The Single Molecule Driving Both Your SIBO and Your MCAS (And Why Nothing Has Worked) — Where this goes

If you&#8217;ve read this far, you understand the frame. The question becomes what to do about it &#8212; and that is not a question I&#8217;m going to answer in a Substack post, because the answer is genuinely individualized and depends on which axis is dominant in your particular case, what your genetic context looks like, what your testing reveals about which specific lesion is driving the failure, and which order to address the cascade in. (These choices matter enormously. The wrong sequence can make people worse. I have seen this in clients who came to me after well-meaning protocols hit the right molecules in the wrong order.) What I will tell you is the direction. The point of intervention is not the mast cells, not the bacteria, not the symptoms downstream. The point of intervention is the colonocyte. Restore the host capacity, and the succinate signal stops. The mast cells de-prime. The TET enzymes unblock. The stem cells re-balance their lineage commitments. The barrier rebuilds. The microbes that fit a hypoxic, butyrate-rich, antimicrobially-policed gut return &#8212; and the ones that fit a leaky, oxygenated, defenseless gut leave. None of this is fast, and it is not done with a single supplement or a single test. But it is possible , and it is mechanistically defensible, and the framework explains why it works when conventional protocols don&#8217;t. The Host Capac