I have been on Tymlos for just short of one month, so I'm hardly an expert but I hope my experiences will help you. I joined this community to hear from others who were further down the road than I was, so that's what I can offer you.
I was terrified to go on Tymlos for all of the reasons. I am 63, small, active, in otherwise great health, and feared ruining all that. My worst number was -3. I also think of myself as someone who gets every side effect there is for everything--which really isn't true-- but close.
I am ramping up the "clicks" very slowly-- heading into week 4, I just administered my first "3" dose. The side effect I get is the increased heart rate. It is scary and uncomfortable, but apparently not dangerous. The Tymlos nurse (and yes, if you start the drug, get assigned a Tymlos nurse-- mine is wonderful--and yes, I am aware of who she works for) recently suggested I lie down and elevate my legs to lessen the effect. It totally worked. This gets into the issue of morning or evening injections (you'll find a lot about that on this site). I started out with evening, but then I found myself dreading the night coming, so I switched to morning-- when I'd be more distracted. But now that I'm lying down after the shot, I'm going back to evenings. I have figured out how to do the injections, so I don't dread them and the evening so much. I could keep talking, but I'll stop for now.
I will be glad to answer any other questions that I can.
Good luck.