Some people, particularly SIBO cases, may need to extend or repeat a pathogen purge. Much of that issue depends upon diet and not necessarily ineffectiveness of a pathogen purge. Because we're dealing with other life forms that have the same directive to adapt and survive, there can be layers of improvement, (i.e. - 60% the first time, 20% the second time) as each life form vies for its personal survival. If symptoms persist, another round may be warranted. If symptoms are reduced but not gone, then a repeat performance is often best done 4-6 months later, because the immune system needs some time to reestablish a new relationship. In this program we're helping Nature, not dictating, thus the gains are more genuine and enduring. However, as in all things with the body, biochemical individuality is the rule and acquired pathogens introduce new competitions. Dietary improvements are hugely important. The program is a quick "leg up" the ladder and a huge boost forward in the process of improving and maintaining optimal health.