Here at the Personalized Natural Medicine Clinic, we routinely perform an hour-long Hydrogen Breath Test. Though this isn’t a new test, few physicians perform it. During all visits, we have each patient blow once into a hydrogen breath machine to get a baseline hydrogen breath measurement. What we look for is an uneven distribution of good bacteria versus bad bacteria. When there is an abundance of bad bacteria, it is called dysbiosis. Common symptoms of dysbiosis include gas, bloating, diarrhea, constipation, heartburn, fatigue, and nausea. If a patient blows a score of 20 parts per million (PPM) or above, we ask them to come back for another office visit to do the full hour-long Hydrogen Breath Test.
How does a Hydrogen Breath Test work?
The test works by monitoring the amount of hydrogen gas that is exhaled during the course of 12 seconds. If the result is in the range of 20-30 PPM, it indicates an excessive amount of “bad” bacteria in the digestive tract. While there are bacteria all over the body from the skin to the digestive tract, they are usually beneficial. When the system gets disrupted, the digestive tract changes and non-commensal bacteria (aka bad bugs) take up residence. These non-commensal bacteria start “stealing” food and supplies and wreaking havoc on the body. While these cells are stealing supplies, they start producing hydrogen gas as a waste product.
What do the results mean?
If the test comes back low, it means one of two things:
- You are healthy and do not have dysbiosis
- You have dysbiosis and might have a strain of bacteria that produce methane instead of hydrogen (very few patients fall under this category
If the test comes back elevated, it can mean a couple things:
- You have dysbiosis
- You have just recently consumed food
Depending on how high your hydrogen level is, we may recommend coming back for a full hydrogen test. A full hydrogen test includes fasting for 12 or more hours followed by taking a baseline hydrogen blow. After we take the baseline blow, the patient drinks a sugary liquid called lactulose. We then take hydrogen breath readings every 15 minutes for the next hour. Lactulose is an undigestible synthetic sugar which bad bacteria love to eat. When the bad bacteria consume the lactulose, they produce hydrogen as they try to digest this undigestible sugar.
The interesting part about the full test is we can gauge where the dysbiosis is depending upon when the result appears. For example, if after the first 15 minutes of drinking lactulose, your hydrogen blow result is high, this indicates bacteria in your upper GI tract. If your hydrogen blow results are high after 45 minutes, it would indicate dysbiosis in the lower GI tract. When a Lactulose test comes back consistently high (20 or above), it can indicate a diagnosis of Small Intestinal Bacterial Overgrowth aka SIBO.