@josn, I was on a half dose of Tymlos for 10 months, because I couldn't tolerate even one more Tymlos click. I did have improvement in my spine, but not my hips. I went to a new endocrinologist who recommended I change to Forteo. She said it doesn't have the vasomotor side effects of Tymlos. She was right, I am able to tolerate a full dose of Forteo. I am mentioning this in case you continue to have trouble with Tymlos.