@jhankins there is no harm in backing down to 1/2 or eve n 1/4 dose of Tymlos. The pen has clicks that measure the dose and 8 clicks is a full dose. Many of us have done this and ramped up to give our bodies time to adjust. I got up to 7/8 dose and had excellent gains.

I had better luck with palpitations when I switched to morning. If your blood pressure is low, that can contribute. I bought a bp cuff and stayed well hydrated to keep bp up (salt helps too). Everyone is different!