@bilchar2 the body tends to adjust over time and many of us who persisted out of necessity *severe osteoporosis and/or fractures) found that things improved.

However, some of us who cannot tolerate a full dose, went back to 1/4 dose for a week or two and then movde up slowly. This is the only way I could get on Tymlos and my doctor said he now suggests this in his practice.

The injection pen has "clicks" for dosing. Full dose is 8 clicks and 1/4 dose is two clicks. You can also play around with timing (I switched to morning). I have low blood pressure and Tymlos lowers it further so I drank water and ate salty things and had a blood pressure cuff. After awhile I stopped doing all that.

Main mesage: if you need it, do everything you can to make it work for you in consultation with your doctor. I went from severe to borderline osteoporosis in my spine!

@bilchar2 they "should" go away in 2 - 3 months (says my doctors/team) at UCSD. They did for me. I had to stop after one month and titrate up (start again at a lower dose and work up). Your body will adapt. You should ask your doctors ahead of time about the side effect possibilities and them for links to reading materials. Things like knowing to take the medicine at night so you sleep the fatigue off, and having anti-nausea meds if you get queasy - I did when I injected in the morning. I had light headaches for a month. Everything went away, like they said! (you can always stay on a lower dose if need be). Drink plenty of fluids.