I also get headaches (migraines) and vertigo (before Tymlos).

There is no formula for ramping up. I did 2 then moved up one when side effects eased at each level. If side effects weren't bad at a certain level, I would just add a click. The pen automatically returns to "0" after you inject. Pinch your skin, stick the needle in and let the skin go at the moment you inject.