I started on 5 mg. After 4 week echo, lowered to 2.5. Just had my 12 week echo and going back to 5 mg as gradients were up a bit. The last week or so I was having a little SOB and fatigue that was gone after day 20. There’s a protocol the Dr. must follow to get you tweaked just right for you specifically. Everyone is different so be patient, do all the right things- no salt, eat a healthy diet, no alcohol, stay hydrated, get some fresh air and exercise. Your care team do their best to help you feel as good as you can. I wish you the best on this journey!