What are the limitations of a hydrogen breath test?

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Patsy Catsos
Nutrition & Dietetics
One problem with hydrogen breath testing is that it is not specific for fructose malabsorption. There are other reasons why your test could be positive for hydrogen in your breath, including invasion of the small intestine by bacteria normally only present in the colon (this is called small intestine bacterial overgrowth, or SIBO).

There are several additional reasons that the test could fail to give a positive result even if you do have fructose malabsorption. Diarrhea or active bowel disease can interfere with the outcome of the test. The dose of fructose given (usually 25 grams) may not be high enough to provoke symptoms in some individuals. In research settings, up to 50 grams of fructose may be given to measure fructose malabsorption. If an individual is a methane producer, and the lab does not analyze breath samples for methane, the test could fail to give a positive result.
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.