I have been on Tymlos for seven weeks now. I have started to experience lower back pain and pain in my left hip (I have AVN on that hip). I started on a very low dose (3 clicks) and added a click every three days. At 6 clicks, I started to experience some side effects. I had a few terrible days with nausea, leg cramps, general malaise, and even "hot flashes". At 7, it was a disaster. I had to skip a day and go down to 5 for a few days. I am back at 6 clicks. The first days were not good: nausea, leg cramps, back and hip pain, and, again, the "hot flashes". But I stuck to my treatment, and the effects have gradually subsided. Only mild nausea and feeling a bit tired, especially in the late afternoon. I plan to hang on at 6 a little bit more to see if my body gets used to it completely, and I'll try 7 clicks one more time. Not really looking forward to trying the full 80 mcg. though.