I cant be sure, maybe the combination of both. I drank more piper for longer tho. Please note that his protocol calls for the citrate and i bought the sulfate by mistake).tho its still effective i may have not had the huge herxing had i bought the right brand. Evenstill it did work, but my hair fell out from either the piper or pinx (which is pyrantel), hard to say which caused hair loss. All i know is my large parasites arent squirming as usual. Theyre wounded.