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roseincalifornia,
I'm glad that you took Tymlos without having any side effects.
I like to be careful not to discourage others, many of whom have been advised by their physicians to titrate, from having the advantage of this medication. We do have clinical trial evidence that it is effective at 40mg.
The hypothesis that weight isn't a factor in side effects isn't supported by Amgen's prescribing guide from 2017. The clinical trials after excluding those at both BMI ends, never tracked weight at all.
It isn't just the active ingredients that can excite either side effects or adverse events.
It seems to me that just the biology of having a larger kidney with more weight would be enough conviction that weight matters. Larger kidney, larger bladder, larger bones.
We were lucky, you and I, but that doesn't put us in the catbird seat.
Best luck with the next medicaion.
Replies to "roseincalifornia, I'm glad that you took Tymlos without having any side effects. I like to be..."
Thanks for the correction @gently. Tymlos targets specific receptors on bone-forming cells to build bone mass. That cellular process doesn't change based on your size.
But, in a smaller body with a lower total blood and fluid volume, the standard dosage of 80 mcg results in a higher concentration in the blood transiently right after the injection. That temporary spike in concentration may trigger the cardiovascular side effects—like a sudden drop in blood pressure, lightheadedness, or a racing heart. So while the bone-building mechanism doesn't care about your weight, your circulatory system feels the peak concentration more intensely if you have a smaller frame.
Some comments on: "It seems to me that just the biology of having a larger kidney with more weight would be enough conviction that weight matters. Larger kidney, larger bladder, larger bones."
1. The Side Effects Happen Before the Kidneys Get Involved
The lightheadedness, drop in blood pressure, and palpitations that happen after a Tymlos injection occur within minutes—driven by the drug temporarily relaxing blood vessels as it circulates in the blood.The kidneys are responsible for filtering waste out of the blood over time, but they don't prevent or control that initial peak concentration in the bloodstream.
Furthermore, Tymlos is actually cleared from the body primarily via glomerular filtration, but its clearance rate does not require dose adjustments based on weight or kidney size.
2. Bone Size Doesn't Mean You Need a Different Dose. While a larger person does have a larger skeletal mass, Tymlos is an anabolic (bone-building) agent that works by binding to specific parathyroid hormone receptors on bone cells. Receptors don't "soak up" the drug like a sponge based on bone size. The 80 mcg flat dose is more than enough to saturate the targeted cellular pathways in anyone, regardless of whether they have a larger or smaller skeletal frame.
3. What Actually Matters: Fluid Volume, Not Organ Size. The real reason a smaller person feels the side effects more intensely comes down to total blood and extracellular fluid volume, not the physical size of their kidneys or bladder.
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@gently
But there are not (generally speaking) substantial differences in size of those organs. Many of the studies are being updated because so many are from 2015-2017.
There must also be a good reason Radius medical who owns the Tymlos patent (not Amgen) goes by the 80mcg?
Radius Health holds the patents on abaloparatide, with expiration dates ranging from 2027 to 2028.
Just my 2 cents worth.🤗