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  • What is Trio-Smart?
    Trio-Smart is a doctor-ordered breath test that uses an at-home sample collection kit. Using the kit, you collect your samples by breathing into 9 collection bags over a 2-hour period. The first bag is considered a “baseline” sample, and the remaining samples are collected after you drink a sugar substrate drink. You then send your samples to our CLIA-certified lab (Prepaid shipping materials are included.), and results are reported to your ordering provider within seven business days. Trio-Smart is the only three-gas breath test that measures all of the primary fermented gases produced in your gut: hydrogen, methane, and hydrogen sulfide.
  • How do I know if Trio-Smart is right for me?
    If you experience any of the following symptoms once a week or more for at least four weeks, then Trio-Smart could be right for you: Bloating (especially after eating) Gas Diarrhea Constipation
  • What does Trio-Smart detect?
    The Trio-Smart breath test measures the three primary fermented gases in your microbiome by way of your breath before and after a sugar substrate drink is consumed. The gases measured are hydrogen, methane, and hydrogen sulfide. Hydrogen is produced when certain bacteria consume sugars. Hydrogen levels are considered abnormal when they rise greater than ≥20 ppm (parts per million) from the baseline within 90 minutes. Abnormal levels of hydrogen are indicative of small intestinal bacterial overgrowth (SIBO). Methane is produced when archaea (single-celled organisms similar to bacteria) consume hydrogen. Methane levels are considered abnormal if they reach ≥10 ppm (parts per million) at any point during the breath test. Abnormal levels of methane are indicative of intestinal methanogenic overgrowth (IMO). Hydrogen sulfide is produced when sulfate-reducing organisms consume hydrogen. Hydrogen sulfide levels are considered abnormal if they reach ≥3 ppm (parts per million) at any point during the breath test. Abnormal levels of hydrogen sulfide are indicative of excess hydrogen sulfide.
  • Are SIBO, IMO, or excess hydrogen sulfide treatable?
    From antibiotics to dietary lifestyle changes, there are evidence-based treatments suggested in the American College of Gastroenterology’s Clinical Guideline for Small Intestinal Bacterial Overgrowth. Learn more about treatment options here.
  • Do I need a doctor to order Trio-Smart for me?
    Patients can order Trio-Smart online through our online service here without needing an appointment. Results are delivered directly to you within seven business days. Trio-Smart can also be ordered directly through your healthcare provider.
  • Does insurance cover Trio-Smart?
    Trio-Smart is covered at least in part by many common insurance plans. If you're interested in asking your insurance provider about coverage, you can reference CPT code: 91065 (billed twice) and NPI number: 1376006932. ​ ​ Medicare and Medicaid may not cover telehealth services. If you would like to use your Medicare or Medicaid coverage for Trio-Smart, please work with a local healthcare provider.
  • Why is Trio-Smart a superior breath test?
    Trio-Smart is the only breath test available that can measure all three of the primary fermented gases in your gut microbiome: hydrogen, methane, and hydrogen sulfide. This allows you and your doctor to get the most complete picture and start you on the right path of treatment quickly.
  • How accurate is Trio-Smart?
    Trio-Smart measures the levels of gases in your breath and adheres to the thresholds laid out in the North American Consensus for breath testing. Trio-Smart is incredibly precise in the gas measurements it provides. Conventional breath testing has a detection sensitivity of ±2 ppm. The Trio-Smart device had a detection sensitivity of ±0.1 ppm, significantly minimizing the rates of false negatives/positives.
  • What can I eat the day before the test?
    During this time period, restrict your diet to only meat (poultry, fish, beef, or pork), tofu, eggs, potatoes, and white rice, limiting your seasonings to oil, salt, and pepper. In addition to water, drink only coffee or tea without any additives. This diet has been specially designed to ensure the accuracy of your test results. Do not eat or drink anything other than the items listed here.
  • How long do I need to be off my antibiotics?
    The North American Consensus on Breath Testing states that antibiotics remain in the patient's system for 28 days after their last dosage. We do not offer specific guidance on how long a patient should be off of antibiotics, as we are not sure why the patient is being tested and what you are looking for with their testing. If the test is to see the effectiveness of the antibiotics, the patient may want to take the test immediately after finishing their treatment. If you are wanting to see if the antibiotics are currently working, they want to take the test during their treatment. If you want to see how effective they were after their course is out of their system, then the patient should wait 28 days. Due to all of the variables, we leave this to the ordering provider's discretion.
  • Can I take my probiotics?
    There is no published data on the impact of probiotics on breath testing. This decision is solely at the discretion of the provider. We recommend taking actions that return the gut microbiome to as neutral a state as possible during sample collection, as long as avoiding the necessary medications and supplements are tolerable by the patient.
  • What is better/should my doctor order glucose or lactulose?
    There are two schools of thought on Lactulose vs. Glucose. Some clinicians prefer Glucose and some prefer Lactulose, so both are available with Trio-Smart. Trio-Smart does not recommend one substrate over the other, as it is up to the ordering provider and patient's history, tolerance, and preference.
  • How do I get a copy of my results?
    Test results are sent to the ordering provider’s office. Once they have been reported to your provider, you can request a copy of your results by emailing our support team at
  • How long will it take to receive my kit?
    Testing kits arrive within 4-8 business days once a completed order is received.
  • What day of the week should I take my test?
    You can collect your samples any day of the week, including weekends and holidays. Samples are optimal for 7 days.
  • What do I do after I receive my results?
    We suggest bringing your results to your local healthcare provider to interpret your results and discuss treatment options. We cannot offer medical advice or treatment.
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