Low MCHC symptoms and who’s at risk

In this article:

• What does low MCHC feel like?
• What are the early signs of low MCHC?
• Other low MCHC symptoms
• Low MCHC symptoms and demographics
• High vs. low MCHC symptoms
• When to see a doctor for low MCHC symptoms
• Complications of low MCHC
• How to treat low MCHC symptoms
• Living with low MCHC
• MCHC management and treatment

In this article

• What does low MCHC feel like?
• What are the early signs of low MCHC?
• Other low MCHC symptoms
• Low MCHC symptoms and demographics
• High vs. low MCHC symptoms
• When to see a doctor for low MCHC symptoms
• Complications of low MCHC
• How to treat low MCHC symptoms
• Living with low MCHC
• MCHC management and treatment

Mean corpuscular hemoglobin concentration, or MCHC, indicates the average hemoglobin, the protein in red blood cells that carries oxygen throughout the body to various tissues, concentration in blood. For someone who is getting bloodwork done for MCHC, they are most likely being evaluated for a condition known as anemia. 

Anemia is a condition where the hemoglobin in the blood does not carry sufficient oxygen throughout the body. Hemoglobin is an iron-rich molecule; therefore, the most common cause of iron-deficiency anemia is insufficient iron. Deficiency anemia can include many potential causes impacted by various factors. Still, the most common causes of anemia are blood loss, lack of red blood cell generation, and rapid and high rates of red blood cell destruction.

The blood level cutoff for low MCHC is any result below 32 g/dL.

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What does low MCHC feel like?

Low MCHC includes feeling generally fatigued, weak, and unwell. Someone with low MCHC may experience dizziness, rapid heartbeats, shortness of breath, drier skin than usual, and abnormal bruising. The skin may also appear paler than normal.

What are the early signs of low MCHC?

Before undergoing diagnostic tests, there may be symptoms present of low MCHC. It is critical to consult with a medical professional if any of the below symptoms are experienced, impacting your overall health. Healthcare providers may complete a physical exam and recommend lab work to determine the root cause of symptoms. Signs of low MCHC may be ambiguous, and hard to pinpoint the exact cause.

Some early signs of low MCHC include:

• Fatigue
• Tiredness
• Dizziness
• Lightheadedness
• Cold extremities (hands and/or feet)
• Numbness or tingling in the extremities
• Paler skin than normal
• Loss of appetite
• Headache

While these are the beginning signs of low MCHC, anemia can progress into more severe symptoms. Worsening signs of low MCHC include:

• Discoloration of the skin or whites of the eyes
• Brittle, easily breakable nails
• Shortness of breath or difficulty breathing at rest or with minimal activity
• Sore, inflamed, or swelled tongue
• Ulcers in the mouth
• Loss of sexual desire
• Heavier and/or longer periods than normal

Other low MCHC symptoms

The most commonly reported MCHC symptoms include fatigue, tiredness, and weakness. More severe symptoms such as difficulty breathing, inflamed or swollen tongue, development of ulcers, and discoloration of the skin are rare and typically present as the disease progresses. However, there may be an underlying condition that can lead to the development of low MCHC. 

Conditions that can lead to low MCHC include:

• Pregnancy
• Ulcers
• Genetic disorders
• Dietary deficiencies of iron, folic acid, and vitamin B12
• Colon polyps
• Cancer
• Blood or bleeding disorders
• Heavier and/or longer periods than normal
• Metabolic disorders

If you are experiencing any of the symptoms above or have a condition listed above, speak with your healthcare provider if you are concerned about your MCHC.

Low MCHC symptoms and demographics

While low MCHC can affect anyone, there are some trends in demographic data. Studies show that gender and race may affect MCHC levels and lead to symptoms of anemia.

The Office of Disease Prevention and Health Promotion states that women are more likely than men to have iron deficiency. This is due to women losing blood during menstruation, in addition to pregnancy and childbirth, also inducing iron deficiency. As of 2016, 11% of women aged 12 to 49 years had iron deficiency.

A 2015 study showed that when compared to white patients, Asian and black patients displayed lower MCHC levels. In contrast, Hispanic patients displayed higher MCHC levels than white patients. Likewise, another paper states that older non-Hispanic black patients are three times more likely to have anemia (27.8%) than older non-Hispanic white patients (9%).

Low MCHC presents similarly in varying demographics, with fatigue, tiredness, and weakness presenting as the most common and recognizable symptoms, though the onset or cause of anemia varies.

High vs. low MCHC symptoms

The normal range of MCHC is 32 g/dL to 36 g/dL and is measured as part of a complete blood count, or CBC, test. Low MCHC, also known as hypochromia, means a low hemoglobin concentration in the blood. Therefore, the ability to deliver oxygen to your tissues is reduced. A low MCHC value can be caused by iron deficiency, lead poisoning, sideroblastic anemia, anemia of chronic disease, or a condition known as thalassemia.

Another condition associated with abnormal iron levels is hypochromic microcytic anemia with iron overload. In this condition, the normal transport of iron in cells is impaired as the red blood cells cannot access iron within the blood. This causes a decrease in red blood cell production, causing abnormal red blood cells that are small and pale.

Contrastingly, high MCHC, also known as hyperchromia, means that the concentration of hemoglobin in the blood is higher than normal. Potential causes of a high MCHC can include autoimmune hemolytic anemia, hereditary spherocytosis, severe burns, liver disease, hyperthyroidism, sickle cell disease, or hemoglobin C disease. The tricky part is that some low and high MCHC symptoms are the same, making it hard to differentiate and determine which you are experiencing. Fatigue, weakness, and paleness may indicate either high or low MCHC. However, many symptoms differentiate the two as well. See below for a comparison of hyperchromic and hypochromic symptoms.

	High MCHC	Low MCHC
Test results	Above 36 g/dL	Below 32 g/dL
Shared symptoms	fatigue weakness paleness
Unique symptoms	yellowing of the skin and/or whites of the eyes chest pain fever fainting abdominal discomfort	dizziness shortness of breath dry skin bruising easily rapid heartbeat

When to see a doctor for low MCHC symptoms

One should see a trusted healthcare provider when experiencing symptoms of low MCHC. The earlier it is caught, the sooner actions can be taken to prevent worsening. Your medical team is equipped to make the best decisions surrounding your treatment plan.

Contact your healthcare provider if you seem more fatigued, tired, and weaker than normal. Tell them of your symptoms. Likely, your healthcare provider will recommend an MCHC test by ordering lab work to determine whether it is low MCHC or another cause. Low MCHC is diagnosed through blood work with an MCHC level of less than 32 g/dL per liter.

However, if you are experiencing more severe symptoms such as difficulty breathing, discoloration of the skin or whites of the eyes, shortness of breath, sore, inflamed, or swollen tongue, or mouth ulcers, you should visit your local emergency room. These signs may indicate a severe case and could lead to serious complications. Visiting the hospital in these circumstances can lead to a more stable condition sooner than waiting for blood work.

As discussed, low MCHC may be caused by heavier and/or longer periods than normal. It is encouraged to consult with a gynecologist if experiencing menstrual changes, as this could indicate a separate issue.

Complications of low MCHC

Low MCHC levels, if left untreated, can lead to more severe symptoms. The most common symptom of low MCHC is lack of energy, tiredness, weakness, and decreased stamina. Low MCHC can result in feeling exhausted at rest or with minimal activity.

A more severe complication of low MCHC levels is anemic hypoxia. Anemic hypoxia happens when blood cannot carry enough oxygen to the tissues throughout the body. This causes a buildup of carbon dioxide and can lead to life-threatening complications if not treated promptly and properly.

Anemic hypoxia presents as rapid heartbeat, confusion, fast breathing, mental changes, irritability, sweating, shortness of breath, wheezing, and coughing. Seek immediate medical attention if you are experiencing these symptoms, as this is a medical emergency.

How to treat low MCHC symptoms

Low MCHC typically requires treatment, which doesn’t necessarily mean taking medication. Treatment options for low MCHC and anemia may include diet changes or taking a supplement. As the type of anemia progresses or in more severe cases, medication, blood transfusions, or blood and bone marrow transplants may be necessary.

• Diet. Eating healthy foods rich in iron (such as spinach, red meat, broccoli, chickpeas, and fish) and foods with lots of Vitamin B12 (such as eggs, yogurt, dairy, and turkey) can replace some nutrients in the body. It is important to eat foods that are iron and B12-rich for someone with mild or severe anemia.
• Medications. Immunosuppression, or medicines that suppress the immune system, may be necessary. Likewise, prescription iron treatments may also be warranted. Iron tablets are available to take by mouth or can also be an infusion.
• Dietary supplements. Dietary supplements can be taken to ensure you are getting enough vitamin B and iron. Taking over-the-counter iron supplements helps to keep your iron level up. B12 is also available as a shot. 
• Procedures. Blood transfusion from blood donors may also be a viable treatment option. Likewise, bone marrow transplants could replace faulty blood-forming cells with healthy cells.

The bottom line? There are options. A diagnosis of anemia may seem scary at first, but there are many options and opportunities to manage it. Speaking with a healthcare provider is essential to receive helpful information and discuss the best treatment plan when experiencing signs of anemia.

Living with low MCHC

While low MCHC can seem complicated, it is important to note that it is treatable and manageable. Taking iron and B12  consistently can help maintain adequate levels and prevent MCHC from dropping.

If your healthcare provider prescribes a prescription treatment, be sure to continue treatment for as long as instructed. Do not stop taking the medication or receiving treatment without consulting with healthcare professionals.

Once MCHC begins to rise, symptoms will improve. Energy and strength will increase as levels rise, reducing tiredness, weakness, and fatigue. Skin pigment should return to normal if it has changed, and breathing should also return to normal.

It is important to take control of your health and stay active while receiving treatment. This is beneficial for all ages, including older adults. Regular walking or other mild exercise can keep the body moving and prevent muscle loss when feeling fatigued. Maintaining a healthy diet full of nutrient-rich, fibrous foods will also help restore energy. Eating healthy will help to avoid nutritional deficiencies and other health problems.

MCHC management and treatment

Low MCHC symptoms may resolve on their own without treatment. However, if low MCHC symptoms continue, worsen, or are accompanied by chest pains, difficulty breathing skin or eye discoloration, or mouth ulcers, it could be a sign of a more complicated case or hypoxic anemia and require an emergency room visit and medical intervention. Only your healthcare provider can rule out infection or other serious health conditions. Visit your doctor to determine the best way to manage symptoms of low MCHC.