amol

Source: Certe

Each value as the laboratory itself publishes it, retrieved in 2026.

MCH (Mean Corpuscular Hemoglobin): what this test measures

How much haemoglobin the red blood cells hold, according to the NVKC, is what Certe reports as the MCH result in attomole (amol) and Diagnostiek voor U in femtomol (fmol); 1000 attomole is 1 femtomol.

MCH (Mean Corpuscular Hemoglobin): why this value matters

Blood loss that goes unnoticed, for example through stomach problems from painkillers, can lead to anaemia according to Thuisarts, and the MCH value is one of the ways to trace the cause of such anaemia, according to the NVKC.

MCH (Mean Corpuscular Hemoglobin): how the blood test works

Referral
No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw
A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Where
650+ draw sites run by independent laboratories across the Netherlands. Draw sites

MCH (Mean Corpuscular Hemoglobin): when is testing worthwhile?

According to the NVKC, finding the cause of anaemia is one reason a doctor can request an MCH test; usually that test comes as part of the complete blood count.

MCH (Mean Corpuscular Hemoglobin): symptoms of a high or low value

Low Levels

According to the NVKC, anaemia from iron deficiency can be the reason an MCH comes out low. According to Thuisarts, blood loss with a disease of the stomach or gut, such as a bowel polyp (a growth on the inside of the bowel) or bowel cancer, can lead to anaemia.

High Levels

According to the NVKC, anaemia from a lack of vitamin B12 and/or folate can be the reason an MCH comes out high. According to Thuisarts, too little vitamin B12 is usually caused by a disease of the stomach or gut, such as atrophic gastritis or Crohn's disease, and the stomach medicines omeprazole and pantoprazole can also cause too little vitamin B12, according to Thuisarts.

MCH (Mean Corpuscular Hemoglobin): causes of a low or high value

What lowers the value

  • 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.

What raises the value

  • 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.

MCH (Mean Corpuscular Hemoglobin): lifestyle and this value

With an abnormal MCH value, the GP is the next step. According to Thuisarts, with anaemia an examination of the stomach or gut may be needed when there are also stomach complaints or when someone is older than 50, to be sure it is not stomach or bowel cancer.

MCH (Mean Corpuscular Hemoglobin): frequently asked questions

Is the MCH limit for men different from that for women?

No, at Certe the MCH limits for men and women older than 18 are the same: 1700 to 2100 amol. For boys aged 12 to 18, Certe uses 1563 to 1874 amol and for girls of that age 1539 to 1874 amol.

Which medicines can lower vitamin B12?

Medicines that according to Thuisarts can cause too little vitamin B12, a shortage that, according to the NVKC, can lie behind anaemia with a high MCH, include the stomach medicines omeprazole and pantoprazole and the diabetes medicine metformin.

MCH (Mean Corpuscular Hemoglobin): sources

  1. Certe, Bepalingenwijzer (referentiewaarden per bepaling), bepalingenwijzer.certe.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenwijzer.certe.nl
  2. NVKC, Alles over testen: MCH, allesovertesten.nl, geraadpleegd 2026-10-06 (retrieved 2026) allesovertesten.nl
  3. Gulati G, Uppal G, Gong J. Unreliable Automated Complete Blood Count Results: Causes, Recognition, and Resolution. Ann Lab Med 2022;42(5):515-530. (retrieved 2026) pmc.ncbi.nlm.nih.gov

Tests with related values

These panels measure values from the same category as this marker.

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