Thanks @windyshores. I'm going to ask the radiologist if s/he can take the Strontium effect out of my score and try to make an appointment with Dr McCormick. I was hoping to increase to at least 40mcg, but am concerned about the cost of Tymlos. I do think that the 20mcg dose does a little something, because I had side effects for a long time. My endo did give me a new sample and of course the sample I have has lasted a long time since I am only taking 20mcg. He said that one pen cost $1800.