I could not tolerate a full dose and started with two clicks out of 8 on the Tymlos pen and moved up a click each week. Most of the 18 months I have been on 7 clicks. sometimes 6, sometimes 8. This last month I am doing full dose with few side effects. My gains were 20% in spine, from severe osteoporosis to almost osteopenia, and 9% in hip. I am still concerned about my femur neck.

Side effects included fast heartbeat for a few minutes (not bad at all), headache the first weeks only, mild dizziness the first weeks only, and fatigue which got better when I got up and out instead of resting. For me, side effects eased fairly quickly. Everyone is different. My doc was happy with 6 out of 8 clicks but I did get more.

My current endo wants me to do Reclast but due to my sensitivities and health issues (Kidneys aren't good) will do a 20% test dose and after 3 months I can choose the next dose.

I love my endo and he is very accommodating but I am seeking a second opinion to consider Evenity, even if just for 4-6 months, to address my femur neck and get more gains in general. My current endo says there is "no data supporting" that but many on this forum are following Forteo or Tymlos with Evenity. Then I will lock in gains with a bisphosphonate. Either partial dose Reclast more often than once/year or an oral, though with GERD not sure I can do oral.

What is your situation?