Other causes include severe liver disease, a diet very low in protein and
water loss (pregnancy, excess
water intake, and certain medications).
High MCH can be a sign of macrocytic anaemia (red blood cells are larger than normal. Enlarged blood cells are often associated with a deficiency or malabsorption of vitamin B12 and folate. Underlying causes can include liver problems, autoimmune diseases, severe hypothyroidism, bone-marrow diseases, use of certain medications and alcohol abuse.