Tymlos seems to be the one bone building med that most tolerate really well. I finished my 2-year protocol of Tymlos in June of this year and other than a few minor side effects, it really was easy peasy. Injections were simple and because I injected at bedtime, the early side effects I had when injecting in the morning were unnoticeable. I started at full dose from the beginning and never lessened the dose. I had an almost 15% increase in my spine and 3.5% in my hips. I’ve never fractured thank God even though my numbers were pretty bad (i.e. -4.7 in my spine). I wish I could have continued it for another 6 months but doc said no. Now I’m on bioidentical hormones but my rheumatologist wants me on Evenity but I’m holding off for a bit but don’t want to lose my gains from Tymlos. Always decisions to make with Osteo. Don’t be nervous about Tymlos…you can start at half dose for a few days to see how u tolerate it and then move up as @windyshores suggested. One day at a time, one step at a time. Rose 🌹