@artscaping i just thought i would reply to this, since it has similarities to my situation -- but my solution is off-label and therefore i am recommending it. @salpert i wonder if, by any chance, you are a small(ish) person? i also had lingering palpitations (plus a high degree of nausea) when i first began doing tymlos -- so much so that after about 2 months my rheumatologist sent me to a cardiologist and i wore a heart monitor for a month. the conclusion of that assessment was that my heart rate was indeed being heightened after the injection more and for a longer time than expected (i.e., some period of increase is a typical side effect of tymlos) but that it was not dangerous if i was not too uncomfortable. wellllll i was tremendously uncomfortable and didn't feel that i could commit to an extended period of good medication compliance under those circumstances. as i am a small adult (small stature and below 100 lbs), i wondered if the standard adult dosage could possibly just be too high for me. i then took it upon myself 🙂 to lower my dosage to half the usual. you can do that by turning the pen only 4 clicks instead of 8. thereafter, my heart rate was heightened for only a hour or so after administration as it is for most people AND at the end of the year, my bone density showed an increase of 14.5%. the makers of tymlos should investigate such dosage issues and perhaps refine their recommendations based on body size and weight.