I had horrible side effects from the full dose of Tymlos, a bad headache, dizziness, light headedness and nausea. As suggested by @windyshores, I cut back to 2 clicks or 20 mcg. I have slowly worked up to 4 clicks or 40 mcg which is a half a dose. I am tolerating this after a week. My endo believes that it doesn't matter how much you take. It works by kicking up the amount of parathyroid hormone briefly.