Optimal Result:
0 - 29.46 ppm.
Hydrogen is produced when certain bacteria in the small intestine consume sugars and produce hydrogen gas as a byproduct.
Hydrogen levels are considered abnormal when they rise greater than ≥20 ppm (parts per million) from the baseline within 90 minutes.
In healthy humans, hydrogen gas is exclusively produced by intestinal bacteria - primarily a result of carbohydrate fermentation by anaerobic bacteria in the colon. In SIBO, fermentation of the malabsorbed lactulose substrate by bacteria residing in the small intestine results in elevated concentration of exhaled hydrogen (H2).
- The hydrogen result is the difference between the baseline hydrogen (S1) and the highest hydrogen finding among S2, S3, S4 or S5. The result does not take into account actual collection times. It is expected that the patient followed recommended collection times.
- A rise of H2 of ≥20 ppm over baseline in those samples collected after 90 minutes maybe positive for SIBO in patients with slower transit time or constipation.
- ELEVATED BASELINE - The clinical significance of elevated baseline H2 levels in patients reporting adherence to fasting and dietary guidelines is not known. In a symptomatic patient, some clinical groups with expertise in SIBO management may consider an elevated hydrogen baseline a positive test.
- Approximately 8 to 27% of individuals do not produce H2 due to the presence of methanogenic microbiota which consume hydrogen molecules to produce methane gas. As a result, low H2 findings through all time points in a symptomatic patient may reflect a false negative result. In this instance, clinical attention should be shifted to evaluation of CH4.
Lab Results Explained and Tracked
What does it mean if your H2 result is too high?
Elevated levels of hydrogen are indicative of SIBO.
SIBO, or small intestinal bacterial overgrowth, is defined as the presence of excessive numbers of bacteria in the small bowel, causing gastrointestinal symptoms. The normal small bowel has lower levels of microbial colonization than does the colon. This normal balance is significantly disrupted with SIBO.
SIBO can be a complex result of various medications and conditions, such as IBS, Celiac, Crohn’s disease, bowel surgeries, and several other gastrointestinal complications. The symptoms of SIBO can arise from the malabsorption of nutrients, alteration in intestinal permeability, inflammation, and/or immune activation that arises from the abnormal bacterial fermentation within the small bowel.
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