I have just completed one month on Tymlos. I have managed to ramp up to a "3" in that time. I have also threatened to give it up twice in that time.... I powered through it with the support of the Tymlos nurse and the comments of women on this site. Thanks to all of you. My side effects are rapid heartbeat-- which is distressing, scary, uncomfortable, but apparently not dangerous despite how it feels. The Tymlos nurse recommended I lie down and elevate my legs after the shot. That definitely helped. At a "3" I got a splitting headache that lasted for hours. But a few days in, that has lessened. Sometimes I will go back to a "2" just to give myself a rest. I have also figured out the injections, which hurt when I first started. I had read that "you don't feel it"-- but that wasn't the case for me. I think I was going too slowly. My rec: don't jam in in, but go with confidence and conviction. I can sometimes make it not hurt. There is always a red mark afterwards. My thought at the end of one month? Only 17 more months to go...