Dosage Adjustments On Tymlos Pen

Posted by julieann9 @julieann9, Apr 16, 2023

I recently started using the Tymlos pen. I am on the beginning of
the second pen. I have been on the full dosage and the
side effects have been horrendous. I am 5 foot, 1 inch and
weigh 110 pounds. I asked my doc and the pharmacist at the
specialty pharmacy about starting at a lower dose. They both said
the pen only administers the full dose.
Now I am reading that people have adjusted the dose on the
Tymlos pen by using clicks. Can someone please explain to me
how to do this. Your help is much appreciated. Thanks.

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@windyshores

@marauder if you can do 6 clicks eventually, that is definitely a therapeutic dose. Five probably is too. I do 800mg calcium daily in supplements because I cannot do dairy. My calcium level remains high normal.

I read that Tymlos "eats" Vitamin D so I do gummies for 3,000 units/day- 3 gummies, one of which includes 445mcg Vitamin K.

Tymlos really helps spine. I had a 20% gain going from severe to borderline osteoporosis (-3.3 to -2.5). @sallyj2 My hip had a 9% gain. Unfortunately femur neck is still -3.6 (down from -4.1) so I convinced my doc to let me do some Evenity (I might only do 3-4 months) before Reclast.

No problems for me with exercising on Tymlos though sometimes I waited a couple of hours after injection. Not always. Every day was different!

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I have been taking D but your notice that Tymlos eats it makes me think I have to get gummies or up the dose too. Thanks for that alert. I was not aware.

Can I ask you how long you were on Tymlos before you saw the gains you report? Did you do a test after a few months or only one test after a year or so of treatment?

I have been trying different treatments unsuccessfully for the past year and finally can manage Tymlos which I've been on for 3 1/2 months. My doc wants to do a dexascan in Jan or Feb but I think that might be too soon. How long were you on Tymlos before checking progress?

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@mspatart

Absolutely. I am doing PT in the pool while on Tymlos and could not live without that outlet. Keep it up.

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Thank you so much! I feel the same!!

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@mspatart

I have been taking D but your notice that Tymlos eats it makes me think I have to get gummies or up the dose too. Thanks for that alert. I was not aware.

Can I ask you how long you were on Tymlos before you saw the gains you report? Did you do a test after a few months or only one test after a year or so of treatment?

I have been trying different treatments unsuccessfully for the past year and finally can manage Tymlos which I've been on for 3 1/2 months. My doc wants to do a dexascan in Jan or Feb but I think that might be too soon. How long were you on Tymlos before checking progress?

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@mspatart I had a DEXA at 18 months.

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@windyshores

@mspatart I had a DEXA at 18 months.

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Oh gosh I guess I have to wait longer than I hoped. I am building up bone so I can have a revision spinal surgery and hoped it might happen sooner. Thanks for the input.

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@mspatart

Oh gosh I guess I have to wait longer than I hoped. I am building up bone so I can have a revision spinal surgery and hoped it might happen sooner. Thanks for the input.

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You could do CTX and P1NP blood tests though my doc does not rely on them. McCormick suggests them in his book. I think it is reasonable to do a DEXA at one year if you are really concerned about whether it is working.

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@windyshores

You could do CTX and P1NP blood tests though my doc does not rely on them. McCormick suggests them in his book. I think it is reasonable to do a DEXA at one year if you are really concerned about whether it is working.

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Thanks for the update on other methods. I'll check with my GP to see what she recommends given the time that has passed. I was on other bone builders before Tymlos and though I could not tolerate the side effects they may have done some good over the past year so she may factor that in as well. This is such a drag and I am so grateful to have fellow "Tymlosers" to check in with.
PatJoh

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@mspatart

Thanks for the update on other methods. I'll check with my GP to see what she recommends given the time that has passed. I was on other bone builders before Tymlos and though I could not tolerate the side effects they may have done some good over the past year so she may factor that in as well. This is such a drag and I am so grateful to have fellow "Tymlosers" to check in with.
PatJoh

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Thanks again. It really helps me to have another experienced Tymlos user wutg wine to bounce off these questions! I'll hang in there till Feb. I guess and then do the Dexa. I also have to get back with my surgeon to see how the spine is holding up. Due to a fall in the nursing home from poorly adjusted equipment, two screws pulled loose in the lumbar cage he had to install. SO my spine is not stable and new equipment has to be installed but we can't till the bone is repaired. The screws moving in and out over the past couple of years has drilled the surface of the vertebrae full of tiny holes.
Thank you again for your support, insight and encouragement. SO HELPFUL!
PatJoh

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@mspatart

Thanks again. It really helps me to have another experienced Tymlos user wutg wine to bounce off these questions! I'll hang in there till Feb. I guess and then do the Dexa. I also have to get back with my surgeon to see how the spine is holding up. Due to a fall in the nursing home from poorly adjusted equipment, two screws pulled loose in the lumbar cage he had to install. SO my spine is not stable and new equipment has to be installed but we can't till the bone is repaired. The screws moving in and out over the past couple of years has drilled the surface of the vertebrae full of tiny holes.
Thank you again for your support, insight and encouragement. SO HELPFUL!
PatJoh

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I meant to say with whom to bounce off these questions. Not sure how the keyboard substituted "wutg wine." Embarrassing! PatJoh

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@windyshores

@jmla I am sensitive to meds and could not tolerate Forteo. I am the exact same size and weight as you. I got up to 6 or even 7 clicks over time with Tymlos and had excellent gains. If you are tolerating 4 clicks I think it is reasonable to go up to 5. Do you need your doc's permission? My doc let me do whatever I wanted and could tolerate. I think side effects are kind of up to us, but effectiveness is the doc's responsibility 🙂

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@windyshores
Update: I started my second pen this week and went up from 40 to 50mcg. I felt fine and let my doctor know that I had bumped it up a bit. He told me to continue at 50 and try 60 in two weeks. I’m very glad to have increased my dose. Thanks for the encouragement. I hope I see the same gains as you’ve had, although my spine bmd is lower than yours was. Depending on how long my body continues to respond to Tymlos, my doctor has suggested that he may keep me on it beyond 2 years. I very much hope my first blood test shows that it’s working at all. Fingers crossed!

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Is dexascan of the neck routine? I’ve only ever had it taken of back and hip. I ask because I have a significant stenosis in my neck.

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