Why Every Protocol Stops Working After Two Weeks: The Mechanistic Pattern Hiding in Plain Sight in Chronic SIBO, MCAS, and Long COVID — Part 1: What the Two-Week Pattern Actually Is

The Clinical Signature The arc has a stereotyped shape. Days one to three are often quiet — the intervention is loading, the body is registering the change, the existing symptom load is unchanged. Days four to ten are the honeymoon: improvement that is real, measurable, and often dramatic. Bloating drops. Reactions cool. Energy comes back. Sleep deepens. Cognition clears, sometimes within hours of dose timing. Days ten to fourteen are the inflection. The slope of improvement bends. Gains that were daily become weekly. The dose-response that was clean becomes noisy. Symptoms that had vanished begin to flicker back, often in lower amplitude but reliably. Days fourteen to twenty-one are the regression. Baseline returns. Sometimes baseline is a few percent better than before — barrier function may have improved at the margins, a single trigger may have been quieted. But the trajectory has reverted from improving to flat or declining. The intervention that was working is no longer working, and increasing the dose either fails to recover the benefit or produces side effects without rescuing the original effect. This is the two-week wall. It is not specific to one disease or one drug class. It is a property of the system, not the intervention. Why It's Not Coincidence Patients with chronic SIBO, MCAS, post-viral syndromes, hEDS/POTS clusters, mold reactivity, and the broader category