I have not followed this whole thread and I don't know if what I'm going to say has already been discussed but here goes.
The trials showed that about 1/3 of people get acute reactions to the first infustion of Reclast. These are most often 1-3 days long starting from 0-3 days after the infusion. Some unknown percentage of people get reactions that start later and may last for long periods. There is as far as I know, no study of these long term reactions. IMO it is these sometimes long lasting and sometimes severe symptoms that is the main problem with Reclast. Not the unpleasant but short term acute symptoms.

There is no evidence as far as I know that all the tricks and strategies for reducing Reclast work. Maybe they work and I'm not denying that they may work, but just saying it's very difficult to be sure they are working. If someone takes Tylenol or Claritin or whatever and has little or no reaction to Reclast that does not necessarily indicate it prevented a reaction. After all, 2/3 of those taking it have no reaction anyway. And a much smaller percentage have reactions to Reclast on subsequent infusions.

Next, there is no evidence as far as I know that stopping the short term symptoms would have any effect on whether or not one might have the much more problematic long term symptoms. It is very important to distinguish between these two symptom categories in evaluating Reclast and most of the discussions on groups and forums mix these two different types of symptoms and their consequences up. Short term could be quite unpleasant but usually gone within a week or so. Long term can wreck lives.

Just to add to the brew there is an analysis suggesting that those with more short term reactions to Reclast have fewer fractures down the road than those that have no reaction. And no one knows whether taking the Tylenol and Claritin and so on might alter the possible benefit seen in those who would have the short term reactions. BTW, the less fractures seen in those with more short term reactions was not shown in bone density, just in fractures. Fractures being the most important thing but harder to measure and study.

And finally there is the possibility, that lower doses which DO work just as well as the standard high dose, would be safer and less likely to cause bad long lasting side effects. It's common sense and quite logical that one should only take as much of a drug as is needed to produce the desired effect. That is not how the dose and scheduling of Reclast was determined. If interested see the discussion I started entitled "Are we overdosing Reclast???" for a lengthy discussion of that topic.