@meitene616 I had some of those side effects that many others have as well, after starting on Tymlos. Bone pain was notable for about 3 weeks, then gone. Fatigue levels were higher but improved since I doubled my protein intake. I am now 5 months into Tymlos (age 77 with -3.3 osteoporosis). The bone marker bloodwork shows a vast improvement in bone formation activity. I can't argue with results. The next bone scan will be informative.