Overall, I've had a good experience w P.A. I get a lot of gut infections, and it's by far the most effective tool I have on hand for knocking out a gut infection and knocking it out quickly... It's not cheap, but compared to other approaches for knocking out gut infections, it's cost effective. I wish I had discovered it earlier.
P.A. is not a cure for gut infections; I'm currently doing a SIBO protocol to try to get to the root of the problem. So, not a miracle worker, either. BTW - I'd encourage you to talk to your doctor about getting a SIBO test, and do some reading on protocols. (e.g. the rx antibiotics, rifaximin is less effective than herbs, per the John Hopkins study. However, the herbs don't have great efficacy - only ~50% - unless done w low-carb, no probiotic diet at the same time...Rifaximin is ~$1k-2k and not necessarily covered by insurance, either, so the (expensive) herb protocol is still often times cheaper than rifaximin route.. But first get the test, and do your homework.).
P.A. tends to make me a little tired, so if I'm already excessively fatigued, I use it sparingly. (eg, in the winter months when it's cold, damp and dark... all my symptoms flare). I also make sure to take it at bedtime... It's not a big problem, but if you have fatigue issues to begin with, you have to be vigilant about what gives or depletes energy.... BTW, haven't heard anyone else complain about this, so probably not a big issue w P.A. in general, and it's not even a deal breaker for me...