MCH and alcohol: folate, vitamin B12 and the MCH value
According to Thuisarts, folate and vitamin B12 are needed to make haemoglobin, the oxygen carrier in the red blood cells. According to the NVKC, MCH is a measure of the haemoglobin filling of the red blood cells.
According to the NVKC, a high MCH can point to anaemia from a lack of vitamin B12 and/or folate, and a low MCH to anaemia from iron deficiency. Only a blood test shows the MCH value.
Certe uses 1700 to 2100 amol for adults older than 18. According to Thuisarts, drinking a lot of alcohol can lead to a shortage of vitamin B12 and folate: drinking a lot for a long time for vitamin B12, often drinking too much for folate.
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
See the value that applies to you:
Choose male or female — this range differs by sex.
Enter your age — this range changes with age.
This range also depends on context such as cycle phase or sample material; the highlighted rows apply to your group.
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.
MCH (Mean Corpuscular Hemoglobin): what Dutch laboratories use
| 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.
MCH (Mean Corpuscular Hemoglobin): what this test measures
According to the NVKC, an MCH value expresses the haemoglobin filling of the red blood cells and is calculated from the haemoglobin and the number of red blood cells; Certe reports that value in attomole (amol). According to Gulati and colleagues (Annals of Laboratory Medicine, 2022), an automated full blood count typically includes MCV, the mean volume of a red blood cell, as well as MCH.
MCH (Mean Corpuscular Hemoglobin): why this value matters
To find the cause of anaemia, a doctor looks at the MCH value among other things, 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, a doctor can use an MCH value to find the cause of anaemia, and also to look for blood disorders with abnormal red blood cells.
MCH (Mean Corpuscular Hemoglobin): symptoms of a high or low value
Low Levels
Anaemia from iron deficiency is one possible explanation the NVKC gives for a reduced MCH.
High Levels
According to the NVKC, a raised MCH value may point to anaemia from too little vitamin B12 and/or folate; in someone who drinks a lot of alcohol for a long time, the vitamin B12 shortage can come from the diet, 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 result, you go to the GP. According to Thuisarts, folate or vitamin B12 pills can be bought at the chemist or pharmacy.
MCH (Mean Corpuscular Hemoglobin): frequently asked questions
How is alcohol linked to folate?
Too little folate, which according to the NVKC can come with anaemia and a raised MCH, comes according to Thuisarts from often drinking too much alcohol, or from too little folate in food, such as spinach, wholemeal bread and beans.
What does a large MCV say about alcohol?
According to a 2009 review in American Family Physician, alcoholism, vitamin B12 and folate deficiencies, and medicines are the most common causes of red blood cells that are too large, read from the MCV, while MCH shows the amount of haemoglobin per cell. That article generally defines red blood cells that are too large as an MCV above 100 fL.
MCH (Mean Corpuscular Hemoglobin): sources
- Certe, Bepalingenwijzer (referentiewaarden per bepaling), bepalingenwijzer.certe.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenwijzer.certe.nl
- NVKC, Alles over testen: MCH, allesovertesten.nl, geraadpleegd 2026-10-06 (retrieved 2026) allesovertesten.nl
- 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
Medical reviewer
Medical standards
Dr. Naimi oversees the medical standards behind our content and assessments.
Medical policy
Welzijn en Sport Official BIG registration BIG 49928676701 Opens in a new tab
Doctor's Assessment Included
Every result includes a professional assessment from a BIG-registered doctor. For treatment decisions, discuss your results with your GP.