I just completed two years of Tymlos. I had only minor side effects including rapid heart rate for about 30 minutes after injection, more pouf in my tummy area, and lethargy at times. The one thing I wish I had done better was to be more consistent with calcium and vitamin D. I went from osteoporosis to osteopenia, although I don't have any BMD measurements from the same machine due to moving around. My doctor just put me on Reclast. I got an infusion within a week of stopping Tymlos. In two years I will get another hip/spine BMD test. Then, if all has gone as expected, I'll do three more Reclast infusions spaced 18 months apart. I felt pretty bad the day after the infusion but ok after that. Build as much bone as you can while on Tymlos. Vitamins and weight-bearing exercise are important I think.