In the Undoctored program, we help followers identify, then manage, small intestinal bacterial overgrowth, SIBO, efforts that are often rewarded by substantial improvements in health conditions such as fibromyalgia, restless leg syndrome, rosacea, irritable bowel syndrome, and furthers recovery from ulcerative colitis, Crohn’s, and celiac disease. Our efforts got a recent boost with the availability of the AIRE consumer device that measures breath hydrogen gas, H2, to help identify SIBO, transmitting the result via Bluetooth to your smartphone, allowing you to identify SIBO from the comfort of your kitchen or living room. It also allows you to assess whether your SIBO-management efforts have succeeded in eradicating H2 production and whether recurrent symptoms represent recurrent SIBO.
When I first received my device, however, I was surprised to see that the accompanying instructions only talked about how the device was useful to navigate a low FODMAPs diet and made no mention of SIBO. It became eminently clear, however, that the AIRE device was, first and foremost, a SIBO-detecting device and that navigating FODMAPs, or nightshades, or histamine-causing foods, or fructose were only secondary to
SIBO. I therefore contacted the inventors/founders of the Food Marble company who developed the device and informed them of this issue. (They have since taken action to accommodate the much larger SIBO conversation for their device and future efforts.)
SIBO. I therefore contacted the inventors/founders of the Food Marble company who developed the device and informed them of this issue. (They have since taken action to accommodate the much larger SIBO conversation for their device and future efforts.)
In my original contact with the inventors of the device, I asked if they’d be willing to share their validation data comparing AIRE readings with formal H2 breath testing. They declined, just as I expected, as this is often proprietary and kept private for purposes of maintaining the integrity of their intellectual property. So I recontacted the founders and asked whether, since we cannot view the actual validation data, could they at least provide some kind of framework for comparing AIRE readings to formal H2 testing. Co-founder Aonghus Short, Phd, from Dublin, Ireland responded:
“To give you an indication of how the fermentation score corresponds to hydrogen in ppm [parts per million], a rule-of-thumb is that hydrogen in ppm is 5 times the fermentation score. So a score of 1.0 corresponds to roughly 5 ppm, 8.0 to 40 ppm. That works better at the lower end, but anything above 5 or 6 is quite high for most purposes.”
That’s helpful. In formal H2-breath testing, a rise of 12-20 ppm H2 above baseline is typically considered positive for SIBO if registered within 90 minutes of consuming a prebiotic fiber. (Between 90 and 180 minutes is equivocal, as it could represent fermentation by bacteria in the colon or mild SIBO that has only risen to the ileum.) By the AIRE device, an AIRE score of 1.0 that rises to 9.8 means that 5 ppm H2 rose to 49 ppm, a definitely positive result. Using the criterion of an H2 rise of 12-20 ppm means that an AIRE score rise of 2.4 to 4 or more would represent a positive score.
Here is a representative positive H2 curve generated via formal H2 breath testing (from Genova Diagnostics):
Dr. Short also informed me that they anticipate release of the methane testing device late in 2020, as they’ve encountered some technical challenges with earlier efforts. This will make it possible to test for breath methane to assess whether methanogenic SIBO is present that accounts for SIBO phenomena and constipation.
If you believe that you have SIBO and want to embark on a self-management effort, see the detailed Undoctored Protocol for SIBO in the Undoctored Inner Circle, as well as our frequent detailed discussions during our weekly two-way video Virtual Meetups.
Would be very helpful having this device
I purchased this device and the highest score was about 6.2 so I’m not sure after reading this as opposed to what I read from Dr. Davis’ on how to obtain the reading if I did this correctly and/or is this reading positive or negative….
Paula Reece wrote: «…the highest score was about 6.2…»
What was the circumstance for that reading?
If a fasting reading early in the morning, it probably doesn’t really mean anything.
On the other hand, if it’s a reading 30 minutes after consuming some prebiotic fibers, it might suggest H₂-generating SIBO.
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