Breath Hydrogen Testing

bacteria2by Robert Brody, ND

Here at the Center of Excellence, 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, heart burn, 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.

How do we treat dysbiosis?

While there are many different ways to treat someone with dysbiosis, we always use an individualized approach. We are all unique and thus should be treated as such. We usually first address Dysbiosis with diet. Changing your SWAMI Diet helps the good bugs proliferate. We will also use probiotics to help address repopulation of the GI tract. Dr. D’Adamo formulated a Probiotic line called Polyflora after 30 years of clinical practice. Polyflora is filled with the bacteria that normally populate individual blood type’s GI tracts. In 2013 Drs. Peter D’Adamo and Natalie Colicci did a small investigation to determine if the Blood Type diet can affect SIBO. They found that patients who followed the diet have a decreased amount of hydrogen levels. Click Here to See the Study

Although there are many symptoms associated with dysbiosis and SIBO, with the proper protocol, this is something that can be treated.