Optimal Result:
0 - 20 ppm.
GENERAL CONSIDERATIONS FOR BREATH TESTING
Small intestinal bacterial overgrowth (SIBO) is a heterogeneous syndrome characterized by an increase in the number and/or the presence of atypical microbiota in the small intestine. Genova's SIBO breath test relies on measurement of gases produced by microbiota in the intestine - hydrogen (H2) and methane (CH4) - following ingestion of lactulose in a fasting state.
A normal transit time of lactulose (10 g) in healthy fasting patients from the mouth to the junction between the small and large intestine (oro-cecal transit time, or OCTT) is approximately 90 minutes. In general, transit times have been found to vary in humans. Given such findings, transit time should be taken into consideration when interpreting breath testing.
To preclude elevated breath levels of hydrogen and methane prior to the ingestion of lactulose (at baseline), impeccable patient preparation and sample collection are imperative. Falsely elevated findings may result from incomplete avoidance of high-fiber foods, residual fiber in the intestine due to delayed transit time, residual oropharyngeal (mouth and throat) bacteria, exposure to tobacco smoke, or napping during collection.
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EVALUATION FOR HYDROGEN (H2)
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.
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References:
Rezaie A, Buresi M, Lembo A, et al. Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus. The American journal of gastroenterology. May 2017;112(5):775-784. [L]
A rise of H2 of > 20 ppm over baseline in the first 90 minutes of testing is positive for SIBO.
An increase in hydrogen (H2) of more than 20 parts per million (ppm) on a Small Intestinal Bacterial Overgrowth (SIBO) breath test typically indicates a positive result for SIBO. The test works by measuring the levels of hydrogen and methane in the breath after the ingestion of a sugar solution (usually lactulose or glucose). Bacteria in the small intestine ferment these sugars, producing hydrogen and/or methane as byproducts, which are then absorbed into the bloodstream and exhaled in the breath.
Here’s what an increase in hydrogen of more than 20 ppm generally signifies:
Presence of Excess Bacteria in the Small Intestine: Normally, the small intestine has relatively few bacteria. A significant increase in hydrogen suggests that bacteria are present in higher-than-normal numbers, fermenting the ingested sugar and producing hydrogen gas.
Positive Diagnosis for SIBO: A rise in hydrogen levels by more than 20 ppm from baseline values typically confirms a diagnosis of SIBO, according to most medical guidelines.
Symptom Correlation: Patients with SIBO often experience symptoms such as bloating, abdominal pain, diarrhea, and/or constipation. The increase in hydrogen is indicative of bacterial overgrowth that correlates with these gastrointestinal symptoms.
It is important to consider other factors such as the specific protocol followed during the test, the patient’s preparation, and baseline hydrogen levels to accurately interpret the results. Consulting a healthcare professional is crucial for a comprehensive assessment and appropriate treatment plan.
When both H2 and CH4 are present, treatment may require more than one antimicrobial agent. Patients who received a combination of rifaximin and neomycin showed a higher rate of methane eradication on breath testing compared to patients who received either rifaximin or neomycin alone. There was also a better clinical response with the combination therapy.
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Potential treatment options:
Treatment options for Small Intestinal Bacterial Overgrowth (SIBO) typically include a combination of dietary modifications, antibiotics, probiotics, and sometimes other supportive measures. Here are the common treatment options:
1. Antibiotics
Rifaximin is the most commonly prescribed antibiotic for SIBO. It is poorly absorbed in the gut, making it effective at targeting bacteria in the small intestine with fewer systemic side effects. Other antibiotics that might be used include:
2. Dietary Changes
3. Probiotics
Probiotics can help restore a healthy balance of gut bacteria. Commonly used strains include:
4. Herbal Antimicrobials
Herbal treatments can be effective for some patients, either alone or in combination with other treatments. Common herbal antimicrobials include:
5. Prokinetics
Prokinetic agents can help improve motility in the gastrointestinal tract, reducing the risk of bacterial overgrowth. Examples include:
6. Supportive Treatments
7. Addressing Underlying Conditions
Treating underlying conditions that may contribute to SIBO, such as:
8. Lifestyle Modifications
Follow-up and Monitoring
Regular follow-up with a healthcare provider is important to monitor symptoms, ensure treatment effectiveness, and adjust the treatment plan as necessary. In some cases, repeat breath tests may be conducted to assess the eradication of bacterial overgrowth.
Consulting with Healthcare Professionals
It's crucial to work closely with healthcare providers, including gastroenterologists and dietitians, to develop and follow an individualized treatment plan tailored to the specific needs and underlying conditions of the patient.
Import lab results from multiple providers, track changes over time, customize your reference ranges, and get clear explanations for each result. Everything is stored securely, exportable in one organized file, and shareable with your doctor—or anyone you choose.
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Easily upload lab results from any provider, whether it's a hospital, independent lab, or home testing service. We support PDFs, scanned documents, and JPEGs from patient portals. No need to log in to multiple platforms — everything is centralized in one secure space.
Easily upload lab results from any provider — we support PDFs, scans, and images. Keep all your reports organized in one secure place.
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Every lab result is automatically organized on a chronological timeline, giving you a complete picture of your health journey. Whether you're tracking a condition, managing treatments, or staying proactive, the timeline helps you and your doctor understand how things progress over time.
Every lab result is automatically organized on a chronological timeline, giving you a complete picture of your health journey.
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Our database covers over 10,000 biomarkers with clear, simple explanations—so you can finally understand your results and what to do next.
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If you'd like to handle inputting your health data into your account, you can do so with our easy-to-use data entry forms. Our user-friendly form is designed to guide you through the quick and easy submission process, making it simple to keep track of your health metrics. This is available to both Complete plan and Unlimited plan members.
Our user-friendly form guides you through a quick, simple submission process, making it easy to enter your health metrics.
Add your results anytime with our easy entry form. It's quick, guided, and helps you stay organized — free for all members.
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View your lab data through easy-to-read graphs and tables. Quickly spot patterns, track changes, and compare results across different dates — all without digging through multiple reports. You can also select and compare graphs of specific biomarkers side-by-side to better understand how they relate and change over time.
See your lab reports in clear graphs and tables. Spot patterns, track changes, and compare results over time — all in one place.
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Export Your Complete Lab History
After collecting lab results from different providers, you can download your entire history combined into a single file. Choose from PDF, Excel, or CSV formats to easily review, share, or get a second opinion—no more juggling multiple reports.
After collecting lab results from different providers, you can download your entire history combined into a single file.
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Data Entry Service for Your Reports
Our inclusive service handles the data entry for your lab reports. Just submit your information and we'll take care of the rest. Complete plan members receive one report entered for free, then $15 per report after that. Unlimited plan members receive ten report entries for free, then $15 per report after that.
Our inclusive service handles the data entry for your lab reports. Just submit your information and we'll take care of the rest.
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Whether you're working with a doctor, nutritionist, caregiver, or wellness coach, you can securely share your complete lab history by sending an invite link to anyone you trust. You have full control over who sees your information and for how long, ensuring your privacy and peace of mind at every step.
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As a PRO member and medical practitioner, Healthmatters.io has been an invaluable tool for tracking my clients' data. The layout is intuitive, making it easy to monitor trends and spot patterns over time. The ability to customize reports and charts helps me present information clearly to my clients, improving communication and outcomes. It's streamlined my workflow, saving me time and providing insights at a glance. Highly recommended for any practitioner looking for a comprehensive and user-friendly solution to track patient labs!
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Healthmatters is a personal health dashboard that helps you organize and understand your lab results. It collects and displays your medical test data from any lab in one secure, easy-to-use platform.
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Healthmatters.io personal account provides in-depth research on 4000+ biomarkers, including information and suggestions for test panels such as, but not limited to:
You can combine all test reports inside your Healthmatters account and keep them in one place. It gives you an excellent overview of all your health data. Once you retest, you can add new results and compare them.
If you are still determining whether Healthmatters support your lab results, the rule is that if you can test it, you can upload it to Healthmatters.
While we work with many popular labs, we welcome reports from lots of other places too.
It's as simple as this: if you can get a test done, you can upload it to Healthmatters and we can interpret results from any lab out there. If laboratories can analyze it, we can interpret it.
If you're on the hunt for a specific biomarker, contact us and we'll add it to our database. Anything from blood, urine, saliva, or stool can be uploaded, understood, and tracked with your Healthmatters account.
The Complete Plan ($15/month) is perfect for individuals who want ongoing access to their health data. It includes unlimited lab imports, visual tracking, custom ranges, result explanations, full account exports, and secure sharing — all with a simple monthly subscription. You can cancel anytime and restart your plan whenever you're ready — your data will still be there waiting for you. You can also upgrade to the Unlimited Plan at any time, with the cost prorated based on what you've already paid.
The Unlimited Plan ($250 one-time) is also designed for individuals but offers lifetime access with no ongoing subscription. You'll get all the same features as the Complete Plan, plus a larger initial data entry allowance (10 reports), making it a great choice if you prefer a one-time payment and long-term use without monthly fees.
In short:
There are two ways to add your test reports to your Healthmatters account. One option is to input the data using the data entry forms. The other method is to utilize our "Data entry service."
Our data entry forms offer an easy, fast, and free way for you to input the reports yourself. Self-entry allows you to add an unlimited number of reports at no cost. We make the self-entry process user-friendly, providing dozens of templates that pre-populate the most popular laboratory panels and offering instant feedback on entered values.
For those who prefer assistance, we offer a "Data entry service" to help you input your data. Simply attach an image or file of your lab test results, and a qualified team member from our data entry team will add the results for you.
We support various file types, including PDFs, JPGs, or Excel. This service is particularly useful if you have many reports to upload or if you're too busy to handle the data entry yourself.
Our Data Entry Service is for when you don't want to manually type in your lab results yourself. You simply upload your report (PDF, image, or screenshot), and our trained team enters the information into your Healthmatters account for you — accurately and neatly organized, ready to view in graphs, tables, and timelines.
The $15 per report covers the time and care it takes for a real person to review your file, make sure each result is entered correctly, and double-check for accuracy. This ensures your health data is precise and easy to work with — without you having to spend the time doing it yourself.
Prefer to do it yourself? You can always use our free self-entry tool to add results manually — it just takes a bit more time and attention.
For users on the Complete monthly plan, the first report is entered free of charge, and each additional report incurs a fee of $15.
Unlimited account holders enjoy the entry of ten reports without charge. Subsequent reports are subject to a $15 fee per report.
Additionally, users on the Complete plan can upgrade to a yearly subscription from the account settings. The annual subscription includes a data entry service for five reports.
All professional accounts allow you to import and onboard an unlimited number of clients and their lab results. The distinction between professional plans lies solely in the data entry service.
The Pro Monthly Plus plan is priced at $75 per month and includes a data entry service for five reports each month. Additional reports can be self-entered at no extra cost or, if preferred, you can use our data entry service for an additional fee of $15 per report.
The Pro Monthly plan is priced at $45 per month and does not include a data entry service. Self-entry is free for an unlimited number of reports, and you can opt for the data entry service at a fee of $15 per report.
You also have the option to upgrade to higher monthly or to annual plans, which come with substantial discounts. All upgrades can be done directly from your account.
Simply log in and navigate to your account settings to cancel your subscription. Scroll down to locate the 'Cancel' button at the bottom of the page. Ensure you cancel at least one day before the renewal date to prevent any charges. Once cancellation is requested, the subscription remains active until the conclusion of the current billing cycle.
Our goal has been to make your Healthmatters account as intuitive as possible.
We've crafted multiple ways for you to navigate your data, whether you're glancing at a single report or delving into your historical test reports.
1. Graph View:Dive into a visual journey with our biomarker graphs, showcasing over 40 data points. Combining years of results unveils trends, empowering you to make informed decisions. Our visualization tools make it a breeze to compare and understand changes over time, even if your results are from different labs. A search function and filters simplify the exploration of extensive data, allowing you to focus on what needs attention.
2. All Tests ViewExplore neatly organized reports on a timeline, highlighting crucial details like dates, critical results, and lab/panel names. Each report opens up to reveal in-depth descriptions and additional recommendations for each biomarker. The history of previous results is just a click away, and you can download a comprehensive report for deeper insights. Color-coded and user-friendly, it's designed for easy reading, understanding, and navigation.
3. Table View:For a holistic view of all biomarkers side by side, our table view is your go-to. Results are neatly displayed in a categorized and dated table, ideal for those with an extensive test history. Utilize sorting, filters, and color-coding to enhance your analysis and gain extra insights.
Yes, you can download your information anytime. We offer two easy ways to export your lab data:
This makes it simple to save, back up, or share your health data whenever you need.
Yes, you can print your report. To do so, navigate to "All tests" and open the report you wish to print. You'll find a print button in the right corner of the report. Click on it, and your browser's print window will open. If you prefer to print in a bigger typeface, adjust the scale using the print window settings.
Yes, you can! We highly recommend activating Two-Factor Authentication (2FA) for your account. To do so, please navigate to the "Profile and Security" section of your account, where you will find instructions for activating 2FA.
Yes, you can. When entering values for the biomarker, you will see an "Edit Range" button. Click this button, and you'll have the option to enter a custom range.
A personal account is all about keeping your own lab test results in check. It's just for you and your personal use.
The professional account is designed for health professionals who wish to track and organize their clients' laboratory results.
To learn more about Healthmatters Pro, please refer to the professional page.
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