Whatever support meds you are on for the rest of your life have to correlate with how effective they are and how long they stay effective. SO make sure you are montered ( thorough labs) to confirm the efficacy of the treament. Bone markers are key per my understanding. I have been on tymlos for 16 months; my P1NP ( building) is 90 and CTX( dissolving) is 535. We are all different and have different base lines but That proportion for me is good and the medicine is effective for my spine ( but no changes in hip or forearm). I will retest soon. If P1NP drops to 50 and CXT stays the same, it is time to stop the tymlos and began a medication that reduces the CTX ( usually a bisphosphante).
Now you may have corrlating issuse that a best supported by tymlos for a longer period. But I recommend you understand why. ANswers are indivual and must be best for you.
Meanwhile on the heart palpatations, I too had them early on ( at only 1/2 dose ) rather serverly. The solution was 2 fold - 1) restart at the lowest dose 2 clicks. Stay there for 1-2 weeks and gradually increase each level at 1-2 weeks. 2) Drink coconut water. Drink 3-4 cups throughout the day consistantly. I went throu gallons of it... THis will help cool the body and the intense effect of the medicines release. Its an ayurvedic principle but many allopathic primary care physicnas know of using coconut water for heart palpitations. May best to you and encorage you to ask questions ..... you are your own best advocate. BLessings of health