Q&A: My SIBO Glucose Breath Test Was Negative. Is It Accurate?

This video addresses patient's experience with SIBO symptoms and the interpretation of their recent Trio Smart breath test results using glucose.
Listener's Situation and Test Results

• The listener reports classic SIBO symptoms such as bloating and gas.
• They underwent a Trio Smart test using glucose, which showed normal results except for a slight increase in hydrogen approximately four hours into the test.
• Confusion arose as the standard test duration is only two hours, and the observed increase was beyond this timeframe and not considered positive.

Expert Analysis: The Glucose Breath Test

• Dr. Siebecker advises against using glucose for SIBO testing, deeming it an ineffective substrate for diagnosis.
• The primary reason cited is that glucose is absorbed very early in the small intestine, specifically within the first three feet. This rapid absorption may prevent it from reaching areas where SIBO bacteria could ferment it and produce measurable gases, leading to potential false negatives or inconclusive results.
• A reference is made to Dr. Hawrelack's insights on this topic, with a resource shared for further viewing.

Recommended Next Steps for Testing
To achieve a more accurate diagnosis, the following alternatives are recommended:

• Redo the Test with a Different Substrate:
  • Fructose: Suggested as a more effective substrate than glucose.
  • Lactulose: Recommended if available. Dr. Allison Siebecker notes that lactulose is often easier to obtain via prescription from a primary care physician because it is commonly recognized and prescribed as a laxative.
• Consider FoodMarble: an at home hand held device
• Utilize Trio Smart Again: The expert specifically suggests redoing the Trio Smart test because it has the capability to test for hydrogen sulfide, in addition to hydrogen and methane. This provides a more comprehensive assessment.

The core takeaway is that the choice of substrate in a breath test is critical for accurate SIBO diagnosis, and glucose may not be the most suitable option for all individuals.

Tests mentioned:
- Lactulose SIBO tests can be ordered directly by anyone, via the following:

• True Health (all U.S. states, Canada, Europe)
• Direct Labs (U.S. [excluding NY, NJ, RI] Canada, Europe)
• Rupa Heath: Genova (U.S. excluding NY, NJ, RI)
• Trio-Smart (all U.S. states) 

- 25g Fructose can be used with Foodmarble SIBO test