Why Nothing Works: How "Adrenal Fatigue" and "Depression" May Be the Same Collapsed Infrastructure at Different Stages

The Flow Collapse Model (FCM) identifies chronic digestive dysfunction as upstream infrastructure collapse. Part 4 introduces a stratification within the Depletion Path based on hepatic enzyme signature (AST/ALT), identifying two distinct clinical presentations: Type A — Low Synthesis Layer (AST/ALT ~10–15): The liver lacks substrate and cofactors to produce enzymes adequately. Standard adrenal fatigue protocols fail because the factory is empty, not broken. Type B — Portal LPS-Driven Layer (AST/ALT ~25–35): The liver is overwhelmed by portal LPS influx from intestinal barrier compromise driven by Silent SIBO. Presents as depression-adjacent symptoms and histamine intolerance. These two layers require fundamentally different intervention sequences. Confusing them produces consistent clinical failure. This paper describes the mechanistic basis of each layer and the correct FCM intervention sequence for each. Related publication: Flow Collapse Model™ (DOI: 10.5281/zenodo.17913136)