I've been on Tymlos for just over 2 months. From the beginning, my health provider instructed me to take in 1200 mg of calcium daily, weather from nutrition or supplements. I'll be sure to take in 800 mg from almond milk and then I take a 400 mg calcium citrate, along with 100 MCG of vitamin K2 and a total of 2500 IU of vitamin D3. My calcium levels and all of my other blood work have remained textbook perfect. My P1NP (128) to CTX (707) ratio was 181, after 3 wks @ full dose + 3 wks @ partial doses. (150 and higher ratio is believed to indicate a bone-building/anabolic response to the med. Good luck!!