How to fix a high MCH? Your guide to understanding and resolving elevated levels

October 1, 2025 •

4 min read

According to Cleveland Clinic, macrocytic anemia, often caused by vitamin B12 or folate deficiency, can lead to high Mean Corpuscular Hemoglobin (MCH). Learning How to fix a high MCH? is a process that requires a careful medical evaluation to determine the specific underlying cause.

Quick Summary

Elevated mean corpuscular hemoglobin levels are primarily corrected by treating the root cause, most often a vitamin B12 or folate deficiency, which can be remedied through diet, supplementation, and managing related conditions like liver disease or excessive alcohol consumption.

Key Points

Identify the Cause: A high MCH is a symptom, not a disease. Your doctor must identify the underlying reason, most commonly a vitamin deficiency, liver disease, or alcohol use.
Address Vitamin Deficiencies: For B12 or folate deficiencies, treatment involves dietary changes and, if necessary, supplements or injections to restore nutrient levels.
Make Lifestyle Changes: If heavy alcohol use is a factor, reducing consumption is a critical step toward normalizing MCH levels.
Treat Underlying Illnesses: Managing chronic conditions like hypothyroidism or liver disease is essential for resolving MCH abnormalities.
Consult a Doctor: Always seek medical advice for an accurate diagnosis and to create a safe, effective treatment plan for your specific situation.

What is a High MCH?

Mean Corpuscular Hemoglobin, or MCH, is a metric reported on a standard Complete Blood Count (CBC) test that measures the average amount of hemoglobin in each red blood cell. High MCH levels, typically over 33 picograms per cell, indicate that red blood cells are larger than normal and contain more hemoglobin. This condition is often referred to as macrocytosis and is a key indicator for further investigation into potential health issues.

Symptoms Associated with High MCH

While high MCH itself is a lab finding, the underlying cause can present with various symptoms. It is important to note that many people may not experience any symptoms at all. When symptoms do occur, they are often related to the associated anemia and can include:

Chronic fatigue and weakness
Shortness of breath
Pale or yellowish skin (jaundice)
Increased heart rate
Numbness or tingling in hands and feet
Trouble with balance or memory

Leading Causes of Elevated MCH

Identifying the cause of a high MCH is the crucial first step toward correcting it. Since MCH levels are a symptom of a larger issue, treatment is focused on addressing the source rather than the MCH value directly. The most common causes include:

Vitamin B12 or Folate Deficiency: These are the most frequent culprits behind macrocytic anemia and high MCH. The body requires these B vitamins to produce healthy red blood cells; without them, red blood cells grow larger and fail to divide properly.
Alcohol Use Disorder: Excessive alcohol consumption can interfere with the metabolism of B vitamins and directly impact bone marrow function, leading to the production of larger red blood cells.
Liver Disease: Conditions affecting the liver, such as chronic liver disease or cirrhosis, can disrupt normal red blood cell production and lead to an increase in MCH.
Hypothyroidism: An underactive thyroid gland can affect overall metabolism and blood cell production, sometimes resulting in macrocytosis.
Certain Medications: Some drugs, including certain chemotherapy agents, can interfere with red blood cell formation and cause MCH levels to rise.

Treatment Options to Address High MCH

The treatment approach for high MCH is entirely dependent on the underlying cause identified by a healthcare professional. A doctor will typically perform a full medical evaluation and blood work to pinpoint the exact issue.

Supplementation for Vitamin Deficiencies

If a vitamin B12 or folate deficiency is the cause, treatment is straightforward and highly effective. Options include:

Oral Supplements: Taking daily oral supplements of vitamin B12 and/or folate can help replenish low levels. Dosage will be determined by your doctor.
Injections: For individuals who have a problem absorbing these vitamins from their gut (such as with pernicious anemia), B12 injections may be necessary.

Dietary Adjustments

Changing your diet is a key, long-term strategy for managing vitamin deficiencies. Increasing your intake of nutrient-rich foods can help regulate MCH levels naturally. Consider incorporating these food sources:

For B12: Meat, eggs, dairy products, shellfish, and fortified cereals.
For Folate: Dark, leafy green vegetables, lentils, beans, citrus fruits, and fortified grains.

Lifestyle Modifications

For those with high MCH due to alcohol use, reducing or eliminating alcohol consumption is critical. This change can allow the body to recover and restore normal red blood cell production. A healthy, balanced diet also supports liver function and overall health.

Addressing Other Conditions

If the cause is related to liver disease, hypothyroidism, or another medical condition, treating that primary issue is the only way to resolve the elevated MCH. This could involve medication, managing the chronic disease, or working with a specialist.

Comparison of Causes and Treatments


Primary Cause	Typical Treatment	Dietary Recommendations	Prognosis
Vitamin B12 Deficiency	Oral supplements or injections	Increase intake of meat, eggs, and fortified cereals	Excellent with proper treatment
Folate Deficiency	Oral supplements	Increase intake of leafy greens, legumes, and citrus fruits	Excellent with proper treatment
Alcohol Use	Reduce or stop alcohol consumption	Balanced diet to support liver recovery	Improves as alcohol intake decreases
Liver Disease	Management of underlying liver condition	Specialized diet based on liver health	Depends on the severity of the liver disease
Hypothyroidism	Thyroid hormone replacement medication	N/A	Excellent with proper medication

Seeking Medical Advice

It is essential to consult with a healthcare professional to receive an accurate diagnosis and a personalized treatment plan. A high MCH reading is a signpost, not the final destination. A doctor can run additional tests to rule out other, less common causes and guide you on the most effective course of action.

For more information on blood health, visit the National Institutes of Health.

Frequently Asked Questions

MCH, or Mean Corpuscular Hemoglobin, measures the average amount of hemoglobin found in each of your red blood cells. A high value indicates that your red blood cells are larger than normal.

A high MCH typically suggests you have macrocytic anemia, which is when your body produces abnormally large red blood cells. The most common causes are vitamin B12 or folate deficiencies.

If high MCH is due to a B12 or folate deficiency, you can help normalize levels by eating foods rich in these nutrients, such as leafy greens, lentils, meat, and fortified cereals. This helps the body produce healthier, normal-sized red blood cells.

The severity depends on the underlying cause. While mildly high levels may be harmless, significantly elevated MCH could indicate a serious underlying condition like severe anemia, liver disease, or a nutrient absorption issue that requires medical attention.

Yes, long-term and excessive alcohol consumption is a common cause of high MCH. It can interfere with nutrient absorption and bone marrow function, leading to macrocytosis. Reducing or eliminating alcohol is often a key part of treatment.

The timeline depends on the cause and treatment. For vitamin deficiencies, levels can begin to normalize within weeks to months with proper diet and supplementation. Other conditions may take longer to manage.

It is always best to consult with a healthcare provider about any abnormal lab results. A high MCH should be investigated to determine its cause and to ensure any underlying health issues are addressed appropriately.