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With heart disease being the leading cause of death in the United States, knowing your family’s health history and the extent of your risk is key to managing your heart health.

How Your Family History Affects Your Heart Health

While you know that traits like the color of your eyes and hair, as well as maybe your love of coffee, have been passed down through your family, you might not realize the extent to which heredity can also influence aspects of your health. With heart disease being the leading cause of death in the United States, knowing your family’s health history and the extent of your risk is key to managing your heart health. Here’s how having heart disease in your family can affect your own heart’s health, what you can do, and everyday ways to keep your heart beating healthy. 

When people talk about heart disease, they’re usually referring to coronary heart disease (also referred to as coronary artery disease).This is the most common type of heart disease and leads to more than 370,000 deaths in the United States every year. 

Coronary heart disease results when plaque builds up on the walls of the arteries that lead to your heart. This buildup narrows the arteries, making it harder for blood to pass through, which can ultimately lead to a heart attack or stroke.

Common risk factors for heart disease include high LDL cholesterol, low HDL cholesterol (the “good” kind), stress, high blood pressure, obesity, diabetes, physical inactivity, smoking, being post-menopausal for women and being older than 45 for men.

According to the American Heart Association, your risk of heart disease is strongly linked to your family history. That means that if someone in your family has diabetes or high LDL cholesterol, for example, then you may be more prone to these heart disease risk factors as well. Similarly, if someone in your family has had a stroke, that makes you more likely to have one. 

To understand your genetic risk of heart disease, you need to first take a look at your family’s health history. You may not know the health history of your entire extended family and that’s okay. A key first step is to start learning the health history of your first-degree relatives: first your parents, then your siblings. Did either of your parents or siblings have a heart attack or stroke, or die from one, at an early age? If they did prior to age 55 for males or age 65 for females, then you’re at an increased risk of heart disease.

Additionally, there are other genetic factors to be aware of that can increase your risk of heart disease. Statistics from the American Heart Association show that African Americans are at a greater risk of high blood pressure, diabetes, and stroke; and about one in three Hispanics will have high blood pressure.

Your family’s home lifestyle and environment can also play a role in your heart health. Living in a household of smokers, for example, can increase your risk of heart disease, while a regular diet of fast food can trigger inflammation in your body and lead to an increased risk of high blood pressure and type 2 diabetes. 

Where you live can also be a factor. City and urban environments can expose you to more air pollution as well as poor water or food quality, which can all contribute to heart disease. 

What to do once you know your family’s health history

Once you have some idea of your immediate family’s health picture and any history of heart disease or risk factors, you’ll next want to assess your own risk. There are various heart attack risk calculators that can help you do this. These take into account your genetics as well as current diet and lifestyle habits to predict your chance of having a heart attack.

Sharing your personal heart disease risk and family history with your doctor is important because it can allow them to come up with a plan to help you lower your risk. Your doctor may also suggest certain medical tests to provide a more accurate diagnosis. A blood test, for example, can look for certain biomarkers in your bloodstream, like LDL cholesterol, that increase your heart disease risk. A heart scan, also known as a coronary calcium scan, can detect any calcium on the walls of your arteries.

You’ll also want to make sure you’re aware of any early heart attack warning signs to watch out for. If you experience symptoms such as chest pain or discomfort, shortness of breath during daily activities, or pain or discomfort in your arms, back, neck, or jaw, you should call 911 to get proper care as soon as possible.

If you discover that you have an extensive family history of cardiovascular disease or you’ve calculated your risk to be higher than average, does that mean you will end up with cardiovascular disease yourself? Not necessarily. Here are some of the things you can do to help reduce your risk. 

Once you have the results of any blood tests, your doctor will factor these into your family history and lifestyle habits to come up with a strategy to help you manage any heart disease risk. They’ll also discuss with you any risks and benefits of taking certain cardiovascular medications, if necessary. 

Adopting a heart-healthy lifestyle will also be a key part of any heart disease management plan. This includes avoiding foods that are high in saturated fat, salt, and sugar, as well as adding more healthy foods to your diet like nuts, fruits, vegetables, beans and fish. You’ll also want to make sure you’re getting enough sleep, managing stress, and staying active. For physical activity, the Department of Health and Human Services recommends at least 30 minutes of heart-pumping exercise such as brisk walking or riding your bike at least five days a week.

If you have any other health conditions such as high blood pressure or diabetes, control these by staying on top of your regimen prescribed by your doctor. You’ll also want to be aware of the other factors you might not realize can influence your risk of heart disease.

While it’s essential to be your own advocate when it comes to your health, we’re here to support you with exceptional pharmacy care every step of the way. If you are prescribed medications for your heart, our pharmacists would be happy to walk you through dosage instructions and answer your questions. We’ll look for any available savings to help you get the lowest price, and we’ll deliver your medications to your home for free. Simply tell your doctor to send your new prescription to Alto or contact our team - we’ll take care of the transfer for you.

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.

Here’s what we know so far about the risk of COVID-19 for people with HIV, vaccine safety, and how to protect yourself from contracting COVID-19. 

What the COVID-19 Vaccine Means for Those With HIV

As of March, 2021, over 115 million people worldwide have been diagnosed with COVID-19. As the COVID-19 pandemic persists, many are wondering what the COVID-19 vaccine could mean for the 38 million people who are living with HIV: is it safe or does it pose a greater risk for these individuals? Here’s what we know so far about the risk of COVID-19 for people with HIV, vaccine safety, and how to protect yourself from contracting COVID-19. 

Are people living with HIV at a higher risk for COVID-19? 

Data is limited and experts are still learning exactly how COVID-19 affects those with HIV, but the Centers for Disease Control and Prevention (CDC) says that those who have HIV (and who are also on effective HIV treatment) generally have the same risk of contracting the virus as those who don’t have HIV. 

So, who is at greater risk? The CDC has evidence that shows older adults and people with certain underlying medical conditions like chronic obstructive pulmonary disease (COPD), type 2 diabetes, and a weakened immune system are at an increased risk for more severe cases of COVID-19. And since nearly half of those living with HIV in the United States are over 50 years old, those living with HIV are encouraged to follow all CDC guidelines to reduce the risk of COVID-19 exposure.

Experts have not found any significant evidence that those living with HIV will experience more severe COVID-19 outcomes; studies performed in Spain and in the United States on a Veterans aging cohort both found no difference in susceptibility to the virus in those with HIV.

Are COVID-19 vaccines safe for people living with HIV?

Yes. According to the United Nations Program on HIV/AIDS (UNAIDS), the COVID-19 vaccines currently being developed or approved by regulators are believed to be safe for most people, including those living with HIV. The COVID-19 vaccines, like other vaccines, undergo the same safety tests and are required to meet rigorous standards. 

Regulators have not yet found any evidence that people living with HIV are at a greater risk from the COVID-19 vaccine in terms of side effects than anyone else.

How does the vaccine work and what symptoms could I expect?

In a recent virtual town hall on COVID-19 and HIV hosted by Getting to Zero San Francisco, experts confirmed that the COVID-19 vaccine has been proven to help reduce the severity of illness from the virus. The vaccine could also prevent infection, reduce transmission, and lead to healthier communities. 

The COVID-19 vaccines work by helping our bodies develop immunity to the virus that causes COVID-19 without us having to actually contract the illness. The different vaccines work in slightly different ways to protect us, but all generally leave the body with a supply of cells that remember how to fight the virus in the future.

After receiving the COVID-19 vaccine, the process of building immunity can result in some people experiencing mild symptoms like a sore arm and mild fever or chills in the days following vaccination. If you have any pain or discomfort, you can talk to your doctor or pharmacist about over-the-counter medications.

How can people with HIV protect themselves from COVID-19?

As you’ve likely heard, the best way to keep from getting sick is simply to avoid exposure to the virus. Everyone, including people living with HIV, should keep taking everyday actions like wearing a mask, staying six feet away from those who don’t live with you, and avoiding crowds, to help avoid contracting and spreading COVID-19.

If you have HIV and are taking your HIV medicine, it’s important to continue doing so and follow any advice from your healthcare provider. This will help keep your immune system healthy and ready to fight off any infection. The CDC also recommends lifestyle practices like eating healthy foods, getting at least eight hours of sleep per night, and minimizing stress as much as you can.

If you develop any symptoms that indicate you might have COVID-19, the CDC recommends calling your healthcare provider and getting tested. Most people have mild illness and can recover at home. If you do develop severe symptoms, the CDC recommends you get emergency medical care immediately.

At Alto, we’re committed to ensuring you receive you medications safely and on time throughout the COVID-19 pandemic. Our pharmacy locations are fully stocked and our pharmacists are on hand to answer any questions and provide ongoing access to support and advice. Reach out to our HIV specialty team through secure in-app messaging or phone at 1-800-874-5881. 

One key test—the A1C blood test—is critical to diagnosing and managing the disease. Here’s what the test measures, why it’s important, and how monitoring your glucose levels at home can help. 

What You Should Know About the A1C Test and Diabetes

An estimated 34 million children and adults in the United States have diabetes, while more than twice that—88 million—are living with prediabetes. What’s more, the American Diabetes Association (ADA) reports that another 7.3 million have diabetes, but don’t know it. One key test—the A1C blood test—is critical to diagnosing and managing the disease. Here’s what the test measures, why it’s important, and how monitoring your glucose levels at home can help. 

The A1C is a common blood test used to diagnose type 1 and type 2 diabetes as well as prediabetes. If you’re living with diabetes, the test is also used to monitor how well you’re managing your blood sugar, or glucose, levels.

The test measures what percentage of hemoglobin proteins in your blood are coated with sugar (glycated) because when glucose builds up, hemoglobin is what it binds to. Hemoglobin is what gives your blood its red color, and its job is to carry oxygen to all of your organs and tissues. 

Since your red blood cells live for about 3 months, the A1C test shows the average level of glucose in your blood from the past 2-3 months. In general, the higher your A1C levels, the poorer your blood sugar control and the higher your risk of diabetes complications. 

In a way, the A1C test captures the bigger picture, like a basketball player’s points-per-game average for the season. It gives you a snapshot into the athlete’s overall success—something that can’t be seen in a single game or from a single day’s blood test results.

What the A1C numbers mean (and what a normal range is)

A1C test results will come back as a percentage—the percent of your red blood cells that have sugar-coated hemoglobin. The higher the percentage, the greater your risk of developing diabetes complications. In addition to helping diagnose diabetes and prediabetes, the test will also give you a baseline A1C level. If you have prediabetes or diabetes, you’ll be tested regularly and can compare those results to your baseline to see how your treatment plan is going. Here’s what your numbers could look like and what they mean: 

If your levels are below 5.7%, that is considered normal. If you land between 5.7% and 6.5%, you fall into the prediabetic category and you’re at a higher risk of developing diabetes. If your test results show you’re above 6.5%, you’re considered in the diabetic range. To confirm a diabetes diagnosis, your healthcare provider will likely look at the results of two blood tests given on different days. The goal A1C for most patients with diabetes is 7% or less, though individual goals may vary depending on the specific circumstances.

Something to keep in mind is that certain factors like pregnancy, kidney and liver disease, certain medications with opioids, some HIV medications, recent or heavy blood loss, or conditions like anemia can all interfere with the accuracy of the A1C test results. These could all influence your A1C goal and are things you can discuss with your healthcare provider ahead of time.

A1IC targets can also change over time as your age or your health condition changes. Generally younger people have a lower A1C goal in order to reduce diabetes-related complications, whereas older people or those with other comorbidities have a higher A1C goal This is why it’s important to work with your doctor to set your own individual A1C goal.

What’s the difference between the A1C test and home glucose monitoring?

If you’re prediabetic or diabetic, you’ll work with your healthcare provider to come up with a treatment plan. A part of your home treatment plan will likely include self-monitoring, which you can do with a blood glucose meter or other device. This will tell you your blood sugar levels at the exact time you do the test—either in milligrams of sugar per deciliter (mg/dL) or millimoles of sugar per liter (mmol/L). 

Blood sugar goes up and down during the day and night, and factors like eating, exercise, or stress, can all affect your blood sugar. So you might see some variability throughout the day in your numbers. To come back to the basketball analogy, these tests can be likened to a single game’s stats and can reveal the daily nuance that the A1C test can’t. 

On the other hand, because the A1C test measures the average blood glucose over the past three months, it provides a good idea of overall glycemic control over time. As we mentioned earlier, it captures the bigger picture. It also doesn't require fasting, like some blood glucose tests, so it can be given at any time.

The in-the-moment precision of self-monitoring can be helpful when it comes to making choices about your diet and exercise throughout the day. It can also help you keep tabs on your A1C target. For example, if your A1C goal is below 7%—a common target for people with diabetes—you should aim for blood sugar below 154 mg/dL (8.6 mmol/L) on average. The ADA offers a simple A1C calculator where you can easily convert between A1C and eAG. 

There’s no one-size-fits-all when it comes to how often you should get tested. The frequency will be determined by your healthcare provider and will depend on a few factors unique to you including your age as well as if you’re on any current diabetes treatment plan with certain goals. 

In general, however, if you have prediabetes, the Mayo Clinic recommends getting tested once a year. If you have diabetes, and if your blood sugar level is consistently within your target range and you don’t use insulin, twice a year is recommended. If your blood sugar levels have been out of your target range and you are using insulin, your doctor might recommend up to four times per year. Additionally, if your diabetes treatment plan changes or you begin taking a new diabetes medication, that could also increase the frequency of A1C testing. You can work with your healthcare provider to decide what works best. 

Whether you're navigating medications for a recent diagnosis or are looking to learn more about diabetes prevention, we know it can be a lot to sort through. That’s why we’re here to help every step of the way. 

From glucose monitors to test strips to medications, our team of patient care pharmacists at Alto is available to chat whenever questions come up. Feel free to reach out any time via in-app secure messaging or phone at 1-800-874-5881.

Here’s why healthy habits are key to improving your health and six ideas to try when you need some “me time.”

6 Science-Backed Ideas for Healthy Living

We know that taking care of our well-being is important, but when work deadlines are calling or the family needs your attention, your own wellness can easily fall to the bottom of your priority list. Fortunately, many healthy lifestyle habits don’t require much time or money, and can even be an enjoyable break from your everyday to-dos. Here’s why healthy habits are key to improving your health and six ideas to try when you need some “me time.”

When we’re overworked, stressed-out, or exhausted, it can be difficult to take care of our own daily maintenance tasks, let alone do activities we enjoy or make time to help others. And when we neglect our own care, it can leave us feeling burnt out, anxious, or depressed—states that affect everything from our performance at work to our relationships at home. 

Studies suggest that carving out “me time” is a key part of a healthy lifestyle. Healthier habits and lifestyle adjustments have been linked to lower levels of stress and higher quality of life, as well as lower levels of morbidity and reduced healthcare costs. And it can start with just a few minutes a day and cost nothing. Here are five science-backed lifestyle practices that your current (and future) self may thank you for. 

1. Practice meditation and mindfulness. 
You don’t need to ascribe to a certain religion or spend a month on a far-flung retreat to meditate or reap its benefits. Numerous studies suggest that even a few minutes a day of meditation can have many health benefits—from helping reduce anxious and stressful thoughts to curbing insomnia. Apps like Headspace or Insight Timer offer meditation basics at low or no cost. You can also ask at your workplace to see if services like Modern Health are offered. 


2. Try breathing practices. 
We know breathing is essential to life, but since it happens automatically, many of us don’t pay much attention to it. But research suggests that certain breathing techniques can help improve everything from your focus to your sleep. Studies have also found that practices like nasal breathing and pursed-lip breathing, as well as the deeper diaphragmatic breathing involved in yoga practices can be helpful in managing symptoms of chronic obstructive pulmonary disease (COPD) as well as asthma. 


3. Cook a meal at home. 
From picking out a new recipe to gathering all the ingredients, cooking at home for yourself or for others can be a relaxing multi-sensory wellness practice. It’s also often a healthier option than grabbing take-out. For this reason, studies suggest it as a top self-care practice to help those with diabetes avoid hospital visits and other health implications.


4. Do something creative. 
When it comes to the arts, you don’t need to have mastered a craft to enjoy it. The act of expressing in an artistic way can be enjoyable regardless of the outcome. And studies show that doing something creative—strumming a guitar, singing to yourself in the shower, or writing creatively—can boost your mood and emotional health as well as contribute to reducing stress and feelings of depression.

5. Stay on top of your medications. 
While this may seem obvious, forgetting to take essential medications is more common than you might think. In fact, studies have shown that up to 20-30% of medications are never filled, and that nearly 50% of medications for chronic disease aren’t taken as prescribed.  Alto can help make sure your prescriptions are delivered on time, as well as connect you with a pharmacist to answer any questions about dosage or side effects.

It's essential to be your own advocate when it comes to your health and well-being, and we’re here to support you with exceptional pharmacy care every step of the way. Talking with your healthcare provider about healthier habits and lifestyle adjustments can be just as important as discussing your medications. 

Our team of patient care pharmacists at Alto is available to chat whenever questions come up. Feel free to reach out any time via in-app secure messaging or phone at 1-800-874-5881.

5 Science-Backed Ideas for Healthy Living

Despite its reputation, cholesterol is not inherently bad. Our pharmacists explain what is meant by good and bad cholesterol and how to maintain healthy cholesterol levels.

Cholesterol 101: The Good vs. The Bad (And What to Do About It)

Despite its reputation, cholesterol is not inherently bad. In fact, some cholesterol is not only good but necessary for our health. Your body needs cholesterol to build cells, help with digestion, and produce hormones. The problem comes when you have too much of the bad type of cholesterol. This can put you at risk for coronary heart disease, a heart attack, or a stroke. Here’s what you need to know to help keep your cholesterol levels in check and healthy. 

Cholesterol is a soft, waxy, fat-like substance that’s found in your bloodstream and in your cells. Since it doesn’t dissolve in the blood, proteins—called lipoproteins—carry cholesterol to where it is needed in the body. Lipoproteins are made up of cholesterol and triglycerides, which are a type of fat the body uses as an energy source, just like carbohydrates. 

Cholesterol comes from two sources: your liver and certain foods you eat, like meat, poultry, and dairy. Your liver, however, makes all the cholesterol your body needs for your cells, digestion, and hormones.

What is meant by good and bad cholesterol?

There are two types of cholesterol: low-density lipoproteins (LDL) and high-density lipoproteins (HDL). LDL is also called “bad cholesterol” because it can build up on the walls of your blood vessels, increasing your risk of a heart attack or stroke. HDL, on the other hand, is considered “good cholesterol” because it can help clear these buildups by removing the bad cholesterol from your body.

Higher levels of HDL cholesterol are associated with a lower risk of atherosclerosis, heart disease, and stroke. So, in general, you want to have higher HDL levels and lower LDL levels to keep your heart healthy. A blood test can measure the amount of each type of cholesterol in your blood. In general, the Cleveland Clinic recommends that you keep your total cholesterol under 200 mg/dL, your LDL cholesterol under 100 mg/dL and your HDL cholesterol over 50 mg/DL for women and under 40 mg/dL for men.

How can I maintain healthy cholesterol levels?

Keeping your cholesterol levels in check and maintaining good heart health primarily comes down to your diet and lifestyle. Here are the American Heart Association’s (AHA) recommendations for what to load up on and what to avoid. 

Whole-grain foods (bread, pasta, brown rice)

Lean meats and poultry without skin. If you choose red meat and pork, select “loin” and “round” options to help minimize the amount of fat. 

Fish like salmon, trout, tuna, and sardines

Unsalted nuts, seeds, and legumes (dried beans or peas)

Non-tropical vegetable oils like olive, corn, canola, or safflower oils

Full-fat dairy products (whole milk, cream, ice cream, butter, and cheese)

Baked goods made with saturated and trans fats like donuts, cakes, and cookies

Foods with “hydrogenated oils” in the ingredients

Tropical oils like coconut, palm, and palm kernel oils

Solid fats like shortening, stick margarine, and lard

What other lifestyle choices can help improve my heart health?

Fortunately, the go-to practices for keeping your heart healthy are a lot of the same ones that are recommended for keeping the rest of your body (and brain) tuned up. Here are four lifestyle choices to consider to support your heart health.

Studies show lacing up those sneakers is key to a healthy heart. Frequent exercise has been associated with a decreased risk of developing cardiovascular disease as well as low blood pressure and higher insulin sensitivity. The AHA recommends at least 150 minutes of moderate-intensity exercise per week like taking a brisk walk in the neighborhood, going for a bike ride, or doing yard work.

2. Reduce stress.
Studies suggest that meditation and mindfulness can help improve everything from your stress levels and blood pressure to your sleep quality and emotional health. Having a furry friend around could also help lower your blood pressure, as well as improve your physical and emotional health by helping you stay more active and social.

3. Get good sleep.
If you’ve ever had a night of poor sleep, you already know the many ways that puts you in a slump. Sleep issues like not sleeping enough, sleep apnea, and insomnia can increase the risk of obesity, high blood pressure, Type 2 diabetes, stroke, and coronary heart disease. Regular exercise, limited screen time before bed, and a consistent sleep schedule can all help improve your sleep. 

Quitting smoking and drinking alcohol in moderation have both been linked to higher levels of good cholesterol. For alcohol, the CDC recommends limiting your intake to 1 drink per day for women and 2 drinks per day for men. 

To learn more about ways to keep your heart healthy, you can also tune into the American Heart Association podcast that covers everything from managing cholesterol to practicing meditation. But before you go about making any major lifestyle changes or if you have concerns about your heart health, it’s important to first consult with your doctor to decide what’s best for you.

It’s important to be your own advocate when it comes to your health and we’re here to support you with exceptional pharmacy care every step of the way. If your doctor prescribes cholesterol-lowering medications or other heart medications, our pharmacists would be happy to walk you through dosage instructions and answer your questions. We’ll also help you get the lowest price by looking for any available savings, as well as deliver your medications to your home for free. Simply tell your doctor to send your new prescription to Alto or contact our care team, and we’ll transfer your existing prescriptions for you.

The health of your gut can impact everything from your mood to your immunity. Here’s what you need to know and how you can keep your gut healthy.

Why Gut Health Is Key (and How To Improve Yours)

You may have noticed in recent years that the topic of gut health seems to come up a lot more in conversation and health news. Why is that? Over the past decade, scientists have been learning that your gastrointestinal (GI) system—of which your gut is a key part—does a lot more than just move food through your body. And that the health of your gut can impact everything from your mood to your immunity. Here’s what you need to know and how you can keep your gut healthy.

Gut Health 101: What It Is and Why It’s Important

Your body is full of trillions of microorganisms that make up your microbiome. Many of these microorganisms are bacteria. Some are harmful and associated with disease, while others are beneficial and key to your health. The ‘gut microbiome’ refers to the bacteria that live in the part of your GI tract where digestion happens—your large and small intestines—where, at any given time, we have between  300 and 500 different species of bacteria living. 

While everyone’s microbiome is unique, a general indicator of a healthy one is having a diversity of bacteria. In unhealthy people, scientists have observed much less diversity although they don’t know for certain which comes first—the bacteria or the disease. 

Inflammation, which studies point to as the root of many diseases, is kept in check in the gut. When the balance of your microbiome gets out of whack, inflammatory bacteria can take charge and, via metabolites, spread inflammation throughout your body. This can affect your brain, heart, and immune system function as well as your skin, weight, and ability to absorb nutrients. 

Having a healthy gut, on the other hand, has been linked to a stronger immune system, reduced symptoms of depression, lower risks of heart disease and certain cancers, as well as reduced symptoms of arthritis. 

So how do we keep our gut healthy? As with many other aspects of health, it largely boils down to the foods we eat and the lifestyle choices we make. Other factors like medication and emotional stress could also play a role. 

To start improving your gut health, it’s helpful to first look at what might be wreaking havoc on your microbiome. While there are many different symptoms that could point to an unhealthy gut, here are the most common.

Upset stomach
Signs of an upset stomach can include gas, bloating, constipation, diarrhea, and heartburn. When your gut is in balance, these symptoms should reduce, since your gut will have an easier time digesting and eliminating your food.

Poor sleep (or constant fatigue)
Serotonin, the sleep and mood hormone, is mainly produced in the gut. An imbalance in your gut can impair serotonin production and affect the quality of your sleep. 

Weight changes
Poor gut health can affect your body’s ability to absorb nutrients, regulate blood sugar, and store fat. Decreased nutrient absorption can result in the urge to overeat and unintentional weight gain. On the other hand, a bacterial overgrowth in the small intestine could cause weight loss.

Skin irritation
When your gut is inflamed, certain bacteria and toxins can leak out into the body, which could irritate your skin.

Autoimmune conditions
As mentioned earlier, research suggests that an unhealthy gut can lead to an inflammatory response in the body and affect your immune function. This could make you more susceptible to autoimmune diseases like Type 1 diabetes and celiac disease where the body attacks itself rather than harmful invaders. 

Food intolerances
It’s theorized that food intolerances can result from an imbalance in the gut. When you’re intolerant to a certain food, you may experience symptoms like bloating, gas, abdominal pain, and nausea.

A high-sugar diet
Sugar, often linked to inflammation in the body, can decrease the amount of good bacteria in the gut. This can cause more sugar cravings, making the situation worse.

You don’t necessarily have to keep your gut under a daily microscope, but following some general health practices—from keeping a balanced diet to getting a good night’s sleep—can go a long way. Your healthcare practitioner can also give gut health recommendations. Here are some common lifestyle choices that research shows can improve gut health. 

Chronic stress can wreak havoc on your whole body, including your gut. Some ways to reduce stress can include exercise, meditation, yoga, connecting with friends or family, and decreasing caffeine consumption.

Having a good pre-bed routine can be as important as the sleep itself. Your pre-bed routine could include minimizing screen time and exercise. In terms of the ideal amount of sleep to log, the National Sleep Foundation has recommendations based on your age. 

3. Avoid smoking
Studies have found that smoking can increase the amount of potentially harmful bacteria in your gut, while decreasing the amount of good bacteria. It’s also been shown to affect heart and lung health, as well as increase your risk of cancer. 

Water helps everything from digestion to carrying nutrients to your cells. And it can help maintain the balance of good bacteria in your gut. Drinking at least four to six cups a day is recommended. 

5. Take a probiotic or prebiotic
Probiotics are live, good bacteria that can come in pill form or from foods like yogurt. Though the science is still out on the extent of the pills efficacy, there seems to be a general consensus that adding a probiotic can be a good idea to help restore your gut’s balance. Prebiotics are the food that probiotics can eat and are usually fiber-rich. Having prebiotics in your gut can help promote the growth of the good bacteria. 

6. Exercise regularly 
Working out may help increase gut health by growing the diversity of good bacteria in your gut. How much should you exercise? For general adults, the recommendation is at least 150 minutes a week or 20 minutes per day. 

Minimize the amount of foods in your diet that are processed or high in sugar or fat—all of which can lead to increased inflammation in the body. When it comes to gut-healthy foods, diversity is key. Here’s what studies show are best for your gut:

Fiber-rich foods like legumes, beans, peas, oats, bananas, asparagus, and berries

Fermented foods like kimchi, sauerkraut, yogurt, kombucha, tempeh, miso, and kefir

Garlic and onion which may also help minimize the risks of certain cancers as well as boost the immune system

Collagen-rich or collagen-boosting foods like salmon, bone broth, mushrooms, egg whites, and cashews

Gut health can be key to helping everything from your brain to your immune system function properly. To keep your gut microbiome healthy, a key place to start is with a balanced diet as well as healthy lifestyle practices. Even though we can’t see our gut, there are many symptoms that can help let us know when ours is out of balance and needs some attention. 

If you are concerned about the potential effects of your medications on your gut health, talk to an Alto pharmacist. Our team of patient care pharmacists are ready to help whenever health questions come up. Reach out any time phone call (1-800-874-5881) or in-app secure messaging.

Why Gut Health Is Key (and How To Improve Yours) 

Continuous glucose monitoring (CGM) devices are designed to make diabetes treatment less burdensome. Here’s how it works, who it benefits most, and how you can go about getting a CGM device for yourself. 

Using Your Continuous Glucose Monitoring Device

Diabetes is known as a silent disease because it often advances gradually and nearly imperceptively. Without treatment, diabetes causes abnormally elevated blood sugar levels, a condition that can eventually have life-threatening consequences. The problem is that the signs and symptoms of high blood sugar are often so subtle that they fly completely under the radar. 

For a more in-depth explanation, read, “What’s the Difference between Type 1 and Type 2 Diabetes?”

The Little Device Providing Round-the-Clock Diabetes Care 

To slow the disease’s progression and minimize serious complications, most people with type 1 and type 2 diabetes must use a device to monitor their blood glucose levels regularly. If their blood sugar is too high or too low, medications or lifestyle interventions must be used to keep it within a safe range. People with diabetes can live long and healthy lives by keeping their blood sugar in check. However, it’s not always easy for those with more advanced conditions who may need to test their blood sugar multiple times a day. 

Continuous glucose monitoring (CGM) devices are designed to make diabetes treatment less burdensome on people who require frequent glucose testing or who are on intensive insulin therapy with tight blood sugar control. Here’s how it works, who it benefits most, and how you can go about getting a CGM device for yourself. 

Before CGM, self-monitoring of blood glucose involved using a traditional blood glucose meter (BGM), which provides a single reading by pricking a finger for a sample of blood. CGM devices, on the other hand, collect glucose readings every five minutes throughout the day via a sensor worn on the body with a tiny wire that is inserted under the skin. Rather than testing blood, it measures the amount of glucose present in the fluid between cells, known as interstitial fluid. 

There are several types of CGM devices approved by the FDA for use in the United States. Generally, they consist of a subcutaneous sensor with an attached transmitter, which sends wireless data to a receiver, such as a monitor or mobile app. By taking approximately 288 readings per day, CGM devices can reveal patterns not easily captured by a single finger prick. 

CGM devices also use past data to predict dips or spikes in blood sugar and alert a wearer to take corrective steps. Data is recorded over time, allowing both the wearer and their healthcare providers to monitor blood glucose fluctuations and identify patterns that can help them make better decisions about nutrition, medications, and other lifestyle factors. 

While CGM can have significant advantages for people with both type 1 and type 2 diabetes, it isn’t the right choice for everyone. The devices can be costly and aren’t always covered by insurance. 

However, CGM can be a gamechanger for those who need to test their blood sugar frequently throughout the day. Not only will they avoid the discomfort of multiple finger pricks, but they may also find that the supplies needed for a traditional BGM are actually more costly than a CGM device over time.

It’s important to note that using a CGM device does not mean that you will no longer need to prick your finger at all. Some models may need to be calibrated using a traditional fingerstick glucose meter to ensure accuracy while getting used to the new device.

If you are curious about using a CGM device, your doctor can help you weigh the pros and cons and decide whether it’s the right choice for you. Should you choose to move forward with CGM, your doctor will need to prescribe one of the several FDA-approved devices available.

Once you’ve received your CGM device, you’ll need to insert the sensor just beneath your skin using the provided applicator. Typically, sensors are placed in the abdomen or upper arm. You should be sure to cleanse the insertion area with soap and water or alcohol first and carefully follow the instructions provided with your device. The applicators are designed to make the whole process quick and simple. 

The sensor will remain in place for several days before it needs to be replaced. The exact duration will depend on your model. Recently, a new type of sensor was developed that must be inserted by your healthcare provider but can remain in place for ninety days. Talk with your doctor about which option is best for you. 

If you are using a receiver, you will need to keep it within five to eight feet of the sensor. As long as it remains within range, the sensor will transmit data to the receiver throughout the day and night, usually every five minutes.  Some devices use Bluetooth or cloud-based technology to send glucose readings directly to compatible smartphones or tablets, eliminating the need for a separate receiver.

An alarm will sound if your glucose level goes above or below the target range you’ve set. The monitor or mobile app will also display a line graph showing how your glucose level has changed over the past several hours. 

Your CGM device can also predict future glucose levels based on past data. Arrows on the screen will indicate which direction your glucose level is heading. Over time, this real-time flow of information can help you become more aware of how diabetes affects your body. For example, you might discover that your glucose levels fluctuate after eating certain foods or engaging in strenuous exercise. In addition, your healthcare provider can also use the data to adjust your insulin dosing and optimize your overall diabetes regimen. 

With all this information may come confusion at first. You should expect a bit of a learning curve as you get used to CGM. Alto’s care team and pharmacists are always an easy in-app message or phone call away should you have any questions as you learn the ins and outs of your device. In no time at all, you’ll find yourself switching out sensors and analyzing trends with ease. 

Heart disease is the leading cause of death for women in the United States. Here’s what our pharmacists think every woman should know about protecting and supporting their hearts. 

What Every Woman Should Know About Heart Health

We’re used to seeing dramatic Hollywood depictions of heart attacks in men. But heart disease is the leading cause of death for women in the United States. The American Heart Association reports that one woman dies of heart disease every minute in America. 

Harvard Health reports that this “heart attack gender gap” can have serious consequences for women. With less awareness of crucial heart-health risk factors and warning signs, many women lack effective prevention strategies or delay life-saving care. 

Though heart disease is deadly, it is also largely preventable. Making heart health part of the conversation for women has the power to save lives. Here’s what our pharmacists think every woman should know about protecting and supporting their hearts. 

The first step in building a heart-health strategy is understanding your individual risk for heart disease. Make sure to undergo any necessary screenings, and discuss risk factors like high blood pressure, high cholesterol, smoking, and age with your doctor at your annual checkup. You’ll want to go over your lifestyle and family history and identify your key health numbers, such as blood pressure, cholesterol, and blood sugar levels. 

According to the American Heart Association, research has uncovered a link between heart disease and pregnancy-related complications. Talk with your doctor if you were diagnosed with diabetes or hypertension during pregnancy or if you had an early delivery. These factors may increase your risk of cardiovascular disease in the future, so it’s essential to be aware and take steps to mitigate that risk. 

All women must understand the signs of a heart attack and the importance of seeking immediate medical attention. Research suggests that women tend to downplay symptoms and delay treatment—a life-threatening issue during a heart attack when every minute counts. 

According to the CDC, the most common signs of a heart attack for both men and women are chest pain or pressure; sharp pain in the jaw, neck, or back; and shortness of breath. However, only about 60% of women experience chest pain or discomfort during a heart attack. Studies suggest that women are more likely to experience less recognizable symptoms like nausea, dizziness, cold sweats, and unexplained fatigue. 

If you experience any discomfort in your chest or upper body or simply feel that something isn’t right, it’s crucial to seek emergency medical attention. Treatment is most effective if given within one hour of the onset of symptoms, so take these symptoms seriously and do not delay care. 

The CDC reports that approximately 200,000 preventable deaths occur each year in the United States due to heart disease and stroke. That’s why it’s so important to put heart-health strategies into place early. Try to augment your diet with plenty of vegetables, fruits, healthy fats, and fiber-rich whole grains while limiting sodium, saturated fats, alcohol, and sugar. Aim for balanced nutrition that you can maintain over time; a little dietary leeway is your best bet for success in the long term. 

Numerous studies have connected poor sleep to heart disease. Not only does a lack of sleep put stress on the body, but it also makes you less likely to exercise and make other healthy choices. If you constantly find yourself cutting back on sleep to tend to your to-do list, it’s time to prioritize rest. 

The American Heart Association recommends getting seven to nine hours of sleep every night to help your body function at its best. Smartphones and other screens are known to disrupt sleep if used at bedtime, so try to power down as early as you can. You might also try using a blue-light blocking filter on your devices at night. Apple devices have a built-in blue-blocking function called “Night Shift,” or you can try out popular apps like Twilight or f.lux. 

It’s also vital that women find ways to manage stress in their daily lives. According to the Mayo Clinic, women's hearts are impacted by stress and depression more than men’s. Stress causes inflammation in the body, which has been linked to heart-health risk factors like high blood pressure and lower “good” HDL cholesterol. It also negatively impacts sleep and may make you less likely to exercise and eat well. 

A comprehensive report on “Stress in America” by the American Psychological Association found that exercise and listening to music were the most popular stress reducers for both men and women. However, women are more likely to find social and sedentary activities relaxing, such as spending time with friends or reading. While daily physical activity is a crucial heart-health strategy, it’s also essential for women to reach out to their social networks and find time to relax and unwind. 

Last year, Harvard Health reported on a recent study, which suggested that women are less likely to be prescribed aspirin, statins, and certain blood pressure medications than men. Experts attribute this discrepancy, in part, to the general lack of awareness about heart disease in women, which can cause both healthcare providers and patients to miss critical warning signs. 

All men and women, regardless of age, should routinely visit their doctor for the necessary heart-health screenings. During these visits, ask your doctor about your individual risk for heart disease, and discuss the risks and benefits of taking cardiovascular medications, if necessary. It’s also crucial to listen to your body and not minimize or explain away any early warning signs of heart trouble. Take any symptoms seriously and seek immediate help. 

While it’s essential to be your own advocate when it comes to your health, we’re here to support you with exceptional pharmacy care every step of the way. If you are prescribed medications for your heart, our pharmacists would be happy to walk you through dosage instructions and answer your questions. We’ll look for any available savings so you can be sure you’re getting the lowest price, and we’ll deliver your medications to your home for free. Simply tell your doctor to send your new prescription to Alto or contact our care team, and we’ll transfer your existing prescriptions for you. 

The beginning of a new year is a perfect opportunity to refresh your routine and set health and wellness goals, but it can be difficult to follow through on these intentions in the long term: studies show that 80% of New Year’s resolutions fail by mid-February. If you entered January with big intentions only to find your new habits slipping, there’s no time like the present to recommit to your physical and mental well-being. Here are a few potential areas to focus on as you hit reset.

A Guide to Year-Round Wellness

Exercising more frequently is one of the most common New Year’s resolutions every year, and for good reason: regular physical activity can lower your risk for many chronic health conditions and improve your mood and sleep, among other benefits.

To make lasting, meaningful changes, set achievable goals. Many Americans exercise less during fall and winter in comparison to warmer months. If you don’t currently have a regular routine, aiming to work out for an hour each day may not be a practical starting point. Behavioral scientist Susan Weinschenk Ph.D., outlines three critical steps for building new habits that stick: start with a small and specific action, tie it to an existing habit, and make it easy to accomplish during the first week. 

Rather than trying to become a hardcore workout enthusiast overnight, resolve to enjoy your morning coffee while walking, then increase your daily walk by ten minutes the next week. When you anchor your intention to an existing action, you give your brain a natural cue to put it into practice. And since the key to solidifying your new habit is repetition, starting with an easy action will create self-trust and allow you to expand on your goal over time.

Mental health is an important aspect of your overall health, as mental health disorders such as depression can increase your risk for numerous physical conditions, from diabetes to heart disease. For many, this is a particularly challenging time from the standpoint of mental health. Approximately 5% of U.S. adults experience seasonal affective disorder (SAD), a type of depression triggered by changes in the weather and reduced exposure to sunlight, while 10-20% of Americans experience a milder form of the winter blues.

To combat the effects of winter depression, try to keep your home as bright as possible by keeping curtains and blinds open and sitting closer to well-lit windows when you can. Be sure to spend some time outside every day, even if the weather is cold or the sky is gray. The morning is an especially impactful time to get outside and walk around.

For many Americans, mental health challenges persist year round. Burnout, a form of chronic stress often linked to workplace demands, has grown increasingly common throughout the course of the Covid-19 pandemic. Of the 1,500 U.S. workers who participated in a 2021 survey about burnout, over half reported experiencing burnout related to their job responsibilities. The effects of burnout go beyond missed deadlines and a lack of motivation — chronic stress influences many aspects of your physical health, from your risk for heart disease to the brain-gut connection.

To maintain emotional balance, start by learning the signs of burnout. Look out for insomnia, exhaustion, changes in your appetite, headaches, and stomachaches. Opt for healthy stress management strategies, like meditation and exercise. In addition, try to stick to your usual sleep schedule. 

If you find that symptoms of burnout or other mental health disorders are interfering with your relationships or daily responsibilities, reach out to your doctor or a mental health professional. You may also benefit from free mental health apps like What’s Up?, which helps you manage stress and negative thoughts through a therapy approach called cognitive behavioral therapy (CBT), and Insight Timer, which has a diverse library of free guided meditations.

As you prioritize your overall mental health, focus on deepening social connections or creating new ones. Social isolation and loneliness have been growing issues in the U.S. even before the Covid-19 pandemic — a 2018 study from the Kaiser Family Foundation and the Economist found that one in five Americans often or always feel isolated — and the pandemic-related rise of remote work has only solidified the trend. In a recent public opinion poll from the American Psychiatric Association (APA), nearly two-thirds of the participants said that they felt isolated or lonely at least sometimes as a result of working from home.

Having a strong social network and regularly connecting with others can improve many areas of your health, including your cardiovascular and cognitive health. Whether volunteering, exploring new hobbies, or catching up with friends or family virtually or in person, small acts of connection go far.

It’s challenging to keep up with health goals if you’re sidelined by the cold, flu, or other illnesses. Fortunately, there are simple steps you can take to give your immunity a boost, even beyond getting your annual flu shot and staying current with vaccines. 

Experts at the Cleveland Clinic recommend incorporating immune-boosting foods into your winter menu to help your body dispatch any seasonal invaders. Fill your grocery cart with a wide range of colorful fruits and vegetables to ensure you consume a full arsenal of antioxidants. Be sure to stock up on raw garlic, which contains antiviral compounds, along with vitamin-C-rich foods like citrus fruits, peppers, broccoli, and kiwis.

According to the Mayo Clinic, people who don’t get enough sleep are more likely to succumb to sickness after being exposed to a virus. Aim for seven to eight hours of sleep per night to support healthy infection-fighting antibodies and cells. We’ve compiled these tips for getting the nightly rest you need when sleep is elusive.

At Alto, we believe that staying on top of your health should be as simple as possible, and we’re here to support you with exceptional pharmacy care all year long. We offer free, same-day delivery and medication management tools like reminders and auto refills in our mobile app.

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

Editor’s Note: This post was originally published in January 2021 and has been updated for accuracy and completeness.

Here are seven unconventional ways to support your heart that have sparked the interest of leading health experts. 

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