@osteopatient2026 Indeed it can cause leg cramps. Tell your doc. It may be that your serum calcium is elevated. And don't accept your doc saying "oh it's only xxx (10.6 in my case) so that's not causing your issues." The deciding factor is how your body is responding, not whether most people respond like that or not. In my case, stopping the Tymlos dropped my calcium back to normal range in one week and the horrific leg cramps went away.