A hydrogen and methane breath test is a valuable diagnostic tool to accurately predict FODMAP intolerance and SIBO. The decrease in hydrogen with the increase in methane is indicative of this microbiome composition. Methane has several important biological effects that can protect cells and organs from inflammation, oxidant, and apoptosis. Meaning, could the body have deliberately ‘allowed’ for a bloom in methanogens (the methane producing organisms) to maintain some degree of health, at the expense of  constipation? These gasses are primarily produced by organisms in the gut, are transported to the lungs and then exhaled. It is thought this might be caused by imbalances in the oral microbiome, stomach microbiome or be indicative of severe constipation. The more calories your body can absorb, the more weight gain you will likely experience. Notice that the plot crosses the dashed line at 20 ppm, which indicates a “supported” (positive) result for hydrogen. It is a type of gas produced by an organism in the human gut called methanogens. The common test results above are guidelines only and should be correlated with clinical information that is unavailable to CDI. Research has discussed how oxidative stress in those with IBD (inflammatory bowel disease) may contribute to poor motility. This is due to the competing methanogens consuming the hydrogen gas to produce methane gas. There are 2 tests that can diagnose SIBO: endoscopy with culture, and hydrogen/methane breath testing. This may be due to hydrogen sulfide production from sulfur-reducing bacteria, which a hydrogen and methane breath test cannot detect. The focus can’t be on just trying to lower the methane levels. Patients that do not produce any hydrogen or methane throughout the entire test, but still present with GI-related symptoms, often have this plot. However, not as many people know that the gas, via different levels of research, has been found to have anti-oxidant, anti-inflammatory and antiapoptosis properties. Patients who produce both methane and hydrogen often demonstrate this plot. Early studies evaluating breath methane as a potential marker for intestinal methane production in the general population, proposed a criterion for methane positivity that was based on the ability to detect breath methane at a level at least 1 ppm higher than the atmospheric methane level of approximately 1.8 … We can do a SIBO Breath test which evaluates he amount of hydrogen and methane an individual is excreting via the breath. Click here to learn more about CDI’s non-invasive at-home breath tests or to place a collection kit order. We first need to establish what a positive methane test is. The North American Consensus criteria state that a result of 10ppm or higher, at any point in the breath test, may be viewed as positive for methane. Healthcare providers should assess each patient’s clinical factors that may affect the interpretation of the test results and ensure that the test results correlate with the patient’s symptoms and other related findings for diagnostic and treatment purposes. Click here to listen to my podcast with Dr. Jacobi on SIBO. Poor motility may allow for a bloom in methane producing organisms – not just because they are ‘slow growers’ but because they may be helping quench the oxidative stress that has contributed to the poor motility. Notice that the two plots do not cross either the dashed line for hydrogen or the dotted line for methane, which indicates the test would be a “not supported” result for either gas production. Generally people consider elevated test results to indicate an imbalance in these methanogens organisms, and an underlying cause of constipation dominant IBS. Notice that the plot is above the dotted line at 10 ppm, which indicates a “supported” (positive) result for methane. The carbon dioxide gas level allows us to check if (a) the breath sample is valid and (b) normalizes the results in case the breath collection is not perfect. We many want to include strategies to directly lower the level of methanogens in the gut, but we also need to be thinking about any underlying factors that may have allowed for this in the first place? I think the main message from this is that we have to take a Functional Medicine/holistic approach to this condition. Medical studies show FODMAP restriction informed by breath tests provides significant and long-term symptom improvement in 75% of IBS patients. In conclusion, the combined measurement of hydrogen and methane should offer considerable improvement in the diagnosis of malabsorption syndromes and SIBO when compared with a single hydrogen breath test. Copyright © 2020 Commonwealth Diagnostics International, Inc. All Rights Reserved. Higher levels of breath methane are also linked with obesity in humans. So the question becomes does this change how we support a client when they have a positive SIBO test? The American College of Gastroenterology’s Clinical Guidelines for SIBO also suggest the use of breath testing (either glucose hydrogen or lactulose hydrogen) for the diagnosis of SIBO in 1) patients with IBS, 2) symptomatic patients with suspected motility disorders or 3) symptomatic patients with previous luminal abdominal surgery. This quote comes from a 2013 paper entitled ‘The importance of methane breath testing: a review‘. Patients who have symptoms such as constipation often will have high methane production that is present at high levels during the entire length of the test. Commonwealth Diagnostics International, Inc. Hydrogen Sulfide: The good, the bad and the misunderstood, The importance of methane breath testing: a review, Chronic Fatigue Syndrome: A Functional Medicine Approach. CDI is working with the research community to assess future modalities for diagnostic testing for H2S (hydrogen sulfide). According to Dr. Pimentel, those who test positive for methane on a breath test have been shown in the data to have higher body mass index numbers (BMI). This test would be a “not supported” result for either gas.