Hydrogen sulfide testing
By BeatSIBO editorial team · Updated August 6, 2026
This is the single most expensive piece of missing information in the whole category, and it is not complicated.
The two facts that matter
The short answer
One breath test measures hydrogen sulfide directly: trio-smart, from Gemelli Biotech. The other four physically cannot detect it. No published guideline sets a threshold for what the resulting number means, so the test can give you a value that nobody has agreed how to read. The table below carries the current prices and the date each was checked.
| Test | Hydrogen sulfide | Hydrogen | Methane | Price | Prescription |
|---|---|---|---|---|---|
| trio-smartGemelli Biotech · results in 7-14 days | Yes | Yes | Yes | $349–369verified 2026-08-03 | No |
| SIBO 2-hour / 3-hourGenova Diagnostics · results in 10-15 days | No | Yes | Yes | $225–349verified 2026-08-03 | Yes |
| SIBO breath testCommonwealth Diagnostics International · results in 7-10 days | No | Yes | Yes | $295verified 2026-08-03 | Yes |
| QuinTron breath testQuinTron / breathtests.com · results in 5-10 days | No | Yes | Yes | $195–249verified 2026-08-03 | No |
| SIBO breath testAerodiagnostics · results in 7-14 days | No | Yes | Yes | $299verified 2026-08-03 | Yes |
Prices verified on the date shown against each provider’s own page. A price without a date is a claim about today made from memory.
What each test cannot tell you
- trio-smart — Gemelli Biotech
- Measures three gases but cannot tell you what to do about the result. There is no validated hydrogen sulfide threshold in any published guideline; the North American Consensus contains no H2S criterion at all. A number without a threshold is not a diagnosis.
- SIBO 2-hour / 3-hour — Genova Diagnostics
- Does not measure hydrogen sulfide. Infers it from a third-hour flatline, which is an unvalidated inference rather than a measurement. A negative result does not rule out hydrogen sulfide overgrowth.
- SIBO breath test — Commonwealth Diagnostics International
- Does not measure hydrogen sulfide, and says so plainly on its own site.Their own site: “no diagnostic technology on the market can test for H2S at levels of parts per billion”
- QuinTron breath test — QuinTron / breathtests.com
- Does not measure hydrogen sulfide. Direct to consumer with no clinician required, which also means no clinician interprets the result for you.
- SIBO breath test — Aerodiagnostics
- Does not measure hydrogen sulfide. We do not link directly to their storefront; order through a clinician or the provider's main site.
Not a SIBO test
These devices come up constantly in the same conversations. They measure something real. They do not answer the same question, and we do not list them above because doing so would imply they do.
- FoodMarble AIRE 2 $269 (verified 2026-08-03)
- A personal fermentation tracker, not a diagnostic test. No CLIA lab, no timed consensus protocol, no clinician report. It measures your breath after meals you choose, which answers a different question from a standardised substrate challenge.
Why a negative from the wrong test is not a negative
The short answer
A two gas test cannot detect hydrogen sulfide. Not poorly, not unreliably: it has no sensor for it. So a negative result from one leaves that gas entirely unexamined, and treating it as a rule-out is reading an answer into a question that was never asked. Unmeasured and absent are different things.
This is the specific sequence that costs people money and time. Someone suspects overgrowth, buys the cheaper test on the reasonable assumption that a SIBO test tests for SIBO, gets a negative, and stops. Nothing on the packaging tells them which gases were in scope.
The missing threshold
Rezaie A et al., American Journal of Gastroenterology 2017 Clinical guidelineThat consensus sets a hydrogen criterion and a methane criterion. It contains no hydrogen sulfide criterion at all. So even with a direct measurement in hand, the question of what counts as high is unsettled at the level of the field, not just at the level of your clinician.
What is not settled here
We think this is the most honest framing available: the three gas test answers a question the two gas test cannot, and the interpretation of that answer is still being worked out. Sites presenting a clean cutoff are ahead of the published evidence. So is any site telling you the measurement is worthless.
What the symptom picture actually looks like
Goldenberg J et al., medRxiv 2023 Preprint, not peer reviewedA preprint drawing on a practitioner-sourced convenience sample. Not peer reviewed, and the sample is self-selected by clinicians who were already looking for hydrogen sulfide.Worth reading carefully, and worth noting what it does to a widely repeated claim. Sulfur burps are commonly described as the signature sign of hydrogen sulfide overgrowth. In that series they appeared in 10% of confirmed cases, making them one of the least common findings rather than a hallmark.
That is also why we do not offer a symptom questionnaire that predicts your gas. The published profiles for methane and hydrogen sulfide are close to identical, and around a quarter of cases in that series were positive for both, so a tool that returns a single answer is wrong by construction for a substantial share of users.
What to do with this
Decide whether hydrogen sulfide is genuinely part of your question before you choose a test, because that decision is what selects the test rather than the other way around. If you already have a result, what the published cutoffs are is the next thing to know. Then take the result, whatever it is, to a clinician who can put it next to everything else about you.
Common questions
- Can a test infer hydrogen sulfide without measuring it?
- One provider infers it from a flat hydrogen curve. That is an inference rather than a measurement and it has not been validated against direct measurement, so we describe it as what it is rather than as a third gas result.
- Why does only one of them measure it?
- Because there is disagreement about whether it can be measured at the relevant levels at all. One of the two gas providers states on its own site that no diagnostic technology on the market can detect hydrogen sulfide at levels of parts per billion. That is a provider disputing what a competitor sells, and the disagreement is technical rather than settled.
- How long do results take?
- Between roughly five and fifteen days across the five tests we track, depending on the provider. It is a mundane detail that matters if you are timing a test around an appointment, because a result arriving after the appointment costs you the appointment. Every figure we publish carries the date it was verified, because a price or a turnaround without a date is a claim from memory.
