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HELPFUL LINKS!

 

LAB COMMUNICATIONS 

 

COLLECTION & HANDLING

 

SPECIMEN TRANSPORTATION

Please call 616.774.7721 for specimen pick up

 

GENERAL INFORMATION

 

GENERAL TEST INFORMATION

 

BILLING

 

WEBSITES

Mayo Clinic Laboratories

Epic Code LAB3097 Lactose Intolerance, Breath Test

Important Note

Test Name Alias

Lactose Intolerance Breath Test | H2 Breath Test for Lactose Intolerance | 4133 |  Hydrogen Breath Test | Methane Breath Test | CH4 for Lactose Intolerance

Interface Order Alias

10399

Quick Collect

Schedule before draw

Clinical Information

This test was developed and its performance characteristics determined by Spectrum Health Laboratory. It has not been cleared or approved by the FDA. The laboratory is regulated under CLIA as qualified to perform high-complexity testing. This test is used for clinical purposes. It should not be regarded as investigational or for research.

Ordering Instructions

Test must be ordered prior to scheduling.

Collection Instructions

Improper specimen collection can adversely affect the outcome of the test. Specimen collection should only be performed by staff with experience in proper specimen collection procedures.

 

Patient will consume Lactose (gluten free)

 

Specimen Type: Alveolar, air from properly prepared patient, who ingested lactose.
Container/Tube: Collection bags (total 6 bags)

Minimum volume: 40 mL

 

LINK: Patient Preparation

 

For pediatric patients weighing 54 pounds (24.5 kg) or less:

  1. Contact the Corewell Health West Helen DeVos Children’s Hospital (HDVCH) Pharmacy at (616) 267-1807 with the amount of lactose needed to be weighed out from the formula  in step 2.
  2. Divide the child’s weight up to 54 pounds by 6.9. Then multiply this number by 3.125 to obtain the number of grams of lactose to weigh out.
  3. Example: If child weighs 35 pounds, weigh out 15.9 grams of lactose and dilute this in 8 ounces of warm water. ({35 pounds divided by 6.9} x 3.125) = 15.9 grams)
  4. Walk LACTOSE to Corewell Health West HDVCH Pharmacy (Room #89101 – 8th floor) and pharmacy staff will weigh out the correct amount of lactose.
  5. If questions on the amount of lactose solution to give a pediatric patient weighing 54 pounds (24.5 kg) or less call Immunochemistry Department at (616) 267-2770.

 

Specimen Stability

  • 750 mL (large) bags: 6 hours  
  • 250 mL (small) bags: 7 days 
  • Syringe: 2 hours.
  • All the above options should be stored ambient.

Test Frequency

By schedule only, test is available Monday – Friday. Usual TAT 1-2 days.

Reference Range

Lactose intolerance is suggested if hydrogen increases at least 20 ppm and/or methane increases at least 10 ppm over the lowest preceding value at any time during the test.

Performing Department

Immunochemistry

Performing Department Laboratory Location

Corewell Health Reference Laboratory, Grand Rapids, MI

Methodology

Gas chromatograph

CPT

91065 x 1

CDM Code

9209106501

Epic Test ID

1230100870

LOINC

Lactose Intolerance LOINC codes for both hydrogen and methane:
Fasting:  33504-2
30 min:  33501-8
60 min:  33505-9
90 min:  33502-6
120 min:  33503-4
180 min:  33489-6

Reviewed Date

3/4/2025

Updated Date

11/27/2024 - Pediatric Patient Information (286) Alias, Stability, Reference range (289)

12/4/2024 - # of bags to collect

5/9/2025 - Patient Preparation Document Updated (PDF)