I do not have side effects with Tymlos. But b4 I inject each morning I drink a full glass of water with a pinch of mineral salt. Also I always move afterwards doing physical chores, or going for a walk. I do not think I wd feel good if I were to lay down. As for HRT-I chose that on my own to help combat any negative effects from Tymlos such as fatigue, wt. gain, etc. I also do weights and want to increase my chance of muscle building. When I look at my health history, ie: cancer and bone loss, these both occurred post estrogen loss so I decided to add that back in to help maintain and generally feel better. I take estradiol patch, progesterone pill at nite and testosterone cream. I will post any updates along my journey. I am hoping for any better alternative over bisphosphonates by the time I end Tymlos.