@lisaberkowitz I started Tylmos 2 weeks ago and began with 4 clicks for four days and increased the dosage by one click every four days. I will be on the full dosage, 80mcg tomorrow. So far I have not had any side effects-in fact feel great. I was very frighten for many years to go on medication and tried to manage it naturally( without success) so for now, am happy and relived I am on the road to treating my severe osteoporosis. I am 63, highly active and on no other medication, and remain hopeful. Hope this helps you in taking this step!