I have been on tecfidera for nearly 5 years and have loved every moment of it. No side effects whatsoever, not even at the beginning. You start on a half dose for a week or longer if needed to get used to it. Eat something fatty eg peanut butter and toast to try and keep possible side effects away. I never had any problems and can take it with any food. High fat with the tablet is just the recommendation in the first few weeks if you worry about gastro issues. Not a must either, so no worries if you don’t want to do this for a week or two when you take the tablet. Don’t worry and give it a go. It’s been like popping a vitamin for me. I only have to change meds now because a new lesion was found. Not happy, tecfidera and I are pals.