@diane0202 as you turn the end of the pen, the pen actually makes little clicking noises every 10mcg. The pen doesn't have any window showing dose. Full dose is 8 clicks of the pen, or 80mcg.

I don't think you get much at all with once click. I started with two but understand if people are nervous, starting with one is reassuring. It may not be necessary to wait a whole week between dose changes at first but after I got to a half dose, I did slow down my ramping up.

I believe therapeutic levels start at 4 clicks. Or so my doc said. As I wrote before, there WILL be some side effects for many but for many of us they fade in time.

Hi-- I'm in the 110 pound club, too. I'm approaching month 5 on Tymlos and I'm only at 4 clicks-- it's all I can tolerate. I ramped up very slowly (I started at 1 for several weeks). I will be having a Dexa scan at month 6 to see if I have made any gains on the half dose. I will report to this site. I have had a lot of side effects and struggled to stay on this drug. It was often thanks to the support of the women on this site that I stuck with it. The tachycardia was the first issue I dealt with. I have managed that by lying down and elevating my legs after the injection. It absolutely helps. My other main side effect is serious hair loss, and this is psychologically very difficult to deal with. It might end up being the deal-breaker. So, recommendations for you: As so many other people on this site have recommended, ramp up the dosage. The time frame for upping your dose is utterly personal: people have reported going up each day-- some each week. Me? I was on each click for weeks at a time. Second--You'll probably need some time to get used to the shot. When I first started it hurt, left a red mark, and sometimes I even drew blood. Not good. I'm a pro at it now. Give yourself some time to figure out the injections. Feel free to ask more questions. Everyone here is so generous with their time and advice.