@kaa1 your doctor may be unfamiliar with the idea of starting low. My doctor at a major teaching hospital was at first amused that I had done thus and now uses it in their practice for those who cannot at first tolerate full dose. Your doctor cannot prescribe this. You can do a lower dose on your own and tell the doc about it. Make sure to refrigerate he pen if doing a lower dose so it lasts longer than 30 days.

Hi. Like @windyshores, after trying the full dose at first, I dialed down to fewer clicks (4). My doctor suggested it. Then, every three to four weeks I’d click up one, and I’ve now been on the full 80 mcg for two months with very mild side effects (slight headache and strong heartbeat which fades within the hour). Your body takes time to get used to the medication. The first time I tried 80 mcg, it was torture. Now it’s totally fine. I will likely feel side effects for the duration of my time on Tymlos, but that’s okay with me. I’ve learned to deal with it and it’s definitely gotten way better over time. Even if 80 mcg is not comfortable for you, a lower dose may still have therapeutic benefits. Everyone is different so do what works best for you.