The pen has 8 "clicks." You can do any number of clicks up to 8. If you can tolerate a full dose, by all means do it. My doc was very happy that I started low and got up to 7 clicks out of 8. Tymlos has hormonal action and our bodies adjust to it. But some people can start at a full dose from the start.

Remember that doctors and pharmacists rely on what was done in studies. My doc is a top doc at a major hospital and would have been happy even with a half dose of 4 clicks versus not doing it at all.