I just started 3 days ago at 2 clicks. That went ok so today I just went to 3. I told my doctor who is an endocrinologist at Cedars Sinai in Los Angeles that this was my plan and she was supportive. She said she had other patients who take less also. I am not clear whether they titrated up to full dose or they stopped at lower dose. In any event, I don't care. I have a serious heart condition and atrial fibrillation, so the only way I was willing to try the medication at all was to start out slow and see how it went. I was not going to start big and wind up in the hospital or have a stroke. My BP is already very low and my heart condition is very sensitive to a drop in BP so I was not going to mess around.

I will stay at 3 for a few days and see how it goes, and if that is well tolerated, I will go to 4 clicks. And so on until I either reach a full dose or don't. And then I will report to my doctor. I also have a rheumatologist who is monitoring my osteoporosis and I told her the same. This was my plan. Neither one fought back. I had to consult with multiple cardiologists and my EP before I even agreed that Tymlos was possible for me, so I am exercising extreme caution. I did recently have a humerus fracture which required ORIF surgery and lots of hardware, and have had relatively recent foot fractures along with one fibula, so I am clearly in need of some support even though my numbers are not too bad.