@riverpark I have been doing Tymlos for two years and often post about how side effects can ease over time as our bodies adjust. Tymlos has an adjustable dose pen so I was only able to get on it by starting low, letting my body adjust, and then moving up on the dose and so on. It sounds like it is possible Forteo will be tolerable for you. I did not do full dose Tymlos for most of the time I took it and still had excellent gains. I believe a score of -3.4 is significant, yes, but ask your doc!