Hydrogen-Methane Breath Test


Analysis of breath samples, collected before and after a challenge drink, determines the likely role of bacterial overgrowth in digestive symptoms. Tests can be conducted in the privacy of your home, or in our Auckland clinic. Watch our videos below.



Written instructions, including the preparation diet are here. In brief, you will follow a special diet for 1-2 days. Then on the morning of testing a baseline breath sample is collected, after which you’ll have a drink with the provided testing substance (a type of sugar). Then, every 15-20 minutes, (for three hours) you will collect another breath sample, the exact spacing and number of samples is dependent on the sugar being tested (see videos belwow). Once your test has been completed, you can eat and drink normally.

The Hydrogen-methane breath test can help determine the role of bacteria in the small intestine in your health and overall digestive function.  Small intestinal bacterial overgrowth (SiBO) has been associated with irritable bowel (IBS), inflammatory bowel diseases (IBD), eczema, rosacea, fibromyalgia, liver disorders and many other conditions. Emerging evidence links it to autoimmune diseases such as scleroderma and neurological disorders such as Parkinson’s Disease & depression.
Breath testing is also used to test for malabsorption or intolerance of other sugars, such as lactose, fructose and sucrose (table sugar).

Who Should do the Hydrogen-Methane Breath Test?

There are several indications for running the Hydrogen-methane breath test. The main thing to be aware of is that it is a measure of bacterial activity – no matter which test you choose. Testing for SiBO test may be indicated if you experience any of these symptoms:
  • Gas, bloating, reflux or heartburn
  • Abdominal pain
  • Constipation or diarrhoea
  • Unexplained malabsorption
  • Digestive disturbance after a tummy bug, antibiotics, pain killers or stomach acid-reducing drugs (may also be worse from probiotics, fibre, certain fruit/veges or wholefoods).
  • Skin problems (acne, psoriasis, rosacea etc)
  • Body pain or fibromyalgia
  • Brain fog or fatigue
  • Iron deficiency or gut symptoms when taking iron supplements
  • Cognitive dysfunction (memory, concentration/brain fog)
  • Neurological disorders including Parkinson’s Disease.

The best strategy for determining if SiBO is likely, is running both a lactulose and glucose challenge. These are tested on different days. For malabsorption testing, lactulose then the sugar/s being tested. Each test is completed on a different day. You have to follow the same preparation diet for each test.

What are the Options for Doing the Hydrogen-Methane Breath Test?

You can do the Breath Test at home or in our Auckland clinic. The hydrogen-methane breath test kit is designed so that you can collect breath samples in the convenience of your own home. The test is also suitable for children, as long as they can blow into a bag following instruction to do so. Alternatively, you can arrange to conduct the test in our clinic (Mt Albert, Auckland). If a person is easily confused, overly anxious or for some reason unable to follow instructions accurately, an in-clinic test is the preferred option for accurate results.

NOTE: In-clinic tests are run on weekdays. You will need to arrive at the clinic between 9.00am and 9.30am on the test day, and expect to be at the clinic for at least 3 hours.

  • Bacterial Overgrowth: Two breath tests should be conducted, first using glucose then lactulose, each has its different advantages and disadvantages. Best practice is to complete three tests – glucose, lactulose and fructose.
  • Lactose Intolerance: If you are concerned about dairy intolerance, then lactulose, followed by lactose is the recommended procedure.
  • Fructose Malabsorption: Commonly associated with IBS, a challenge with fructose can be run after a lactulose challenge.

NOTE: according to current breath testing guidelines, a lactulose (+/- glucose) challenge must be conducted before lactose intolerance or fructose malabsorption testing is done.  

How is the Hydrogen-Methane Breath Test Done?

The test is collected in the morning, over about 3-hours (depending on the test sugar), after period of diet preparation. You will need to:

  • Follow a restricted diet for one day (or two if constipated). Diet preparation instructions are here.
  • Fast (water-only) overnight (12 hours)
  • Be awake (no exercise) for one hour before starting the test.
  • Collect a baseline breath sample. Conduct a mouthwash (supplied), then another breath sample.
  • Drink the provided substrate, mixed or dissoved in water
  • Then, at the specified intervals, you will collect additional breath samples (11 samples in total for glucose & lactulose, 7 or 8 samples for frucose & lactose). Follow the instructions on your paperwork. If you are doing multiple tests (e.g., lactulose & glucose), you will only do the mouthwash once.

Watch our instructional video here: (you can pause it at any time) For conducting the GLUCOSE test

For conducting the LACTULOSE test

If you are conducting Lactose or Fructose testing, please check with us for the instructions.

What Will I Need to Conduct the Breath Test at Home?

If you choose to do the hydrogen-methane breath test at home, you will need:

  • A timer (the one on your cell phone is perfect)
  • Water and glass
  • Pen
  • A 4-hour period for conducting the test (one hour of which is being awake before testing can start)

Everything else is supplied in the test kit. For accurate results, it is crucial that the breath samples are collected correctly. Please watch the videos above and read the instructions in your kit, which explains the procedure. If you are unsure whether you can collect the samples correctly, please book the in-clinic test. Once your test has been completed, you can eat and drink normally. Package the tubes in the box they came in, place in the pre-paid courier bag provided and either phone the courier to collect or drop in to your local post shop.

How do I get the Results of my Breath Test?

A consultation is required to discuss your breath test results and to develop a management plan when your samples have been analysed. Reports are typically ready within 5-7 working days of them being received at our lab. The results session/initial (comprehensive 90-minute) consultation can be booked with either Sharon Erdrich, Emma Gardiner, Latimer Clark, Sandy Watts or Verity Vincent, or your report will be forwarded directly to your registered health practitioner. You can read more about breath testing here. Our testing and interpretation protocols are congruent with those outlined in the North American Breath Testing Guidelines (2017) as published in the American Journal of Gastroenterology (PMID28323273), the American College of Gastroenterology Clinical Guideline for breath testing, and have been further refined based on our own research. Please note: Test results are delivered in the context of a professional consultation – either in our clinic, online or we can send the results to the registered health consultant you specify. For more information about the background and science behind the SiBO test, please read here or give us a call 09 846 5566 Read more about SiBO here Samples must reach us within 5 days of collection (a return courier bag is provided).Turnaround time for results: 5-7 working days. You can read more about Hydrogen-methane breath testing here. Book your test here.

or give us a call on 09 846 5566

Additional information

Weight 0.3 kg
Dimensions N/A
Test Options

Test kit (at Home), Two-test combo (Kits, Any two), Three-test combo (Kits, Any three), In-clinic test (by appointment, Mt Albert, Auckland)

Test Substrate #1

Lactulose, Glucose

Test Substrate #2

Glucose, Fructose, Lactose, Sucrose, None

Test Substrate #3

Glucose, Fructose, Lactose, Sucrose, None