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Epic Code LAB3097 Lactose Intolerance, Breath Test

Important Note

Test Name Alias

Lactose Intolerance Breath Test | H2 Breath Test for Lactose Intolerance | 4133

Interface Order Alias


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 7 bags)

Minimum volume: 40 mL


LINK: Patient Preparation


For pediatric patients weighing less than 55 pounds contact the Spectrum Health (Butterworth Hospital) Outpatient Pharmacy at 616.267.1807 with the patient’s weight and the test being performed (Lactose Intolerance Breath Test) so that they can adjust the amount of LACTOSE administered according to the following formula:

Divide the child’s weight (up to 55 pounds) by 6.9.  Then multiply this number by 3.125 to obtain the number of grams of lactose to weigh out. Example: if child weighs 35 pounds, you would weigh out 15.9 gm of lactose and dilute this in 8 ounces of water. (({35 lbs ÷ 6.9} x 3.125) = 15.9 gm)


Specimen Stability

Ambient: 6 Hours

Test Frequency

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

Reference Range

Any time during the test, a 20 ppm increase in hydrogen gas over the lowest preceding value indicates lactose deficiency

Performing Department


Performing Department Laboratory Location

Corewell Health Reference Laboratory, Grand Rapids, MI


Gas chromatograph



CDM Code


Epic Test ID



Fasting H2 Breath: 33490-4

30 Minutes H2 Breath: 50000-9

60 Minutes H2 Breath: 50001-7

90 Minutes H2 Breath: 50002-5

120 Minutes H2 Breath: 50003-3

150 Minutes H2 Breath: 50013-2

180 Minutes H2 Breath: 50004-1

Lactose Intolerance Comment: 8251-1

Reviewed Date