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@mmodestti

I was too. I started out at 3 clicks, mostly because I was scared of side effects, and because @windyshores was super helpful in these chats explaining how we could start at a lower dose and work our way to a therapeutic dose. I discussed it with my endocrinologist, who said she didn't have a problem with that as long as I reached a therapeutic dose as soon as possible.
So I went up a click every 3-4 days. Everything was beautiful until I reached 6 clicks, where I started to feel nauseous, and tired, and had some palpitations. But it really was very tolerable and I took it as a sign that I was reaching my therapeutic dose. I tried 7, but I definitely wasn't ready, so Y skipped a day, went down to 5, and worked my way back to 6. I have been at 6 for a couple of weeks and the effects have diminished notably (still a little nauseous, a couple of hip or lower back pain here and there, but very tolerable.

If you go to http://www.tymlos.com, they have a great video on how to prep the pen for the first time and how to use it. I only used that video and found it was a lot easier to get used to than I would have thought. I have read a few studies about results and am very grateful to have found this alternative. I have suffered 8 vertebral fractures (5 lumbar and 3 thoracic) and two rib fractures. That is way worse than any side effect.
I prepared a table where I track my dosing and side effects to discuss with my doctor. Here is a screenshot if you might find it useful. I have duplicated it and have a new tab for each pen.

I wish you success with your treatment.

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Replies to "I was too. I started out at 3 clicks, mostly because I was scared of side..."

@mmodestti great post and exactly what I did. Backing off if side effects are hard and then working back up. My only comment is that I have found side effects vary from day to day. At 7 clicks I might still get some fatigue, or dizziness some days but I do stick with it most of the time. Headache as a side effect went away quite quickly. So sticking with a dose even if it has side effects can sometimes mean those side effects go away.

We have a similar fracture history and similar commitment. I would take a few days a month of nausea to avoid any fractures given the pain and disability that results. But Tymlos really has been very tolerable. So grateful.

That chart is great!

Thank you very much for explaining all of that. My Tymlos pen is arriving today and I am anxious to get the medicine started now that you and windy shores started at a low dose. That has calmed my concerns a lot so I am going to start with 2 clicks. I wonder if since I haven’t fractured yet if I can just increase by one per week. . . if the video is good I can use that to learn.

Thank you- is moderate activity like slow walking stair climber ? I do that every day now for twenty minutes.

You are making me feel good bc my Numbers are so severe and this medicine is better for me than other options bc we can customize the dose to our needs. May I ask you to send me a copy of your spreadsheet.