@cathyf31 Cathy , I was on Tymlos for 21 months and had to keep lowering my dose due to side effects (severe knee pain, tetany and cramps,so much fatigue) I couldnt tolerate 80mcg...it affected my heart. I did mostly 70 and 60 but the pain in my knees was so bad I went down to 40 mcg the last several months of using tymlos. All my symptoms have gone since stopping than the lord. And surprisingly , my dexascan which was done this month 2 years after starting Tymlos shows 9.7% improvement in r femorol neck and 5.5% in r hip. I have increased bone in all areas, with a low of 2.4% in forearm and spine and a3.5 %improvement in l hip. I had the watermelon belly as well. It is gradually lessening in size.