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Several of Dihexa's foundational mechanism papers were retracted in 2025 after a WSU investigation found image manipulation by the lead author

Those cell changes inhibit glutamine synthesis and glutamate receptor expression, reducing its neuronal uptake and triggering an imbalance in the glutamate-glutamine cycle with the consequent increase in brain blood flow, edema, and intracranial pressure, leading to the neuropsychiatric and neurologic clinical manifestations seen in HE.16 6 Systemic inflammation, oxidative stress, alterations in intestinal permeability and the gut microbiota, sarcopenia, zinc deficiency, and neurogliovascular unit dysfunction are other factors that contribute to the presence and severity of HE

Patients are monitored throughout treatment

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If your burnt sienna feels cool or neutral, you've added too much blue

Many patients report feeling satisfied with smaller portions than they consumed before starting the medication