I am a little late to this thread, but thought I'd share my experiences anyway . . .
I got in bed one night recently after finishing up in the bathroom, and said to my husband, "I didn't hardly flush at all this morning, and I didn't flush tonight at all!" He looked at me like I was crazy -- why tell him that? I realized what he thought and cracked up -- he had a different type of flushing in mind . . . hope that makes someone laugh!
So, that is my issue with Tecfidera now - these intense itchy rather painful unpredictable flushing episodes. I never know when they'll strike. They don't last too long, maybe 20 minutes. But I did notice that jalepenos bring on a serious almost immediate flush. After reading through this thread, I have another clue as to what is causing the flushing -- acidic foods. I had a very bad flush at our xmas lunch yesterday (we celebrated with my family day after) and I had eaten ham, a little bfast casserole and some pineapple for breakfast before taking it. i thought that would be plenty of fat so I was surprised to get a flush. Up until now, i have been focused on eating some fat with it (even my doc suggested this), and it has mostly worked. Even some coconut oil in my oatmeal and fruit has been okay. I was also puzzled when I had horrible flushing at thanksgiving, but I had some wine so maybe that was the problem.
I also have GERD and take medication for that, but I take it right before bed. I tried mornings for a while but it did not work as well for me. I take Dexilant, and recently tried switching back to Nexium (which I was on for years), and no go - I had horrible heartburn the next day. I recall reading something about taking aspirin to reduce flushing, but I didn't think you could take even coated acid with GERD. I'm pretty afraid to try . . . Given my GERD issues, you all would think I avoid more acidic foods but I don't worry about it for the most part because I have tried and that didn't work . . . there are just a few things I absolutely can't have -- that Starbucks VIa instant coffee or any regular coffee in the afternoon other than a latte (I do drink two cups of coffee in the mornings - I cannot give that up!), and I cannot drink red wine. Anyway, as much as I love tomatoes, spicy food, etc., I will avoid these at bfast and lunch for now on and see if that helps with the flushing.
Sorry this post is growing long, but I did want to share my GI/tecfidera experience as some of the posts here were very similar to what I experienced. I actually quit on about day 12 of taking the normal dosage (120 mg 2x day for a week, then 240 2x a day). I had horrible GI issues to the point of being unable to eat, and having to take Bentyl to relax my stomach. I was considering the ER - the cramps were so awful. I decided I could not deal with being that sick in the middle of October. I told the doc I would try again in January when things were slower but he suggested I just titrate more slowly. So, I took one 120 mg per day for 4 weeks in November and then moved up to 2 120s per day for the next 4 weeks. I have about a week to go on that, and then will take one 120 mg and one 240 mg for four weeks, and then go full-dose. With this dosage I initially had some bloating/belching but nothing too severe and now I have almost no stomach issues at all with it. And the flushing has just been really erratic.