Why Every Protocol Stops Working After Two Weeks: The Mechanistic Pattern Hiding in Plain Sight in Chronic SIBO, MCAS, and Long COVID — Part 4: What the Two-Week Pattern Does Not Mean

A few important boundaries. The two-week pattern does not mean that downstream interventions are useless. They are not. A correctly chosen mast cell stabilizer can reduce acute reactivity to a level where the patient can eat, sleep, and function. A correctly timed antimicrobial course can produce months of relief in a patient who is otherwise stable. A correctly targeted substrate supply can fix a substrate-limited lesion. Symptom-layer intervention is essential and valuable. What the two-week pattern means is that symptom-layer intervention is not curative when the lesion is at the capacity layer. The intervention will buy you a window. It will not move the floor. The two-week pattern also does not mean that all chronic illness is host-capacity-limited. There are patients whose primary lesion is genuinely microbial (acute infection, established pathogen reservoir), genuinely immunological (autoimmune disease with identified target), genuinely structural (severe motility disorder from neuropathy or surgery), or genuinely substrate-limited. These patients respond to interventions in their primary layer with sustained, non-plateauing benefit. The two-week wall is a finding in patients whose interventions have not produced that response — which, in my consulting experience, is the large majority of patients carrying SIBO, MCAS, and long COVID labels who have not improved on standa