Tymlos will raise your calcium level briefly. There are other posters on Mayo who have dealt with this. Also I took 3,000 units Vitamin D while on Tymlos, more than usual, and my levels stayed the same.

Why are you having it in the doctor's office? Not sure anyone at the doctor's office will do a lower dose. Maybe.

There are 8 clicks on the pen. You can start with two or one if you are really nervous. I have atrial fibrillation and while on Tymlos went the entire two years without any afib.

Your doctor can guide you on dealing with palpitations but I did not need to medicate heart issues while on Tymlos.