@stress101, I could only manage 2 clicks at first and stayed on 2 clicks for 3 months. Then I broke my foot just by starting out for a walk. I pushed up to 3 clicks and did that for a couple weeks, then moved up to 4 clicks, but that was all I could tolerate. Side effects originally were dizziness, orthostatic hypotension and a queezy stomach. In time, I had no side effects on 4 clicks. I was on 4 clicks for 9 months. I saw a new endocrinologist who wanted me to try Forteo. Since she gave me a free sample, I tried it and surprisingly it didn't bother me. I was on a full dose of Forteo for 6 months. During the fifth month, I started having a lot of pain, fatigue and brain fog. I realized that I didn't have the energy to get much done. I changed back to 4 clicks of Tymlos a week ago. I have had some minor dizziness with it, still have some pain but less than with Forto,and I have more energy than when I was on Forteo. I have an endocrinologist appt next week and might get in trouble for changing my medicine on my own.