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A healthy immune system offers protection against the bacteria and viruses that cause illness, deploying antibodies that attack these invaders. An autoimmune disease occurs when the immune system cannot differentiate between outside germs and healthy cells and mistakenly attacks various tissues and organs throughout the body.

What is an autoimmune disease?

A healthy immune system offers protection against the bacteria and viruses that cause illness, deploying antibodies that attack these invaders. An autoimmune disease occurs when the immune system cannot differentiate between germs and the body’s own cells and mistakenly attacks various tissues and organs.

There are more than 80 of these conditions, with variation in the affected area of the body; some of the most common autoimmune disorders involve the joints and muscles, digestive tract, nervous system, and skin. There is also significant variation in day-to-day life with autoimmune disorders. Some, like type 1 diabetes, require daily management, while others may have periods of intensified symptoms known as flare-ups. In all cases, there are treatment options that can reduce discomfort and help you experience a better quality of life. Here’s what to know about the most common types of autoimmune disorders.

Causes and symptoms of autoimmune disorders

Many autoimmune disorders do not have a specific known trigger, but the following factors may play a role in the development of certain conditions.

Genetics — some autoimmune disorders such as lupus and multiple sclerosis run in families and likely have a genetic component.

Sex — of the 23.5 million Americans living with an autoimmune disease, 78% are women. Specific autoimmune disorders that are more common in women than men include rheumatoid arthritis, psoriasis, celiac disease, inflammatory bowel disease, lupus and multiple sclerosis, among others.

Obesity — being overweight or obese may increase an individual’s risk of developing rheumatoid arthritis or psoriatic arthritis.

Smoking — research suggests a connection between cigarette smoking and lupus, rheumatoid arthritis, hyperthyroidism, and multiple sclerosis.

Medications — some medications including blood pressure medications, statins (which are commonly used to treat high cholesterol), and antibiotics may increase a person’s risk for certain autoimmune disorders. Consult with your doctor about medication side effects if you have concerns.

While exact symptoms and treatment options vary by condition, as explained in more detail below, there is also some overlap. Fatigue, joint pain and swelling, rashes and other skin issues, digestive issues, and swollen glands are common signs of a variety of autoimmune disorders.

Most autoimmune disorders do not have one single test to confirm or rule out a diagnosis. With the majority of these conditions, the diagnosis process involves several steps including a physical exam and multiple tests.

If you have potential symptoms of an autoimmune disease, a common first step is an antinuclear antibody (ANA) test. This is a blood test that checks for antinuclear antibodies, the type of antibodies that attack healthy cells. If you have a positive ANA result, your doctor will likely recommend additional tests to identify the specific autoimmune disease.

A negative ANA test does not necessarily mean that you do not have an autoimmune disease. If you have negative ANA results, your doctor may recommend additional tests for other antibodies or inflammation markers depending on your symptoms. Tests used to diagnose autoimmune disorders include:

An erythrocyte sedimentation rate (ESR) test — which examines how quickly your red blood cells sink to the bottom of a test tube — may be used to diagnose rheumatoid arthritis and lupus. Higher rates of settlement may indicate inflammation.

A c-reactive protein (CRP) test — which identifies your blood levels of CRP, an inflammation-linked protein produced in your liver — may be used to diagnose rheumatoid arthritis, lupus, and inflammatory bowel disease.

A rheumatoid factor (RF) test checks for rheumatoid factor, an antibody found in about 80% of individuals with rheumatoid arthritis.

Depending on your symptoms, your healthcare provider may refer you to one of the following specialists:

A rheumatologist who treats autoimmune disorders of the joints and muscles including rheumatoid arthritis and lupus.

A gastroenterologist who treats autoimmune disorders of the digestive system including Crohn’s disease, celiac disease, and ulcerative colitis.

An endocrinologist who treats autoimmune disorders of the endocrine system including Graves’ disease and Hashimoto’s thyroiditis.

A dermatologist who treats skin-related autoimmune disorders including psoriasis.

Common autoimmune disorders and treatment

These are some of the most common types of autoimmune disorders affecting individuals in the U.S. Symptoms, treatment, and diagnostic tests vary by condition.

Rheumatoid arthritis occurs when your immune system attacks the lining of your joints, causing pain and inflammation throughout your body. It is a progressive condition, and getting an early diagnosis and staying proactive about treatment can help prevent more severe damage to your joints.

Several medications may be used to reduce the pain and inflammation caused by rheumatoid arthritis, including over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil®), aspirin (Bayer®) or naproxen (Aleve®); acetaminophen (Tylenol®); and Janus kinase (JAK) inhibitors such as baricitinib (Olumiant®), tofacitinib (Xeljanz®), and upadacitinib (Rinvoq®). In addition, avoiding or reducing your intake of sugars and refined carbohydrates and gluten can also help reduce inflammation.

Disease-modifying anti-rheumatic drugs (DMARDs) like methotrexate (Rheumatrex®), sulfasalazine (Azulfidine®), and leflunomide (Arava®) and injectable biologic DMARDs like etanercept (Enbrel®), infliximab (Remicade®), adalimumab (Humira®), and certolizumab pegol (Cimzia®) are often prescribed to slow tissue damage.

Type 1 diabetes is an autoimmune condition that occurs when the body mistakenly attacks the pancreas with antibodies. This destroys the pancreas’s insulin-producing cells, so individuals with type 1 diabetes cannot produce any insulin and rely on daily insulin therapy to manage their blood sugar.

For more information on managing type 1 diabetes, read our previous blogs:

What’s the Difference between Type 1 and Type 2 Diabetes?

How to Live with Type 1 Diabetes at Any Age

Psoriasis is a skin disorder that occurs when inflammation caused by an immune response causes new skin cells to grow too quickly. It is characterized by thick patches of skin covered with white or silver scales, also referred to as plaques. There is a genetic component, and psoriasis often runs in families. 

Many individuals with psoriasis experience periodic flare-ups. While not all psoriasis flare-ups can be attributed to a specific cause, skin injury, stress, and cold weather are common triggers.

There are a variety of treatments for psoriasis, including steroid creams; anthralin (Drithocreme HP® and Zithranol®), an anti-inflammatory medication; moisturizers; UV light therapy; vitamin D3 ointment; and vitamin A creams.

Systemic lupus erythematosus (SLE), the most common type of lupus, affects many different parts of the body including the skin, joints, kidneys, brain, and heart. Common symptoms include joint pain and swelling, severe fatigue, and rashes. Without effective treatment, lupus can lead to other health complications over time, including blood clots and inflammation of the heart or kidneys, and increase your risk for a heart attack or stroke. Getting diagnosed early and starting treatment as soon as possible is critical to managing lupus.

Lupus treatment varies depending on the severity of symptoms and which part of the body is affected. Other-the-counter NSAIDs and oral corticosteroids including prednisone (Deltasone®, Prednicot®) may be used to treat joint pain and stiffness. Antimalarial medications including hydroxychloroquine (Plaquenil®) are often prescribed to reduce pain and inflammation, prevent flare-ups, and treat rashes.

Inflammatory bowel disease refers to several autoimmune diseases that affect the digestive tract including Crohn’s disease, which involves any part of the small or large intestine, and ulcerative colitis, which involves the colon, rectum, or both organs.

Common symptoms of both Crohn’s disease and ulcerative colitis include diarrhea, abdominal cramps, bloody stools, fever, fatigue, loss of appetite, and weight loss. Many individuals with these conditions experience periods of time without symptoms, also known as remission. Treatment options include the following:

Antidiarrheal and anti-inflammatory medications such as oral 5-aminosalicylates and corticosteroids

Immunomodulators, a group of medications that act on the immune system to reduce the inflammation that causes Crohn’s

Biologics, a group of medications that are derived from antibodies and used to prevent inflammation in more severe cases, such as adalimumab (Humira®), golimumab (Simponi®), infliximab (Remicade®), tofacitinib (Xeljanz®), ustekinumab (Stelara®), and vedolizumab (Entyvio®)

Other common autoimmune diseases include:

Multiple sclerosis, which affects the nervous system

Addison’s disease, which affects the adrenal glands

Graves’ disease, which affects the thyroid gland in the neck

Celiac disease, which affects the digestive tract

Living with any chronic condition is easier with a reliable pharmacy partner by your side. Our pharmacists have specialized training in the treatment of autoimmune diseases and can answer any questions you may have, from medication side effects to non-pharmacological treatment options and navigating lifestyle changes. In addition, we offer free, same-day delivery and medication management tools like reminders and auto refills in our app to make it as simple as possible to stay on track with your treatment.

To learn more, reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

Millions of individuals with type 1 and type 2 diabetes need insulin every day to keep their blood sugar levels in a healthy range. In recent decades, it has grown increasingly difficult for many to access this life-saving medication, as insulin prices continue to rise.

Managing the Costs of Insulin

Millions of individuals with type 1 and type 2 diabetes need insulin every day to keep their blood sugar levels in a healthy range. In recent decades, it has grown increasingly difficult for many to access this life-saving medication, as insulin prices continue to rise. Take a look at these recent statistics:

The cost of insulin increased by an average of 14% every year from 2012 to 2018.

In 2017, insulin accounted for 20% of all diabetes-related healthcare spending before rebates and discounts and 6.3% after rebates and discounts.

In a 2018 survey on insulin affordability conducted by the American Diabetes Association, 39% of the respondents reported an increase in their insulin costs between 2017 and 2018.

Rising insulin costs can significantly impact an individual’s ability to manage their health. 27% of those surveyed by the ADA said that insulin prices affected how much of the medication they could buy or use. Missed insulin doses can lead to serious health complications including diabetic ketoacidosis.

While insulin access remains a critical issue for many Americans with diabetes, lawmakers have recognized the urgency of lowering insulin costs. In November 2021, the U.S. House of Representatives passed the Build Back Better Act, which caps out-of-pocket copays for insulin at $35 per month. The legislation has yet to pass in the U.S. Senate, but President Joe Biden recently reaffirmed his commitment to lowering insulin costs — and prescription medication costs more broadly — as part of his domestic agenda.

In the meantime, there are a variety of resources to help you manage the costs of insulin, including patient assistance programs and copay savings cards from insulin manufacturers. Here’s more on eligibility for these programs.

The Lilly Cares® Foundation Patient Assistance Program

The Lilly Cares Foundation Patient Assistance Program provides free insulin and glucagon products for individuals who have Medicare Part D or no health insurance coverage and meet certain income requirements.

Learn more about program terms and conditions and the application process.

The Novo Nordisk® Patient Assistance Program

The Novo Nordisk Patient Assistance Program provides insulin and other diabetes medications at no cost to individuals who have Medicare or no health insurance coverage and whose total household income is at or below 400% of the federal poverty level.

Sanofi Patient Connection provides Sanofi medications including insulin at no cost to individuals whose total household income is at or below 400% of the federal poverty level.

The Lilly Insulin Value Program offers all Lilly insulins at $35 per month to individuals with commercial health insurance or no health insurance coverage. Download the copay card here.

Sanofi offers a copay savings card for those with insurance as well as the Valyou Savings Program for those without insurance, which offers Sanofi insulin at $99 per month. Learn more about Sanofi savings opportunities.

Novo Nordisk offers savings cards that reduce copays for a variety of insulin products. Get more details here.

Your financial well-being is our priority

At Alto, we understand how stressful it can be to navigate insurance coverage benefits and savings opportunities. We prioritize your financial wellness, working with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to make your insulin and other medications as affordable as possible. In addition to automatically applying any coupon savings, we’ll connect you with any outside programs that require you to apply directly.

We also offer free, same-day delivery to simplify your diabetes management, and our dedicated diabetes support team is here to answer any questions you may have. Get started or learn more about Alto, reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

For many individuals, the journey of living with type 2 diabetes starts early. Once referred to as adult-onset diabetes due to its prevalence among middle-aged and older Americans, the condition has become more common in children, adolescents, and young adults, due in part to growing childhood obesity rates. While some aspects of type 2 diabetes management, like glucose monitoring and healthy lifestyle choices, are important for all age groups, other parts of treatment may change with time. Here’s a snapshot of what type 2 diabetes may look like at each stage of life and tips for living with the condition.

Managing Type 2 Diabetes at Any Age

All type 2 diabetes treatment plans include healthy eating, frequent physical activity, and blood sugar monitoring regardless of age. Depending on a child or adult’s blood sugar levels and overall health, they may also need diabetes medication or insulin therapy to supplement these lifestyle changes. In addition to insulin, two other diabetes medications may be used to treat type 2 diabetes during childhood: metformin, an oral medication, and liraglutide, an injectable medication.

Younger children will need assistance with blood sugar monitoring, and if your child takes insulin, they will also need help with insulin administration. It’s important that teachers or other school staff are able to provide support during school days. Make sure that someone at the school is prepared to administer glucagon if your child’s blood sugar falls below a healthy range (known as hypoglycemia).

Inform your child’s teacher and/or other school staff of your child’s type 2 diagnosis before classes begin. Be sure to discuss daily treatment needs like blood sugar monitoring, insulin therapy, or other medication needs, as well as how to spot the signs and symptoms of low blood sugar. The American Diabetes Association (ADA) has resources that can help you start these conversations.

Living with type 2 diabetes as a young child can be emotionally challenging. It often helps to build connections with other children who are on the same journey. Explore programming for children with type 2 diabetes, like the ADA’s summer camps.

If your child is overweight, their doctor may recommend that you focus on slowing weight gain rather than losing weight since they are still growing. Follow your doctor’s recommendations and look for simple but impactful changes, like swapping carbohydrate-rich foods for a snackable fruit or vegetable, or trading soft drinks and fruit juices for water.

Whether you’ve had type 2 diabetes since childhood or are newly diagnosed, living with the condition as a young adult requires you to take an active role in the management of your health. It’s important to build a relationship with a care team that you trust to avoid any gaps in your treatment. Depending on your treatment plan, you may also have to learn about the logistics of filling prescriptions, ordering diabetes supplies, and coordinating with your insurance company.

Taking on additional responsibilities and navigating life more independently doesn’t mean that you’re completely on your own in managing your diabetes. If parents or another relative previously helped you with blood sugar monitoring, scheduling doctor’s appointments, or other aspects of care, use them as a resource during this transitional period as you become more confident managing your health. You may also want to expand your support system by working with a certified diabetes educator or connecting with other young adults living with type 2 diabetes.

Make sure you understand how other health issues can affect diabetes. For example, the common cold or flu can impact your calorie intake and blood sugar levels, so it’s important to be prepared to manage other illnesses. Alcohol safety is also extra important when living with type 2 diabetes, as alcohol is a factor in your blood sugar levels. For those taking insulin, be mindful of how alcohol use affects insulin therapy.

Build a diabetes care team you trust. In addition to seeing a primary care physician for general health issues, search for an endocrinologist who specializes in diabetes treatment.

Familiarize yourself with all aspects of managing type 2 diabetes, from navigating health insurance to monitoring blood sugar. Consider working with a certified diabetes educator. These are healthcare professionals with extensive knowledge of the condition who can offer individualized support. You can also search for a diabetes education program.

Find opportunities to connect with other young adults learning how to manage type 2 diabetes, like the Beyond Type 2 community.

The progression of type 2 diabetes varies significantly by individual. While many individuals are just beginning the journey of living with the condition in their 30s or 40s, diabetes management may feel like second nature for those who were diagnosed at an earlier age. It’s also possible for a person’s treatment needs to evolve at this stage of life. If lifestyle changes and other medications are effective, you may be tapering off of insulin. Conversely, you may need to begin taking additional medications, such as insulin, in order to manage your diabetes even more effectively. As always, follow your care team’s recommendations for your specific needs.

Regardless of what type 2 diabetes looks like for you, one thing’s for certain: it’s important to stay on top of your care and put your health first even when life is at its busiest. Make sure there’s plenty of room in your calendar for physical activity and doctor’s appointments. If you take insulin, find the right delivery method for your schedule and lifestyle. Many people who work long days in a physical setting find insulin pumps and pens convenient as they eliminate the need to remember the timing of injections.

If you are considering starting a family, your doctor can help you plan to have a healthy pregnancy. Get clarity on your A1C targets — your average blood sugar levels over several months — and how long to maintain them before pregnancy. Once you become pregnant, make a doctor’s appointment as soon as possible to learn about any potential changes to your treatment plan.

Revisit your fitness routine, if needed, to find the right activities for your schedule. If you find it challenging to fit enough exercise into your life — ideally 150 minutes of moderate-intensity aerobic activity per week — try to fit shorter bursts of physical activity into your day. 

If you take insulin, consult with your doctor about insulin delivery options to find the best fit for your needs.

Choose a diabetes pharmacy partner that simplifies your treatment. At Alto, we consolidate all of your medications and supplies into a single monthly delivery, and our mobile app can help you manage all of your diabetes needs in one place.

Preventative care and healthy lifestyle choices take on additional importance when you’re living with diabetes, which increases your risk for other chronic conditions like heart disease, high blood pressure, high cholesterol, and dementia.

Many older adults with diabetes also have high blood pressure, which is linked to a higher risk for strokes and heart attacks as well as vision and kidney function. Stay on top of key numbers like your blood pressure and cholesterol levels, and follow your doctor’s recommendations for treatment. You may also want to ask your doctor about additional screenings related to your mental health or cognitive health, as older adults with diabetes are more likely to experience depression or cognitive impairment. (If caring for an older adult with diabetes, watch for the signs of depression and dementia.)

Stay current with vaccines, including the annual flu shot and the pneumonia vaccine. If you are unsure which vaccines you need, ask your doctor.

Ask your doctor about the recommended frequency of screenings for other health conditions, including cancer screenings and kidney function tests.

Find a loved one to help with insulin administration and recording blood sugar readings, if needed.

Managing diabetes is easier at any age with the right pharmacy partner by your side. The Alto app can help you manage all of your diabetes needs in one place, and our dedicated diabetes support team is here to offer guidance and make sure you have everything you need for your treatment.

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881 to learn how we can support your diabetes care.

Rheumatoid arthritis is an inflammatory autoimmune disorder in which your immune system mistakenly attacks the lining of your joints, leading to pain and inflammation throughout your body. While it can cause discomfort, there are many effective treatment options that can help reduce the frequency of flare-ups and prevent the condition from progressing to a more advanced stage.

Understanding Rheumatoid Arthritis

Rheumatoid arthritis is an inflammatory autoimmune disorder in which your immune system mistakenly attacks the lining of your joints, leading to pain and inflammation throughout your body. While it can cause discomfort, there are many effective treatment options that can help reduce the frequency of flare-ups and prevent the condition from progressing to a more advanced stage. Read on for information about rheumatoid arthritis symptoms and treatment.

Like all autoimmune disorders, rheumatoid arthritis occurs as the result of an improper immune response. However, the specific triggers of this response have not been identified. Evidence suggests that there is a genetic component; some individuals may be more sensitive to certain viruses and bacteria that can trigger rheumatoid arthritis, and having a family history of rheumatoid arthritis is a risk factor for the condition, especially if you smoke or are overweight.

Rheumatoid arthritis affects about three times as many women as men, potentially due to estrogen levels and sex differences in the physiological effects of stress. Women are also more likely to experience a more severe form of rheumatoid arthritis.

The condition often first develops during middle age, but it can affect anyone of any age. Children and adolescents under 16 may experience a form of arthritis called juvenile idiopathic arthritis (JIA).

Rheumatoid arthritis is characterized by inflammation and pain in the joints. In most cases, the pain happens on both sides of the body — a symptom that distinguishes rheumatoid arthritis from other types of arthritis. Some individuals also experience joint stiffness that intensifies in the morning and after periods of physical inactivity.

Early-stage rheumatoid arthritis often affects your smaller joints — for example, the joints between your fingers and hands and toes and feet — before spreading to the wrists, knees, ankles, elbows, hips, and shoulders. Additional symptoms may include fatigue, fever, loss of appetite, and a feeling of weakness.

Symptoms may vary by individual, and they can also fluctuate over time. Many people experience flare-ups in which symptoms intensify, followed by periods of mild symptoms or none at all.

As a progressive condition, rheumatoid arthritis can become more severe if untreated. The inflammation damages your joints, which can lead to chronic pain, balance issues, or misshapen joints. It can also lead to problems in other important organs like your lungs, heart, and eyes.

Getting an early diagnosis makes a big difference in the prognosis and effectiveness of treatment. If you have any concerns about potential rheumatoid arthritis symptoms, contact your doctor as soon as possible for an evaluation.

The diagnosis process often involves several steps. Your doctor will first ask about your medical history and your experience of rheumatoid arthritis symptoms. They will then conduct a physical exam of your joints, checking for swelling, redness, and limitations in movement. 

After your physical exam, your doctor may recommend blood tests to check for antibodies and inflammation markers linked to rheumatoid arthritis, including:

An erythrocyte sedimentation rate (ESR) test, which examines how quickly your red blood cells sink to the bottom of a test tube. Higher rates of settlement may indicate inflammation.

A c-reactive protein (CRP) test, which identifies your blood levels of CRP, an inflammation-linked protein produced in your liver.

A rheumatoid factor (RF) test, which checks for rheumatoid factor, an antibody found in about 80% of individuals with rheumatoid arthritis.

Imaging tests like ultrasounds, X-rays, and magnetic resonance imaging (MRI) scans may also be used to support a diagnosis.

Rheumatoid arthritis is not curable, but there are a variety of treatment options that can help you manage the condition and prevent severe tissue damage.

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil®), aspirin (Bayer®) or naproxen (Aleve®) can you help you manage pain and inflammation during flare-ups, as well as corticosteroids. Acetaminophen (Tylenol®) is also effective at reducing pain. Be sure to consult your doctor before taking any over-the-counter medication for an extended period of time.

Janus kinase (JAK) inhibitors such as baricitinib (Olumiant®), tofacitinib (Xeljanz®), and upadacitinib (Rinvoq®) can also help relieve pain and inflammation.

Other medications may be prescribed to slow the tissue damage caused by rheumatoid arthritis, including disease-modifying anti-rheumatic drugs (DMARDs) like methotrexate (Rheumatrex®), sulfasalazine (Azulfidine®), and leflunomide (Arava®), which prevent your immune system’s response to triggers. If a traditional DMARD is not effective, your doctor may prescribe an injectable biologic DMARD, which targets a more specific pathway in your immune system. Commonly prescribed biologic DMARDs include etanercept (Enbrel®), infliximab (Remicade®), adalimumab (Humira®), and certolizumab pegol (Cimzia®).

Many individuals with rheumatoid arthritis use cold compresses and ice packs or hot compresses and warm showers to treat inflammation and pain during flare-ups. Some people prefer a balance of hot and cold treatments.

Making lifestyle adjustments can improve your quality of life and lower your risk for RA-related health complications. 

While rheumatoid arthritis can affect your mobility and limit certain forms of exercise, it’s important to stay physically active. Gentle exercise like water exercise, tai chi, yoga, and stretching can reduce joint pressure and expand your joints’ range of motion.

Nutrition and diet choices can reduce inflammation and help you maintain a healthy weight. Avoid or reduce your intake of foods that may contribute to joint pain and inflammation including sugars and refined carbohydrates and gluten. In addition, consume alcohol in moderation.

Avoiding smoking and getting enough rest are also part of managing rheumatoid arthritis and preventing related health issues.

Since rheumatoid arthritis affects your immune system, those living with the condition often have a higher risk for other infections. Vaccines for the flu, pneumonia, shingles, and COVID-19 can protect you against illness. Check with your doctor about which vaccines you need.

Life with rheumatoid arthritis is easier with a reliable pharmacy partner by your side. Our pharmacists have specialized training in arthritis treatment and can answer any questions you may have, from medication side effects to non-pharmacological treatment options and navigating lifestyle changes. In addition, we offer free, same-day delivery and medication management tools like reminders and auto refills in our app to make it as simple as possible to stay on track with your treatment.

Cystic fibrosis is a progressive genetic condition that primarily affects your respiratory and digestive function. More than 30,000 children and adults in the U.S. are living with cystic fibrosis. Currently, there is no cure for this condition, but it is manageable. With advances in treatment, people with cystic fibrosis are able to experience a better quality of life and live to a longer age. Here’s what to know about managing cystic fibrosis.

Understanding Cystic Fibrosis

Our bodies all produce mucus, digestive enzymes, and other fluids that lubricate our organs and tissues. People with cystic fibrosis have a genetic mutation that increases the thickness of these fluids. This can affect many organs in your body, particularly your lungs and digestive tract. Cystic fibrosis makes it more difficult for air to pass through your lungs and for the intestine to absorb vital nutrients. In more advanced stages, cystic fibrosis may result in severely impaired respiratory function. The thicker fluids can also trap bacteria, making individuals with cystic fibrosis more susceptible to a variety of infections.

Cystic fibrosis is caused by a mutation to a gene — the cystic fibrosis transmembrane conductance regulator (CFTR) gene — that affects how water and salt move through your body’s cells. Both parents must carry a mutated copy of this gene in order for a child to develop cystic fibrosis. However, having two carrier parents does not guarantee that a child will have cystic fibrosis; there is a 25% chance.

A child with just one carrier parent will not have cystic fibrosis, but they may become a carrier themselves, increasing their own children’s risk for the condition. Genetic testing can identify a child’s risk of developing cystic fibrosis or becoming a carrier. Tests may also be performed during pregnancy if you have concerns about your baby’s potential risk for cystic fibrosis.

There is a spectrum of severity in cystic fibrosis, and early symptoms may vary for different individuals. In some cases, symptoms first develop early during childhood or infancy, but in others, symptoms appear later in life.  Many primary symptoms are respiratory or digestive-related, including:

A persistent cough, often with thick mucus or blood

Another key trait of cystic fibrosis is very salty sweat, since the condition affects how salt moves through the body. If an individual has symptoms of cystic fibrosis, a sweat test, which measures the amount of salt in a person’s sweat, may be used to confirm a diagnosis.

Having an effective treatment plan for your individual needs is a big part of managing life with cystic fibrosis and will improve your comfort and quality of life. Your treatment plan may include airway clearance exercises, medications taken orally or via inhalation, and proper nutrition and fitness.

Airway clearance techniques use coughing or huffing to loosen the mucus in your lungs. These exercises are performed multiple times each day, often alongside medications like inhaled bronchodilators and antibiotics. A respiratory therapist can demonstrate different airway clearance exercises and help you find the best fit for your needs.

Several types of medications may be used to treat symptoms of cystic fibrosis or related health complications. Bronchodilators relax airway muscles and are available as an inhaler or in a vial for nebulizer use. Inhaled and oral corticosteroids can help reduce inflammation in the airways.

Mucus-thinning medications such as hypertonic saline and dornase alfa (Pulmozyme®) may be used to help you cough up mucus and clear your airways. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are sometimes used to treat airway inflammation. Some research indicates that NSAIDs are most effective in cystic fibrosis treatment for those between ages 6 and 17. Your doctor may also prescribe antibiotics to treat lung infections.

Many people with cystic fibrosis experience gastroesophageal reflux disease (GERD), commonly referred to as heartburn or acid reflux. Proton pump inhibitors including omeprazole (Prilosec®), lansoprazole (Prevacid®), and esomeprazole (Nexium®) and H2 blockers including ranitidine (Zantac®), famotidine (Pepcid®), and nizatidine (Axid®) may also be used to treat this condition.

An over-the-counter medication called polyethylene glycol (MiraLAX®, GoLYTELY®, and NuLYTELY®) can help reduce constipation, a common symptom of cystic fibrosis.

People with cystic fibrosis have to pay extra attention to what they eat. It isn’t uncommon for individuals with the condition to consume twice as many calories as others of a similar age, weight, and height, since they use more energy to breathe, fight lung infections, and compensate for poor digestion. Your doctor will make recommendations about nutrition and diet tailored to your individual needs, which may include treatments or medications to help you digest food, absorb nutrients, and maintain a healthy weight.

A consistent exercise routine is also an important part of managing cystic fibrosis, as it provides more energy for daily activities and improves lung function. Work with your care team to develop an appropriate fitness routine for your health needs.

Living with a chronic condition like cystic fibrosis affects many aspects of life, so it’s important to build a strong support system and take care of your emotional health. In addition to support from friends, family, and mental health professionals, there are many resources that can help you navigate life with cystic fibrosis and connect with others who share your experiences. As a starting point, explore what these leading cystic fibrosis organizations can offer:

The right pharmacy for your cystic fibrosis treatment

Here at Alto, we make it as easy as possible to follow the treatment your doctor has recommended. We offer free hand-delivery of your medication, automatic savings investigations, and easy medication management tools through our website and app. And our team of pharmacists is always here to answer your questions by phone, text, or chat.

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881 to learn how Alto can support your cystic fibrosis treatment plan.

While fertility preservation treatments like egg freezing and IVF are significant investments of time and resources, there are many ways to lower or manage the costs of treatment. As you prepare for the financial aspects of treatment, be sure to explore all of your options for financial assistance and savings, including patient assistance programs from fertility medication manufacturers.

A Guide to Ferring Pharmaceuticals’ Fertility Medication Savings Programs

If Alto is your fertility pharmacy, your fertility medication protocol may include medications manufactured by Ferring Pharmaceuticals, which has several financial assistance programs that offset the cost of fertility medications. Here’s more on eligibility for these programs and how to apply.

The OneHeart program provides a $200 rebate for out-of-pocket costs for select Ferring fertility medications. Eligibility is for those with no insurance coverage or commercial health insurance plans. In addition, you must have started your ovarian stimulation cycle between June 1, 2020 and June 30, 2022, with all medications purchased by June 30, 2022.

The HeartFelt program helps individuals whose cycles were canceled due to COVID-19 or a natural disaster resume fertility treatment. It offers medication replacement for up to 15 vials of Menopur® and up to five syringes of Fyremadel™ (ganirelix acetate) depending on the amount of medication used in the canceled cycle. Eligibility is for those with no insurance coverage or commercial insurance coverage.

To learn more about program terms and conditions and the application process, download the HeartFelt brochure on Ferring’s patient resources page.

The HeartTomorrow program provides Menopur® at $68 per vial for those undergoing an elective egg freezing cycle. To be eligible, you must be paying cash for your fertility medications and purchase a minimum of 20 vials in your first fill.

The Heart for Heroes program provides IVF medications at no cost to eligible military veterans who have experienced infertility due to a service-related injury or who do not have insurance coverage for fertility medications. To learn more about terms and conditions and the application process, call 1-800-515-3784.

The HeartBeat program provides select fertility medications at no cost for cancer patients. To be eligible, you must be a female U.S. citizen or permanent resident with a cancer diagnosis who has not received chemotherapy within the previous six months. To learn more about terms and conditions and the application process, call 1-888-347-3415. (Residents of Arkansas, Massachusetts, or New Jersey can call 1-877-252-0553.)

If your fertility medications are manufactured by EMD Serono, read our previous post for an overview of EMD Serono’s patient assistance programs. You can also read our previous posts on managing the costs of fertility treatment to learn about additional financial resources, including Alto’s financial support for fertility medications:

Managing the Costs of Fertility Treatment

A Financial Planning Guide for Egg Freezing

We’re here for you during fertility treatment

At Alto, we understand that fertility treatment is a physical, emotional, and financial investment, and we offer support with all aspects of your fertility journey.

We prioritize your financial wellness, working with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to make your medications as affordable as possible. In addition to automatically applying any coupon savings, we’ll connect you with any outside programs that require you to apply directly.

We’re here to help with the rest of the process, too, with free same-day delivery of your medications, temperature controlled packaging, and fertility resources like personalized injection guide videos and one-on-one consultations with fertility-trained pharmacists.

To get a price quote specific to your fertility medication protocol, complete our online form.

Many medications for respiratory conditions like asthma and chronic obstructive pulmonary disease (COPD) are taken by using a metered dose inhaler (MDI), also referred to as a hydrofluoroalkane (HFA) inhaler. These handheld devices — one of several types of inhalers used to treat asthma and COPD — are pressurized canisters of aerosol medication in a plastic container with a mouthpiece. They use a chemical propellant to release medication from the canister. 

The Right Way to Use a Metered Dose Inhaler

Many individuals use a plastic tube called a spacer with their metered dose inhaler, which can help ensure that the full dose of medication is received. Spacers may also be used to reduce side effects of corticosteroid inhalers such as mouth and throat irritation. Ask your doctor if a spacer is right for your health needs.

Taking your medication exactly as prescribed is critical to managing symptoms of asthma, COPD, and other lung diseases. If you and your doctor have decided that a metered dose inhaler is a good method of medication delivery for your treatment plan, it’s important to learn about proper use and cleaning of the device. Below, we explain how to use a metered dose inhaler with and without a spacer and share other considerations when using these devices.

The steps below offer a general overview of how to use a metered dose inhaler correctly. Consult with your doctor for more specific instructions. If using your inhaler for the first time, or if it’s been at least two weeks since your last use, be sure to prime your inhaler by spraying several puffs into the air to ensure that it is working.

1. Remove the cap from the inhaler and shake the inhaler for a few seconds. If using a spacer, remove the cap from the spacer and place the inhaler into the open end of the spacer.

2. If you are using your inhaler without a spacer, exhale completely and place the inhaler’s mouthpiece in your mouth and seal your lips around it. If you are using a spacer, place the spacer’s mouthpiece in your mouth first and then exhale completely.

3. Begin to inhale slowly, pressing down on the canister once.

4. Continue to inhale slowly and deeply for about five seconds.

5. Hold your breath for ten seconds so that the medication can enter your airways.

6. If your doctor has instructed you to take more than one puff of your medication, repeat these steps as needed, waiting about a minute between puffs.

If taking a corticosteroid medication, rinse your mouth with water after each dose to prevent mouth and throat irritation and oral yeast infections. Using a spacer will also minimize the chance of these side effects.

Cleaning your metered dose inhaler and spacer

Most metered dose inhalers can be cleaned by removing the medication canister and rinsing the plastic container under warm running water. If you are unable to remove the canister from the container, wipe the mouthpiece with a cloth or cotton swab. Refer to the manufacturer’s instructions for your inhaler as needed.

To clean your spacer, remove the soft ring at the end and soak both the tube and ring in warm water with light soap. Clean and rinse thoroughly and let the pieces air dry.

Frequency of cleaning depends on how often you take your medication. Consult with your doctor about when to clean your inhaler and spacer.

Keeping track of medication in your inhaler

It’s important to keep track of how much medication is left in your metered dose inhaler so that you can stay on top of refills and avoid any missed doses. For many metered dose inhalers, the total number of puffs will be printed on the medication canister. You must discard your inhaler after you have used that many puffs even if your inhaler continues to dispense medication. Priming puffs count toward the total number of puffs.

If you use a metered dose inhaler every day to take maintenance medication, divide the total number of puffs in your inhaler by the number puffs you take every day. That number is how many days you can use your inhaler before you need a refill. If you use your metered dose inhaler as needed for quick relief, you’ll have to keep track of each individual puff. Some metered dose inhalers now come with built-in counting devices, and there are also external dose counters that can attach to the inhaler. Ask your healthcare provider for recommendations.

There are other delivery methods available for asthma and COPD medications. Your healthcare provider can advise you on the best option for your individual treatment plan.

Dry powder inhalers are another option for medication delivery. Like metered dose inhalers, dry powder inhalers are a small handheld device, but the medication is in the form of a dry powder. Many dry powder inhalers provide a visual indication that the full dose of medication has been delivered, which is helpful for many individuals, as well as a built-in dose counter.

You can also take most asthma and COPD medications using a nebulizer, which transforms liquid medication into a fine mist. Nebulizers take longer than inhalers to deliver medication, but they are often helpful for those who find it difficult to properly use an inhaler. Many children with asthma use nebulizers.

Our team of pharmacists is here to help you get started with your medication for asthma or COPD. We can walk you through the steps of using your inhaler, discuss potential side effects, and answer any other questions you may have. In addition, we offer free, same-day delivery and medication management tools like reminders and auto refills in our app to make it as simple as possible to stay on track with managing your asthma. 

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

With one in ten Americans living with type 1 or type 2 diabetes and more than 88 million adults living with prediabetes, many more people have a connection to diabetes than it may seem. And whether you are living with diabetes yourself or care about someone who is, or if you simply want to know more about diabetes prevention, there’s no shortage of information to learn or actions to take. Thankfully, there are a variety of resources that can help, from online support groups and events to diabetes education programs and advocacy materials. Explore our diabetes resource round-up below to get started.

Diabetes Resource Round-up

With a mission of improving the lives of everyone affected by diabetes, the American Diabetes Association (ADA) is a comprehensive hub for diabetes research, education, advocacy, and support. The national organization also has local offices throughout the U.S. where you can learn about community resources and events.

Beyond Type 1 and Beyond Type 2 are global online communities for individuals living with diabetes, powered by a nonprofit organization (also named Beyond Type 1) that funds a variety of diabetes research and projects.

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