Why Every Protocol Stops Working After Two Weeks: The Mechanistic Pattern Hiding in Plain Sight in Chronic SIBO, MCAS, and Long COVID — Part 3: How to Read Your Own Two-Week Histories

Most patients have accumulated five to thirty discrete intervention trials over the course of their illness, each one with its own arc. This is an extraordinary dataset, and it is sitting unread on the desk of nearly every chronically ill person I have worked with. Reading it requires three steps. Step One: Map the Arcs Take a sheet of paper or a spreadsheet and list every meaningful intervention you have attempted in the last three to five years. For each one, record what category of mechanism it belongs to (substrate supply, antimicrobial, mast cell stabilizer, dietary substrate restriction, autonomic, anti-inflammatory, other), the duration of your trial, the time to first noticeable benefit, the time to peak benefit, the time to plateau or regression, and whether the post-trial baseline was better, the same, or worse than the pre-trial baseline. Do this honestly. Do not give an intervention credit for the placebo effect of starting something new. Look at the symptom data, the lab data if you have it, the function data — how far you could walk, how many foods you could eat, how many hours you could think clearly. What you will almost always find is that the arcs are not random. The plateaus cluster around the same point in calendar time — typically ten to twenty-one days. The post-trial baselines are usually within a few percent of the pre-trial baselines, regardless of how