@drsuefowler maybe you would do better with Forteo. I could see doing 40mcg but not sure 20mcg is enough. Let us know what your doc says. One person I PM'ed with did 20mcg but twice a day. I had never heard of that but you could ask.
I never had NO side effects from Tymlos, even ramping up. I did get to 6 or 7 clicks but I wasn't entirely free of fatigue, sometimes dizzy , low bp etc.