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This is why providers use a titration schedule, starting at a low dose (like 2.5 mg) and slowly increasing it every four weeks

DPP-4-Integrin-1 signaling levels and the associated TGF dimerization, which is the first step in activating the TGF signaling transduction cascade (Shi et al., 2015)

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While that study found more deficiencies recorded in the dietitian-visited group, its likely because those patients had more thorough screening and counseling underscoring the benefit of having a nutrition specialist involved in your care

A Randomized Controlled Trial of Omega 3 Fatty Acids in Rosacea Patients with Dry Eye Symptoms