I believe it is because they did studies with full doses so they are kind of locked in. In fact, the speciality pharmacy won't even provide different needles from the study. And studies were done with shots in the abdomen so they will say no to thighs with Tymlos (not Forteo). Etc.

Doctors are under the same restrictions- limited to data from studies- but my doc is flexible and I brought the partial dose suggestion to him. Given that that was my only shot after literally 14 years of trying to tolerate meds, he was delighted-but could not prescribe it himself!

I think it’s all about the money. They only want to offer a one dose pen because it’s cheaper. My feeling is that the docs just go by what the studies show. They don’t share their experiences of what they have seen with their own patients. I consulted with a doc who shares his years of experience with what works. He agreed with starting low and increasing my dose as my body adjusts. It’s like my experience with gabapentin. I took what is considered a holistic dose of 100 mg. Most take 2 thousand or more mg. Well I was so groggy and tired the next day that I had to start with 25 mg and slowly work up to the 100. My doc thinks I metabolize drugs very slowly so it takes a long time to get through my system.