@cloud60 I am not sure that the Tymlos dose is customizable. We don't know for sure what the therapeutic dose is for each individual. Studies have only been done with the full 8 clicks/80mcg. We don't know what factors affect therapeutic dose either, such as body size.

The goal is the full 8 clicks, which is what our docs prescribe and what has been studied. Ramping up is intended to reach that goal. Starting low helps with anxiety about side effects and lets the body get used to the drug, but it should be done as quickly as possible, which is different for each person. For me it took a month to get to 6 clicks but someone else might do it in 4 days.

I would expect side effects from any therapeutic dose. In fact I view the presence of some side effects as proof the drug is working. That may be wrong but is how I felt. That said, many side effects are short-lived (lasting an hour or two) and many ease up as the body adjusts. So you have to stick with it.

It is true that some of us truly cannot tolerate 80mcg no matter how hard we try. In that case, 7 clicks or even 6 is definitely of value and I had excellent gains. But the goal should still be 8 clicks if at all possible. There will be side effects on some days no matter which level you end up with but it is a small price to pay for safer bone density.