@pgn are you willing to just go ahead and try? I first tried a half dose ( 4 clicks, 40mcg). Many of us seem to have some reaction at first but not that "severe" for most and very manageable. You can certainly start at 2 clicks but move up as fast as you can toward the full 8. This is just a way to deal with anxiety for most people. You will feel reassured and move forward. I don't know your PCP but if they don't know about starting low, are you not going to do it?

My world class endo does this with his patients. It is okay. Titration does no harm, lets your body say hello to the med, reassures you, and should allow you to move along on dose quickly.