From the Guidelines
Your MCHC level of 31.5 g/dL is slightly below the normal range, indicating a potential mild hypochromic anemia, and I strongly recommend further evaluation to determine the underlying cause, particularly iron deficiency, as suggested by the British Society of Gastroenterology guidelines 1. To address this minor decrease, it is essential to consider the potential causes, including iron deficiency, chronic disease, or thalassemia minor. According to the guidelines, a reduction in MCH is a reliable marker of iron deficiency, and it may be more sensitive than MCV 1.
- Key points to consider:
- Iron deficiency can be diagnosed using serum markers such as low ferritin, low transferrin saturation, and raised total iron-binding capacity 1.
- A serum ferritin level of <15 μg/L is highly specific for iron deficiency, while a cut-off of 45 μg/L provides a respectable specificity of 0.92 1.
- Increasing dietary intake of iron-rich foods, such as lean red meat, beans, lentils, spinach, and fortified cereals, may help address mild iron deficiency.
- If supplements are considered, taking an over-the-counter iron supplement containing 18-25 mg of elemental iron daily, preferably with vitamin C to enhance absorption, may be beneficial. It is crucial to follow up with a healthcare provider for further evaluation, especially if symptoms like fatigue are present or if other blood values are abnormal, to determine the underlying cause of the decreased MCHC level and develop an appropriate treatment plan.
From the Research
MCHC Levels and Anemia
- The given MCHC level is 31.5, which is below the low normal range of 31.7-35.3.
- According to 2, iron deficiency anemia is the most common microcytic anemia, and MCHC levels can be used to diagnose and evaluate anemia.
- A study by 3 found that MCHC levels can be used to discriminate iron deficiency anemia, with a cutoff value of 337.5 g/L having an area under the ROC curve (AUC) of 0.80.
Diagnostic Accuracy of MCHC
- Research by 4 found that MCHC is only moderately accurate in diagnosing empty iron stores in children and young adults, with an area under the ROC curve of 0.68-0.87.
- The study by 3 also found that MCHC levels can be used to diagnose iron deficiency anemia, but further studies are needed to elucidate its utility in discriminating iron deficiency.
- Another study by 5 found that the platelet count/MCH ratio can distinguish combined iron and vitamin B12 deficiency from uncomplicated iron deficiency, but did not specifically address the diagnostic accuracy of MCHC.
Prognostic Role of MCHC
- A study by 6 found that low MCHC values are significantly associated with poor prognostic outcomes in patients with hepatocellular carcinoma after hepatectomy.
- The study suggests that preoperative MCHC can predict prognosis for patients with hepatocellular carcinoma, but does not address the relationship between MCHC levels and anemia.