@susanjohnston , for the first month and a half after starting Forteo, i was very fatigued which i found out quickly it was due to low blood pressure (low 80s/low 50s), this lasted 24/7. Lying down helped a lot so i injected in the night to "sleep it off", but still very tired during the day, not fun.... the good news is body adapted in less than 2 mo by increasing water intake with added salt if needed.

To me the drawback of dosing in the night is when i forgot a dose and went to bed fell asleep, i couldnt make it up. This is the main reason for the switch in my case.

There was a published study on teriparatide (forteo) showing am injection yielded higher bmd gain when compared to pm injection. However the study was very small, the conclusion needs to be looked at with a grain of salt. If true, doctors and pharmacists will no doubt recommend it without hesitations.

Wish you a great success with Tymlos!