Why Every Protocol Stops Working After Two Weeks: The Mechanistic Pattern Hiding in Plain Sight in Chronic SIBO, MCAS, and Long COVID — The Pattern You've Lived Through and Never Heard Explained

You started a new protocol. Maybe it was rifaximin. Maybe berberine and allicin. Maybe ketotifen, or cromolyn, or quercetin. Maybe a low-histamine diet, or carnivore, or elemental. Maybe NAD precursors, glycine, methylene blue, or vagus nerve work. The first week, something shifted. The bloating loosened. The reactions softened. Your head felt less compressed. Sleep was deeper. You thought, finally, the thing. By day ten, the curve had bent. By day fourteen, the gains had stalled. By day twenty-one, you were either back to baseline or, in some cases, slightly worse than when you started. The protocol hadn't failed in the way a placebo fails — it had worked, demonstrably, and then it had stopped working, with the same demonstrability. You probably blamed yourself. You probably tightened compliance. You probably read the forum threads where someone with the same diagnosis says it took them six months, so you doubled down. Eventually, you switched protocols and lived through the same arc again. If you've been chronically ill for more than two years, you have lived this two-week arc somewhere between three and thirty times. It is the single most universal pattern in complex chronic illness, and it is almost never named, much less explained, by the practitioners running the protocols. This essay is the explanation. The pattern is not coincidence. It is not non-compliance. It is not