I was on Tymlos at only 4 clicks for about 4 months (after being at 3 for a month)… then was was able to go up 1 click every couple weeks without any worsening of symptoms and am at 8 now. I still get what I call a “bad head rush” for about 15 minutes, along with tachycardia, but that is all. At my specialist’s encouragement, I didn’t rush it. She was happy at any level I was on, as keeping with it was better than quitting and she was optimistic that even a lower dose would be beneficial. So do what you can and kudos for persevering.