Psnmonna,
so Tymlos works by temporarily raising parathyroid levels. High PTH causes rapid heartrate. There is a sequence the Tymlos causes vasodilation. Vasodilation lowers blood pressure. Low blood pressure raises heartrate and the heart beats faster to make up for the low pressure. You might hydrate more so the heart doesn't work so hard. Salt constricts the blood vessels so I like to use it as an excuse to eat a couple of blue corn chips, or salted cashews. If the back and shoulder pain recur, you might get a cuff to measure the heart rate because tachycardia can cause afib and afib can cause cardiac remodeling. Your md is almost certainly right to say-- don't worry. The effect may lessen as your body adjust to the medication.
You could take estradiol in addition to Tymlos. I'm partial to the low dose patch for safety, though I don't use it myself.
Your doctors are planning Reclast for two years. The cognoscenti know that one year is good for two years. And the 4mg zolendronates. works just as well as the 5mg Reclast dose. The groundlings are planning month break and then a third year of Tymlos.
And the researchers https://www.cell.com/cell-reports-medicine/fulltext/S2666-3791(24)00266-0?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2666379124002660%3Fshowall%3Dtrue