Conquering SIBO and IMO with At-Home Breath Testing

Welcome to The Perfect Stool: Understanding and Healing the Gut Microbiome.

This is your host, Lindsey Parsons, and today I'll be talking with Ricky Harrison, MPH, the client engagement coordinator at FoodMarble, developers of handheld personal devices for SIBO and IMO and food intolerance testing, which is small intestine bacterial overgrowth, intestinal methanogens, overgrowth. He has been with FoodMarble since 2018, supporting the company in customer relations, logistics, research, and business development. Most of his background is in health science and healthcare administration, having held tenures in general hospital administration, private mental health, data protection, and safeguarding governance. In the interest of full disclosure, I did get a free FoodMarble Air 2 or MedAir 2 device in exchange for this podcast appearance, but there's no other sponsorship by the company of this podcast other than the fact that I have an affiliate account with them, which I've had for over a year. But before our conversation, if you haven't yet followed or subscribed to the show, be sure to do so. And if you want to get transcripts of the podcast, pop over to my website, HighDesertHealthCoaching.com, and sign up for my newsletter. You'll also get my free ebooklet, Finding Your Root Cause Through Stool and Organic Acids Testing, when you sign up. And if you haven't yet done my quiz on which stool test would help you get to your root cause, you can find a link in the show notes and take that. Now onto the show.

Welcome to the podcast, Ricky.

Hi, thanks so much for having me, Lindsey Parsons.

Yeah, it's my pleasure.

So can you tell tell us about how long the FoodMarble's been around and what are the different things it measures?

Absolutely. First, we started out through crowdfunding, and that helped us with a lot of R&D and getting things set up with, like, logistics, those types of things. So just basically getting set up and ready to start to distribute. Once we were ready to sell, we went for live sale in 2019, or I guess you can really say around November, December of 2018. So that was with our AIR1 device, and we had that going live and we shortly released the MedAir device after that. And in the summer of 2022, we released AIR2 and MedAir2 followed that.

Okay. And are the Med versions the medical ones? Yes.

So our AIR versions are our consumer devices, and then we have our MedAir devices, which are FDA-approved Class I medical devices.

And when I recommend a device to a client, are they getting the medical one?

Yes. So they'll be getting MedAir 2, and that's available only in the United States. The Air 2 and the Air 1 devices are still available also in the US consumer market, but that's distributed everywhere else in the world.

Cool. So I didn't realize it was an FDA-approved device. So how hard was that approval to get?

It was a very long, very long process, but we got there in the end. A lot of sending forms and developing various pathways for things like calibration, the way we handle complaints, all sorts of things. So it was quite involved and that took us quite a while to get done.

So do you have to prove to the FDA that you're accurate, you know, sensitive, and what's the other word?

Specificity?

Yeah. Yeah.

We're a completely validated machine that can produce valid results that can be used for the diagnosis of medical conditions such as SIBO, IMO, carbohydrate malabsorption, those types of things. And on the back of that, the AIR1 and MedAIR1 devices measure hydrogen, and the AIR2 and MedAIR2 devices measure hydrogen and methane. And the devices can be used to either diagnose or aid in SIBO, IMO, carbohydrate malabsorption, and food intolerance.

Okay.

And what kinds of food intolerances?

So we offer currently 4 different substrates for patients or customers to see how they respond to different FODMAPs. The ones that we provide currently are fructose, inulin, lactose, and sorbitol.

Okay.

And so what are you hearing from practitioners about why they prefer the FoodMarble to laboratory SIBO and EMO testing?

A big part of it is having the immediate results so they can start patient treatment faster. And another thing that they are able to monitor the patient. So one thing that, or one of the huge advantages that we offer with FoodMarble devices is that clinicians can follow their patients along. So let's say a SIBO test comes back positive. And they start treating the patient. They can then have the patient take daily breath tests to see how the patient is responding to treatment, how their gas profile changes as they move through the treatment. And this gives them quite a bit of information. One of them, it helps them to glean whether the treatment is working. And the second one is it allows them to see when the optimal time for retesting is. So, you'll have a period where the patient is testing along and their scores may be a bit higher or whatever, but over time, what you would expect to happen if the treatment is working is that that overall breath ranges will go down and eventually they'll level out to a point. And this gives you an idea somewhere around this point after they've been leveled out for a little bit, when the optimal time for retesting is to see if you've cleared the SIBO.

Right. So those daily breath tests are not with a substrate like glucose or lactulose, and then the official tests are, correct?

Absolutely. Yeah.

And so for the regular ones, you just do it after a meal, or when would you do it?

So there are a couple of different ways to do it, and we're always investigating this based on data that we've collected. Since 2018, millions of breath tests have been taken with the device. So we've lots of breath test data, lots of meal data, and we can look at all of this stuff and find out when those optimal times for breath testing are. And we're constantly learning about that process. But the way that it would normally work is if you have a patient and they are going through a SIBO treatment, say, they can basically take one breath test an hour to 90 minutes after they've consumed their first meal of the day, and then they can repeat that again in the evening following their evening meal. And then that will be enough so that you can see over time as they move through treatment if their gas profile is going down.

And why so long after a meal?

Well, since it's solid food, it's not quite as fast as the substrate. So when they are drinking the solution, that's obviously in liquid form. It goes right down the esophagus, right through the stomach, and starts working in the small intestine. However, when you're dealing with solid food, that's gonna take a bit longer. It's going to take it longer to break down in the stomach. It's going to take a while to eat it all. So you just want to give it a bit of time to make certain that it's in the small intestine and in the large intestine, and then you can see how gas production is going along in those times.

Ah, okay, great. I'm glad I asked you that because I've just told my clients, oh, just Just take it any old time. Just see what you get. So I'm still learning how to use the device properly as opposed to, you know, the official lab tests. And can you explain the difference between the typical testing substrates, the glucose and lactulose? And I know there's also fructose that people are using and what they're recommended for.

Oh yeah, absolutely. So the standard substrates for SIBO would be glucose and lactulose. And for IMO, you're testing the small intestine and the large intestine. So lactulose is a good one for that one because it will stay in the system from start to finish. So basically for SIBO, you're looking for a rise in hydrogen of 20 parts per million within 90 minutes of the test. And that's above baseline. So if the baseline is 5, you're looking for a rise of 20 parts per million. So you'll be looking at a minimum of 25 parts per million by 90 minutes. And for IMO, you're looking for a rise of 10 parts per million at any time during the test. So this can be before 90 minutes, after 90 minutes, it doesn't matter. And again, that's based on the baseline. So if the baseline is 2, you're looking for 12, to at least reach 12.

I believe I've been watching webinars where SIBO experts have been saying for emo, if you've got a rise of 5 plus the symptoms, the bloating, the constipation, that that's probably good enough.

Yeah, absolutely. So symptoms play a very large part in a lot of this testing, and You mentioned fructose before. So fructose has been found to be quite effective in determining whether there's the possibility of SIBO. And what is quite interestingly enough, it's been found in a study done by Dr. Horalek that testing with all 3 substrates gives you nearly or at 100% accuracy in determining whether there's the presence of SIBO. And fructose on its own was more effective than both lactulose and glucose in his study. So that's also another substrate that can be used. And even working with clinicians, I've seen that become a more popular option.

And do you use that in the same quantities you would use the glucose and the lactulose?

So we offer it in a 25-gram sachet, which is pretty much what you'd use for fructose intolerance. So it's the same substrate. You can use it for both.

Okay. Yeah. What then differentiates fructose intolerance from SIBO? And is, is it possible that fructose intolerance isn't actually a thing, that, that it's just SIBO?

So there is SIBO-induced fructose intolerance, and then there's fructose intolerance. So SIBO-induced fructose intolerance is basically, say that you're testing a patient and you're using fructose as your substrate and they have that initial high rise or they have that typical rise that you're looking for for SIBO. In a way, it's, you may not know it's SIBO. SIBO-induced fructose until you treat for the SIBO. And then if you test again with the fructose, you may see it flattens out, and then you may see a rise at the end, which means it's in the colon, which is normally where you would expect to see it if it is the food intolerance or fructose intolerance. You expect to see it after that 90 minutes because it would be colonic at that point.

Oh, okay. So fructose intolerance is normally something in the colon?

Typically, yes.

Okay.

And what about the other food intolerances? Are they measured differently than say on a SIBO test? Like what constitutes a positive test for the other substrates?

Yeah, so for our food intolerance, we use the European guidelines. And so it's really fructose and lactose. And so you're really looking for a rise based on the European guidelines at any point during the test. So it could in turn be SIBO-induced fructose intolerance, so we use that for all of them. Them. So for inulin, lactose, sorbitol, we use that guideline. At any point during the test, you're looking for a rise of 20 parts per million.

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So the dilemma, of course, you know, you talked about it. Yeah, if you do all 3 substrates, you'll get a Perfect reading on SIBO. The dilemma is that it's really kind of a big deal to do a breath test. And now having just done them, I can say, right, so the day before you have to restrict your diet to like 4 foods, right?

What is it?

Chicken, rice, eggs, a little bit of butter or oil, salt and pepper, potato.

Yeah, we would definitely recommend staying away from butter unless it's lactose-free butter. Oh, right.

Okay. Or ghee. Ghee, I think it was.

Right.

Okay. So. You've already done that. So then the next day you've gotta wake up and drink this solution that's full of sugar. So a lot of the people that I'm dealing with already have very sensitive guts that really don't like sugar in any, any form. It's cuz it's gonna cause inflammation, right? So then they have to drink this solution and then they have to spend the next almost 3 hours, is it?

So it's 2 hours if you're using glucose, but 3 hours if you're using any other substrate.

Okay. So, so 2 to 3 hours testing every 15 to 20 minutes depending on whose test you take.

Absolutely.

Yeah.

So it's a bit of a commitment. So, you know, you gotta be home, you've gotta, and you can't eat anything else. And right. So the whole process is kind of cumbersome, say, compared to a stool test. So the idea of doing 3 different substrates to me seems kind of silly. Like you wanna get, okay, well what's the most bang for your buck? It seems like the Horolek study showed that fructose was actually the best bang for your buck. Well, I guess there's also the dilemma that in the US you cannot get lactulose without a prescription. So, so then I'm suggesting get your own fructose online or whatever if they've gotten the glucose kit and then use that instead to test with.

Right.

So that just makes me think of a question I hadn't thought of, which is, have you guys considered just sending out fructose as a testing medium or is it just not accepted in the standards of practice yet so you can't do that?

Well, if the clinician is comfortable diagnosing SIBO using fructose, we are more than happy to provide that for the clinician.

Instead of glucose.

Yeah. Just let us know that I use fructose, I want to use fructose, and contact me typically. I'll be the— I'll sort it out for you.

Oh, okay. Great. Great. You know, that would be wonderful because I think I'd much rather catch more of the cases with fructose, especially because a lot of my people that I'm recommending it to are people who have the signs of methane overgrowth of the constipation and bloating and sometimes smelly gas and such. So yeah. Yeah.

Back to the point of Dr. Horolak's study is just the 3 will just get you the 100% accuracy. Now fructose on its own will give you the highest of the 3 at— he found it was around 85.7%, I think it was. But you can even combine 2. So in one of his interviews that I I did watch some time back, he said that he stopped using glucose altogether and was just doing lactulose and fructose. And I think that gives you somewhere in the 90s of accuracy.

Right, right.

Yeah.

But again, in the US, it's, you know, if you're not a doctor, you can't prescribe it, so you can't really get there, but okay. And then what was it? What was the percentage for glucose alone?

Glucose on its own? I think it was, I think it was 70-something.

Okay. But so when, what was he testing it against? So he was saying, we know these people have SIBO. How did he know that? Because some other testing medium showed it or because there was some other, you know, an endoscopy with a—

So one of the limitations that he did point out was that it was just the breath testing that was used. So it was a lactulose breath test on its own, a fructose breath test on its own, and a glucose-fructose test. Okay.

So the assumption was That if they took all 3 breath tests and one of them came back positive, they have SIBO. Now let's see how they did in each individual one, essentially.

Essentially.

Right. Okay. So I have recommended the FoodMarble to some clients and their biggest concern is accuracy. So I'm just curious if you have done a study of comparisons between the FoodMarble results and standard breath testing.

Absolutely. We've done several studies with research groups, some independent groups who've done studies with the device as well. We do a lot of in-house studies as well. And we've several abstracts and papers that are available. If you go to our website, foodmarble.com/gi/science, you'll be able to see all of our studies there on the website. So you'll be able to read them all. We have one abstract that we're waiting to be published. We presented it at ACG, and that one goes over the validation of the hydrogen and methane against benchtop machines such as Quintrons and Bedford.

Lindsey Parsons: Okay. So I actually did 2 tests at the same time. I did with my test with the FoodMarble and I did one through Arrow Diagnostics that I got my doctor to order for me. And although each reading wasn't at the exact same time, cuz the FoodMarble was every 15 minutes, but the other test was every 20, both came out negative for SIBO and both showed that the only gas that went up much at all was hydrogen. So the highest point on the Arrow Diagnostics for me was 16 parts per million at 80 minutes. And at 81 minutes, the FoodMarble showed 7 parts per million. And so I think this might be different because of the way you instruct people to breathe out without taking a breath, which is kind of tricky because otherwise you got, I'm just barely having enough breath to finish going out because you're supposed to breathe out for 3 seconds and then put it in your mouth and then keep breathing out. Whereas the other breath test, I would breathe in, hold it a little, then I would just breathe out into the thing so it would get the whole thing. So I'm kind of wondering why, why the breathe out for 3 seconds, then go onto the device.

So you're not actually breathing out. So I have the device here, so it's not powered on or anything, but when it's on, all these lights will be lit up in blue all the way around. I would stop breathing and hold down this button.

Mm-hmm.

So I pause my breathing. I won't, I don't suck in or anything like that. I just pause my breathing.

Okay. After you've conceivably taken a breath, right?

Well, I normally just, I'm just in my normal state.

Yeah, but I mean, you're very conscious of whether you've taken a breath or not. So I mean, I, that's the tricky part. You have to have enough breath to get 5 seconds worth of breath out, so you really have to taken a breath.

Well, maybe, I don't know. But what I do, I can, I'll stop talking to you and then I'll just do it and I'll show you. I don't, I don't take in a breath or anything. So I'm just now talking and I have plenty of breath left.

Okay.

I do know at the start it does take quite a bit of practice, but you saw, I went straight from talking to you to holding my breath for, you're really breathing for 8 seconds.

And what's the concern if you actually just breathe in first, if you aren't like taking a super deep breath, but you're just taking a normal breath?

Oh, you'll be fine. The way that it works is basically as you're breathing through the device, you have that 5-second exhalation period. The actual sample is only collected at the end of that 5 seconds. So it's ensuring that it's getting alveolar breath. And so what we are trying to do by keeping people from taking in big breaths is that they are not contaminating it with ambient air.

Yeah. So, okay, now I see the dilemma because as I'm breathing out in the device, I was breathing out for 3, then putting it on my lips, continuing to breathe out for 5. Sometimes by the end I barely had any breath left. So that might explain why I had lower, lower results on my FoodMarble than on my AeroDiagnostics. But most of them were pretty consistent. In fact, I was gonna just share this screen and show you what the two tests looked like.

Oh, perfect.

Yeah.

Yeah. So this is my results from the FoodMarble MedAir 2. I assume I've got the med version.. And so you see my highest reading here, baseline was 5 parts per million on hydrogen, nothing on methane. And then I went up only as high as 8. So even though I had some amount of bloating, even some nausea after drinking that glucose solution, it did not show that I had SIBO. Yeah. And then this was my AeroDiagnostics test. It was faxed or whatever, you know, it's a scan of a fax, which Medical systems are still in the dark ages. But anyway, this is the hydrogen column. This is the methane column. And you can see here on the chart that this is the methane down here. So I only had one at baseline and nothing else. But basically my highest number was this 16.

What was your baseline? Is it 11 or 12? It looks like they're two.

I know it does look like it. Oh, it's the combined. That's, that's the combined line. 11 was my baseline for hydrogen. Yeah. So my baseline for hydrogen here was 5, whereas it was 11. So I'm sure the way I was breathing out was different. Is there a lot of hydrogen in the air?

Is that—

did they get the contamination?

Oh no, you'll be fine. Well, so it doesn't really look like they're that far apart though when you think about it. So your baseline's 11.

No, I mean most of the numbers are exactly the same, like 5, 6, 7, 6, 7, same thing. I have 5, 7, 5. From baseline, I've only essentially gone up by 5 at the most here. So, right.

So yeah. So not terribly different at all.

Yeah.

Tragically, I did not have SIBO, so I did not get any Rifaximin. My original plan was actually to do the Food Marble Test, determine if I had SIBO, and then if I didn't wait until I got it, because I always, it keeps coming back for me cuz I have autoimmune IBS. So anyway, I did not unfortunately come out positive this time. So I'm having to keep doing the herbal supplements and control it with diet and such, which is— maybe it's a good testament to the fact that I'm actually controlling it better than I think it is, and I'm mostly just overeating, and that's why I'm bloating every time I go out to dinner.

And I would like to point out, here's another benefit to FoodMarble, is that you now have your device. If you want to test again, all you need is the substrate. You don't have to order a whole nother kit.

Oh yeah, no, that's the no-brainer for me when I recommend it to clients, is that if you do 2 tests And people who have emo, they're typically having to go through multiple rounds of herbal antimicrobials. It's very hard to eliminate. So if you can have some sense of, okay, I know it feels like this is taking forever, but some hope along the way, well, your numbers are actually going down over time. And here we have this device that can measure it versus I'm gonna have to send you out, you're gonna have to finish up your herbal antimicrobials, then the per the protocol by request of the company, you're probably supposed to wait 2 weeks after that or a week or something. And then you're supposed to do the prep day, all that, send it in, then 3 weeks later you have the results and you're supposed to continue treatment. In the meantime, they've probably started recurring. So I definitely prefer a model in which they can keep testing.

And that was one of the things that we really wanted to, to do, 'cause we know it's a huge barrier. We hosted a webinar not too long ago and we had two clinicians who work with us and, well, they both said that having the ability, that the hurdle being removed of people being able to take a retest has been transformative for them. So that's really good.

Yeah. And those practitioners, I remember I've watched one of those webinars, they're typically using it more or less, you finish treatment the next day, you do the prep diet, the next day you do the device, right?

Yeah. Okay.

Yeah.

So I mean, they're doing it right after treatment, so you really know, okay, right after we finish, where do you stand? So then it's a, then it's, do we do another round of treatment or do we wait and see whether it recurs after some period of time or that kind of thing.

And of course that's completely up to the clinician though. So you can do it immediately or you can, so say that a patient isn't responding as quickly as you like. Some people can sometimes respond outside of the window of treatments, so you may want to just monitor them for an additional week perhaps, and then you may see the drop-off then. So it just gives you that power that you didn't have before. Before it was guesswork, and now you know exactly.

Yeah. And so I think it'd be helpful to clarify for people what is different about what's measured by a SIBO breath test than what's measured in a stool test.

Ah, okay. Yeah. I, I will say that they both have their purposes. Now, a stool test is giving you more of an idea of which bacteria are present and maybe the quantities in which they are there in the colon. The issue is that what you get in a stool test is more so indicative of what's happening in the distal colon, whereas breath testing is basically telling you what the activity of the bacteria is, whether it's high activity of the bacteria whether it be based on timings in the small intestine or the large intestine, and the stool is just basically telling you what's mostly there in a sense in the distal colon. So they do quite different things and you can glean different things from them. So both very useful and practical tests.

Hey, this is Lindsey here, just letting you know that if you're tired of dealing with digestive issues like bloating, indigestion, soft stool, diarrhea, constipation, reflux, IBS, IBD, or the numerous health conditions that come about when your gut is off, like brain fog, weight gain, UTIs, fatigue, mental health issues, or complex conditions like fibromyalgia and ME/CFS. That's my specialty. With my 3 or 5 session gut health coaching packages, we'll discuss different stool and functional medicine tests to find out the root cause of your symptoms. I'll interpret the results and provide clear explanations, empowering you to make informed choices for your gut and overall health. And together we'll develop a customized action plan based on your test results so you can find relief and regain your health and vitality. I come from a functional medicine perspective, trying to incorporate the latest peer-reviewed research and educating you on protocols used by functional medicine practitioners, but devoting lots of time and support to my clients the way a doctor simply can't.

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Now back to the show.

So my understanding watching like Mark Pimentel webinars, who is one of the biggest researchers on SIBO, is that they're seeing SIBO almost as an infection with certain predominant bacteria in the small intestine. And then I might see a stool test from somebody who's got a positive SIBO test, but it does not show that that's an overgrown bacteria. Like I think it's typically like Klebsiella and Citrobacter and E. coli are the, the 3 big ones. Am I right? For hydrogen SIBO? Oh yeah.

I think so. I don't quite recall them.

Okay.

But then you might not see those elevated in the stool test, so it doesn't necessarily tell you what's going on at all in the, when you look at the stool, the colon. Now methane being different because it's now called emo-intestinal methanogen overgrowth and acknowledge that it, or it can be in any part of the intestine. So it could be in the small or in the large intestine. Absolutely. So Lucy Meiling recently published a blog post again, questioning whether SIBO is an accurate description of what's going on when one has dysbiosis and the symptoms of SIBO, which for me, the big one is always bloating. Like if there's bloating, if there's no bloating, I'm almost like, mm, probably not SIBO. Although I, I'm suspicious that there are some people who strangely just don't bloat, like they have SIBO, but for whatever reason they do not have a bloaty kind of system. Whereas I'm the kind of person who has a very bloaty kind of system. So even when I don't have SIBO, I bloat. But anyway, she was also questioning breath testing as a method of diagnosis. So any comments on that article?

So I thought it was a well-written article, and of course everything has its drawbacks. I mean, she even pointed out aspirate cultures, which are considered the gold standard currently. So, I mean, it has its drawbacks. Breath testing has its drawbacks, and even qPCR has its drawbacks. The thing is that what's great about all of this and what's great about science in general is that the way that we get better is that we see where there is a drawback And we address that drawback and we constantly grow. And yeah, it, there's no denying that breath testing has its drawbacks. It does. Just like qPCR has its drawbacks and like anything else. So what she does in practice, or in that blog article, I think she'd said that she has largely moved to qPCR for that type of thing, which is totally fine. It's, it's always just up to the clinician really.

Yeah. Which is doing something like a GI-MAP or a GI-FX or one of those tests, right? Or I think she also used metagenomic sequencing or shotgun sequencing too. Yeah. Well, at any rate, for me it's kind of one of these things, like for a while I stopped saying SIBO and I would just say dysbiosis. And then at the end of the day I'm like, I have this thing and it does feel like an overgrowth. It feels like I sit down to dinner with everybody and we eat the same quantity of food and I grow a food baby and they eat twice as much as I can. And there's something overgrown in there. Like there's something fermenting and You know, it, that's what it feels like to me. So I feel like the word SIBO is accurate in my personal experience. It resonates with me. Yeah.

I don't have a problem with the term SIBO. They're not really the same in a sense.

What, dysbiosis and SIBO? Yeah.

I don't think they're entirely the same. So SIBO is exactly what it says it is. It's an overgrowth of bacteria that doesn't normally hang out in those numbers in your small intestine.

Right. And dysbiosis is sort of saying the same thing, but could also be something else. Else. Could be a parasite or Candida or could be a bunch of other things.

Anything. Yeah, absolutely.

So I'm gonna get my FoodMarble and we're gonna do a little demo of me using my FoodMarble so I can show people how it's used.

Okay. No problem. Okay.

So you start and you have to what, double-click on it, right?

Right. So you just give it quick double tap and that's what powers it on. So you'll have to wait like 2 minutes or 1 minute and 40 seconds.

Okay. Well, in the meantime, the next piece is that you then pick up your phone, which you've gotta have downloaded the app. And the app for the medical device is different than the other app.

Right.

It's the one with the green that says FoodMarble Healthcare.

Yeah.

It has a green icon. Yeah. Okay. So then on the device, I will now show this is, you press this little plus button, right, to take a reading.

Correct.

Then you choose, it has logging options, and I'm going to choose breath. So now it says it's warming up and it shows that I've got to wait till these things are all blue for me to go.

Correct.

Okay.

So the warm-up feature, for anyone who wonders why does it, why does it take so long, is the sensors have to reach a certain temperature. So what it's doing is it's warming up to the temperature in which the the sensors will start to function.

Okay. Okay. So now holding the device, that's the air. That's the one you blow into. Yeah.

Correct. Yes.

So now I hold it down. I'm not actually sure that worked. The phone. Oh, and it says, let's, let's practice.

Okay.

So, okay. So I gotta practice. Practice. Let the air mix in your lungs by pausing your breathing for 3 seconds without inhaling. Right.

So just like I did, I was, I was speaking with you and I just stopped talking and held my breath. Okay.

So I'm gonna hold my breath for 3 seconds after I breathe again, cuz I don't have enough breath left.

Okay. And it'll vibrate. Yeah. And just keep blowing until it vibrates again.

Okay. I was definitely at the end of my breath at that point.

Okay.

Now the exciting part.

Yeah.

So that was your practice breath.

Yeah, that was my practice. Now I have to do it for real. Right now I take a real test. Okay. Definitely was the last of my breath at that point. Okay. So now on my device, I get this reading that says low. And then I say, okay, it says, looks, there's a little bit of methane in there. It's always interesting to me cuz I always think I have like no methane producers, but I know you can have methane producers in your, in your mouth, but not in your gut.

You can, yeah.

Yeah. It says show more. Oh, okay. So I got some detail under show more. Methane 0.9, hydrogen 0.4, overall 1.2. But those numbers are not the official breath testing numbers. This is on a score of what, 1 to 10?

It's 0 to 10. Yeah.

0 to 10, right? Okay. Now what's interesting for me though is that I can then go onto my FoodMarble dashboard. Let me share my screen now and day to day, and then I will be able to see today's test, methane 4 parts per million and hydrogen 2 parts per million. That's really funny to me. So, and then, then this would be other symptoms if I had recorded any of those.

Right.

And medications and such, which I could do by pressing that plus on the device and adding those in. Right. And then I can see the challenge that I did from the other day, which I already showed you in the other format, but this was the actual glucose challenge that I did. So I had more methane now than I did when I did the challenge. Always funny.

Okay.

Anything else you wanna say about this?

Well, one cool thing is say that you had a positive test here. So you see this area under the curve? Mm-hmm. So what will be cool is say that you had a positive result and then you had another test after treatment and it was still a positive result, but the area under the curve was lower. This would give you some sense that although both tests were positive, there was some improvement, and maybe you just need a little longer treatment or something like that. So that's pretty handy. You can also download the report. You can add it to the patient's EHR.

Electronic health record. Yeah.

And you can also download a PDF, and this will allow you to then play around and make graphs and charts or whatever you want and share those with the patients as well.

I can download this and give it to the patient. They won't see this.

So if you click the download button there, you'll get that report that you showed before.

Right. But will they get that too, or only if I give it to them?

You have to send that to them.

Okay. So in other words, there's a lot of advantages to going through me if they're my client, which would be that they're gonna get the MedAir device that does methane and not just hydrogen. So that's like the huge one. And then number two, that they're going to get the chance to get a testing substrate?

Correct.

Or do you send out the glucose for people who just buy it on their own?

So if you use glucose, when you add a patient, you'll have the opportunity to select what you want them to have for testing. So you can select the food intolerance kit, you can select the glucose as well, and then you can submit that. And so what happens after that is the patient then receives an email. They agree to the privacy policy, which gives their express consent for you to be able to view their data. And then after they've done that, they're taken to a payment screen and then they'll be able to pay for it and we ship it directly to the patient. Now there are several different account types. You can extend discounts to your patients based on which type of account you have.

Right. I think there is a discount in effect for my, my clients.

So depending on what your account type is, you can get them a cool discount up to 20%. Right.

And no, I was just asking though, in the direct-to-consumer model, are you getting the testing substrates? Are you getting glucose? In the US at least. Yeah.

So you, you cannot get the glucose from the website. You have to be linked to a clinician in order to get glucose. Okay.

Got it.

But they can get the food intolerance kit. Now in the United States, the price is lower for the food intolerance kit than if they were to purchase it from the website. So they're getting quite a few advantages by going through the clinician.

Okay. And so for the food intolerance tests, are you supposed to have a prep day as well, or can you just do those anytime? Yeah.

So you should prep exactly the same as you do for the SIBO test. And the reason for that is so that it's the substrate that you're testing and not something else. So if you had to eat the night before, you don't know when you're taking your test the next day, you don't know if it's the cake or if it's the actual substrate.

Yeah.

No, that was also the dilemma. I got the food intolerance test and I had every good intention of trying everything but the, but the lactose because I don't intend to torture myself by taking lactose, which I know I'm quite intolerant to, but I was gonna do the others. But then I was like, I just had to do this whole prep day, whatever. I'm not terribly tempted to do this again. Although I have had, I have had clients say after the prep day, they're like, I haven't felt so well in ages because they clearly had low FODMAPs food.

Yeah.

And whereas I'm less attentive to that on a regular basis, I mean, I think maybe naturally I've fallen into choosing the foods that feel better in my body. I don't purposefully follow a low FODMAP diet all the time.

Yes. Low FODMAP diet isn't something that you want to carry on for a prolonged period of time anyway.

No, no. Uh, so this is the nice thing for me as a practitioner is that you can in fact see right away what the results are. As soon as you're taking the test, I can go on my screen and say, okay, you've got it or you don't. And then I can let you know what I think should be the next step. So that's what I really like. And so how much is the device normally for retail?

$249 is the retail price for the device in USD.

That comes with the glucose?

So no. So the retail price is $249 for the device. Retail for the glucose is $19 USD, and that is for 2 2 sachets for the initial test and the retest. And the food intolerance kit is $49 USD, and that includes the fructose, inulin, lactose, and sorbitol.

And that's without the discount through the practitioner?

Correct. So that's the— and then depending on what your discount is, would be 15%, 10%, or 20% off of that, depending on the type of account you have.

Okay.

You don't know offhand what the type of account I have is?

I think you're at 15/15, so your clinicians will get a 15%.

Oh, okay. So they get 15% off. off.

Yeah.

Okay, great. So they have 15% off of $249 plus the glucose. But if I want them to use fructose, they could just get fructose online for probably a lot less than $20 or something and, and just use that, buy a big bag of fructose and plan to keep using it or testing over and over again. Okay. And then, and then you're saying if I want, I can sub this for fructose officially through, through you guys?

Yeah.

Got it. Okay, wonderful. Well, any, anything else that we haven't covered that we should have?

I think that is pretty much everything. I would like to ask you though, do mostly practitioners listen to your podcast or is it just a wide range of people?

I would guess that it's mostly people who have gut health issues. That's my experience anyway. I'm sure there are some practitioners who listen, but I wouldn't say that's my primary audience.

So that was my only question.

Okay, great.

I think we've covered everything. If you have any more questions for me, please let me know.

No, I think I got it. So I'm glad to be able to demo it for people. And I did say in my intro that, that I got the free device in exchange for the podcast, but there's no other concrete sponsorship other than the fact that I have the affiliate account, which is something I've had for a good while now. So I did just wanna share about it because honestly, I think that for me it's a game changer because sending somebody out for a breath test often results in disaster. And one of the biggest disasters that it results in, and this has happened multiple times, Of course, there is the TRIO Smart Test that tests for all 3 gases, including the hydrogen sulfide. But I've had multiple times now that people have done that test and 1 or 2 or even 3 or sometimes even enough samples were invalid that the test was nullified. As a result, they had to retest, or in some cases it just never worked. Like I had one client who did it twice, it never worked. And I thought, you know, at the very least, if I have a hydrogen and a methane breath test that comes out negative, then I can go, oh, well maybe this is a hydrogen sulfide person. But if I got no results at all, you, it's hard to do anything with it.

Yeah, for sure.

Yeah. Anyway.

Okay.

Well, thank you so much for being here, Ricki.

Oh, thank you so much for having me. It was a pleasure.

Okay.

Take care.

Well, I hope that was helpful to you guys. If you're interested in ordering a FoodMarble device, please reach out to me at Lindsey, L-I-N-D-S-E-Y, at highdeserthealthcoaching.com. Or sign up for a free breakthrough session, and I can put in the requisition for you, and you'll get an email directing you on what to do from there. If you'd like to support the podcast, you can buy supplements at a discount from my FullScript Dispensary, order tests at a discount from my Rupa Health Lab store, or use my affiliate links to iHerb, which is available worldwide, Bulk Supplements, or Amazon. If you'd like to connect with me online, you can follow my High Desert Health Facebook page, join my Gut Healing Facebook group, or join my newsletter list at highdeserthealthcoaching.com, as well as follow me on X, Instagram, TikTok, and Pinterest. Links for those are in the show notes. Thanks for joining me today, and here's wishing you all the perfect stool.