The trio-smart breath test is applicable to patients who experience bloating, gas, abdominal pain, constipation and/or diarrhea.

trio-smart measures the levels of hydrogen, methane, and hydrogen sulfide in your breath. Elevated levels of gases can indicate small intestinal bacterial overgrowth (SIBO), intestinal methanogenic overgrowth (IMO), and/or excess hydrogen sulfide.

Data from the trio-smart breath test can help guide treatment and is the fist step towards feeling better. Learn more below.




Complete a symptoms screening questionnaire which is reviewed by one of our specialists. If it is determined you are not a good candidate, we will reach out and issue you a full refund. Otherwise your trio-smart sample collection kit will be shipped directly to your home.



Collect your breath samples using the materials included in the kit, and follow along with a step-by-step instructional video. Return samples using prepaid shipping label.


Get Answers

The trio-smart results will be emailed directly to you, with detailed explanations and the next steps. If your results come back positive, please talk to your primary care provider to discuss treatment which may include antibiotic therapy. If you cannot see your provider, you can make an appointment with one of the QuickMD providers for $75 to discuss treatment options and possibly get a prescription.


The trio-smart test is $319. If it is determined by our doctors that the test is not right for you, you will be refunded the full cost of the test prior to the test being shipped out.
Along with your results, you will receive an itemized receipt (superbill) for use when filing an insurance claim. 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 for the two separate tests in the kit).​

The online prescriber service may not be covered by Medicare or Medicaid. If you would like to use your Medicare or Medicaid coverage for trio-smart, please work with a local provider.


trio-smart is the only breath test available that can measure all three of the primary fermented gases in your microbiome: hydrogen, methane, and hydrogen sulfide.

Measuring the three primary fermented gases can offer you and your doctor valuable and more complete insight into your GI symptoms, leading to a personalized treatment plan more quickly.

How does the trio-smart breath test work?

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 the test results are reported to your doctor within a week.

A step-by-step sample collection instructional video is available here.

What does the trio-smart breath test measure?

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. 

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.

Hydrogen sulfide is produced when sulfate-reducing organisms consume hydrogen.

  • Hydrogen sulfide levels are considered abnormal if they reach ≥3ppm (parts per million) at any point during the breath test.

See a doctor to get treated for positive test results