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However, for individuals actively managing complex, reactive chronic illnesses like Long COVID, ME/CFS, or severe dysautonomia, such high starting doses are rarely recommended due to the high potential for gastrointestinal upset or rapid, uncomfortable detoxification reactions (often referred to as a Herxheimer reaction)

[6] As a result, classifying drugs by terminal () half-life can poorly predict duration of action, whereas half-life is often more informativethough less commonly reported in labels and reviews

One such study, looking at the effects of clarithromycin and metronidazole treatment on gut microbiota of three participants, reported dramatic shifts in microbiota diversity one week after antimicrobial treatment that eventually recovered to initial baseline states 16

A B12 injection at this point can give your system a much-needed boost