Stress
It's not easy being the boss. From the moment you drop out of med school to sell organic vegan pickles in a bag, to the moment you realize you forgot to mention "gluten-free" on the label, this job is challenging work.
Every day as a niche food entrepreneur means putting it all on the line to produce an unexpected snack that people will be dying to munch on, and making sure that the world gets the chance to share your obscure flavor-vision.
Nine out of ten startup companies fail (source). Many of the ten successful percent are run by folks who are on their second (or tenth) try. If you think failing once is tough, try starting over again and again, never sure if this time will be the time you get it right.
That's a lot of weight on your shoulders. Even when you do succeed, being at the top means that you have employees who depend on you to continue succeeding. There's no telling how many birthdays, anniversaries, or Christmases you might miss for this job. You're to blame if something goes wrong. Stress is the evil twin that always seems to hang around when money and glory are present.