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Blog | Alto Pharmacy

Navigating a Diagnosis of Prediabetes

1 in 3 U.S. adults have prediabetes, a health condition defined by higher than normal blood sugar levels and which often precedes type 2 diabetes. While it can be overwhelming to receive a diagnosis of prediabetes, the condition is both treatable and reversible. Simple lifestyle changes, sometimes combined with medication, can prevent prediabetes from progressing into type 2 diabetes.

Here’s an overview of common next steps after a prediabetes diagnosis. This is intended to provide general information about managing prediabetes. Always follow your doctor’s recommendations.

Prediabetes is primarily defined by blood sugar levels that are higher than normal but still below the official range for a type 2 diabetes diagnosis. Two tests may be used to diagnose prediabetes:

The fasting blood sugar test, which measures your blood sugar after an overnight fast. A fasting blood sugar level between 100-125 mg/dL indicates a prediabetes diagnosis.

The A1C test, which measures your average blood sugar levels over the past three months. An A1C level of 5.7%-6.4% indicates a prediabetes diagnosis.

Prediabetes does not have visible symptoms. More than 84% of all those living with the condition don’t know that they have it. It’s important to be proactive about testing if you are at risk. Speak with your doctor if you are:

Black, Hispanic/Latino, Native American, Asian American, or Pacific Islander — for reasons not yet understood, researchers have found higher rates of type 2 diabetes in these racial and ethnic groups

Nutrition plays a significant role in the management of prediabetes and type 2 diabetes. Prioritizing certain foods and avoiding or reducing your intake of others can help you maintain healthy blood sugar levels.

Here are general dietary considerations for people with prediabetes. It’s important to work closely with a doctor or dietitian before starting a new diet plan.

Fiber is a carbohydrate found in plant-based foods, and which the body can’t digest. Since it isn’t digested, it does not increase glucose levels. It is commonly found in:

Fruits including apples, bananas, oranges, and strawberries

Non-starchy vegetables including beets, brussels sprouts, broccoli, cabbage, and carrots

Nuts and seeds including almonds, chestnuts, chia seeds, flax seeds, sesame seeds, sunflower seeds, and pistachios

Whole grains - check nutrition labels for the words “whole” or “whole grains”

Legumes including black beans, chickpeas, kidney beans, lentils, and peas

Limit your intake of sweetened, sugary beverages

Without any fat or protein to balance carbohydrates, sweetened beverages are associated with a greater risk for type 2 diabetes. Limit your intake of soda, sweetened tea, sports drinks, and other sugary beverages.

Speak with your doctor about your recommended carbohydrate intake

Certain carbohydrates affect blood sugar levels more than others, specifically refined carbohydrates such as white bread, white rice, and some potatoes. (Soda and some types of juice also fall under this category.) They digest quickly and should be consumed in small amounts by those with prediabetes and diabetes.

At the same time, it’s a misconception that you should avoid all carbohydrates if you have prediabetes. Low-carb diets may not be appropriate for some individuals with other health conditions such as high cholesterol or heart disease. Speak with your doctor for individualized recommendations.

There are several reasons why physical activity is important for individuals with prediabetes:

It increases your body’s sensitivity to insulin.

It can help you maintain a healthy weight.

The American Heart Association recommends about 150 minutes of moderate-intensity physical activity a week, or 20-25 minutes each day. Activities that fall under that category include brisk walking, swimming, or biking.

To build a fitness routine that sticks, start off slower and build your way up to a more intense workout, and be sure to find activities that you enjoy.

Smoking is a known risk factor for type 2 diabetes. It increases inflammation and oxidative stress, both of which have been associated with diabetes. Heavier, more frequent smoking is linked to a greater risk for diabetes.

If you are finding it challenging to quit, ask your doctor for resources that may help. Nicotine replacement therapy can ease withdrawal symptoms and cravings.

In some cases, your doctor may recommend supplementing the above lifestyle changes with medication to keep your blood sugar levels in a healthy range.

Metformin is one of the most common oral medications used to treat prediabetes and type 2 diabetes. It regulates your blood sugar levels by reducing how much glucose is produced during digestion.

To experience the full benefits of metformin, it’s important to maintain a healthy lifestyle while taking the medication.

Read What to Know About Metformin for additional information.

Some individuals with prediabetes may be prescribed weight loss medications for short-term use, as maintaining a healthy weight is part of managing prediabetes. Many of these medications are associated with health risks like high blood pressure and may not be appropriate for some individuals.

Keep in mind that your treatment needs may change over time. If you are prescribed medication for prediabetes, you won’t necessarily have to take it indefinitely. For instance, if lifestyle changes and metformin are effective at restoring healthy blood sugar levels, your doctor may have you taper off of the medication.

Managing prediabetes is easier with the right pharmacy partner by your side. The Alto app simplifies medication management and our dedicated diabetes support team is here to make sure you have everything you need.

To learn more, reach out any time through secure in-app 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 air quality significantly impacts your respiratory health, not just outdoor air pollution. Indoor air is often filled with irritants including smoke, allergens, and chemicals. These substances can irritate the lungs and airways, causing inflammation and reducing lung function, which refers to how well your lungs work.

How to Improve Indoor Air Quality at Home

Given that the average American spends approximately 90% of their time inside, it’s important to keep the air inside your home as clean as possible, especially if you are susceptible to seasonal allergies or have respiratory conditions such as asthma or COPD.

Use the simple precautions below as a starting point for better breathing at home.

Exposure to secondhand smoke, or exhaled cigarette smoke, adversely impacts respiratory health. It is a contributing factor to the development of COPD and may also cause a flare-up of COPD symptoms, also referred to as an acute exacerbation. For some individuals with asthma, secondhand smoke can trigger an asthma attack, which is defined by sudden shortness of breath and difficulty breathing.

Thirdhand smoke, or the residual smoke that remains on clothing or surrounding indoor surfaces after a person smokes, is an additional health risk that affects air quality.

Avoiding all indoor smoking is one of the most important actions you can take to improve indoor air quality at home. Of course, outdoor smoking also contributes to lung diseases. In addition to limiting your exposure to secondhand and thirdhand smoke at home, ask your doctor for support with smoking cessation if needed.

2. Avoid cleaning products with certain chemicals and strong scents.

Certain household products are worse for your respiratory health than others. Some disinfectants, personal hygiene products, and cleaning supplies contain chemicals known as volatile organic compounds (VOCs), which can tighten the airways and make it more difficult to breathe. Examples of common VOCs include formaldehyde, benzene, and toluene.

Ammonia, hydrogen peroxide, and chlorine bleach are other chemicals that should be avoided, along with scented products.

As an alternative, opt for natural, non-toxic products. You may even be able to create cleaning solutions from ingredients that are already in the house. Try using baking soda or a mixture of soap and water to scrub and wipe down surfaces. A combination of vinegar and water can be used to clean glass.

If you are using a product that contains a VOC or other harmful chemicals inside of your home, ventilate the area as much as possible by using exhaust fans and opening windows and doors. ​​You may also want to invest in an air purifier, which extracts irritants from the air.

Household allergens including dust mites and animal dander can trigger asthma symptoms and COPD exacerbations. Unfortunately, dust mites love to make themselves comfortable in your pillows and blankets as much as you do, so regularly wash pillows and bedding. Consider using dust mite pillow and mattress covers.

It’s best to vacuum at least once a week, ideally with a high-efficiency particulate air (HEPA) vacuum that catches smaller particles like allergens. An air purifier can also be used to remove allergens from indoor air.

During prime allergy season, avoid bringing pollen inside by changing and washing your clothes and removing your shoes after time outdoors. Dry clothes in a dryer instead of on a clothesline, where they’re likely to gather more pollen.

Dust mites aren’t the only indoor allergen to avoid. Mold exposure can also intensify symptoms of allergies, asthma, and COPD.

Moisture is typically the underlying cause of mold growth inside the home. As part of your allergy-proofing efforts, use a dehumidifier to keep indoor air dry during more humid seasons. (This can also help keep the dust mites away!) Keep bathrooms well ventilated and remove any visible mold as quickly as possible.

In addition, try to increase ventilation in the bathroom and kitchen, as well as other areas where steam accumulates. Use a fan or crack open a window when showering or cooking.

5. Clean air filters and increase ventilation.

There are steps you can take to keep clean air flowing throughout your home as much as possible.

First, change any filters in your home’s heating and cooling systems on a regular basis. If your house or apartment has a forced-air heating system — which uses air ducts and vents to circulate temperature-controlled air throughout your house or apartment — it’s especially important to change the filters regularly.

In addition, make sure that any air ducts inside of your home are clean, since they are a frequent source of dust accumulation.

If pollen is low, opening windows to let outdoor air flow throughout the building may also help improve indoor air quality. Most weather apps include a local daily pollen count.

Alto Pharmacy is here every step of the way to help you manage respiratory conditions like asthma, COPD, and allergies. Our team of pharmacists is available to answer questions about your medications, and we offer free, same-day delivery and medication management tools like reminders and auto refills in our app.

Reach out by phone at 1-800-874-5881 or in-app messaging to learn how we can support your treatment plan.

While fertility treatments like in vitro fertilization (IVF) have become an increasingly common path to parenthood, helping millions of individuals conceive throughout the past four decades, they remain a significant financial investment.

How Alto Lowers the Cost of Fertility Treatment Through Better Medication Management

Fertility medications used to support egg production, retrievals, and implantations frequently factor heavily into the overall cost of treatment. An average IVF cycle costs between $10,000 and $15,000, with medications an additional $5,000 or more depending on factors like a patient’s age and health history and a clinic’s treatment approach. Unfortunately, a portion of these medications often go unused, as many fertility treatment plans involve last-minute medication changes unsuited for the traditional retail pharmacy model.

As part of our commitment to your financial well-being, we offer a medication management experience that reduces fertility medication waste to lower the cost of treatment, developed in collaboration with Progyny. Take a closer look at our approach.

IVF is a process in which eggs and sperm are fertilized and then placed into the uterus with the potential outcome of a pregnancy. Multiple medications are used on a precisely timed schedule to grow follicles — fluid-filled sacs in the ovaries that potentially contain an egg — retrieve eggs, and, finally, implant a fertilized egg into the uterus. 

Here’s a snapshot of a typical IVF medication schedule:

Days 1-4: stimulation medications such as Gonal-f®, Follistim®, Menopur®, or Low-Dose hCG to stimulate egg production, so that you produce multiple follicles

Days 5-10: continuation of stimulation medications and introduction of antagonists such as Fyremadel™ (ganirelix acetate) and Cetrotide® to prevent premature ovulation

Days 10+: trigger shots of leuprolide acetate, Ovidrel®, and/or Novarel®/Pregnyl® to stimulate final growth spurt and ovulation

After transfer: estrogen and progesterone to support successful implantation of the embryo

Fertility medications are complex, with nightly dosages dependent upon hormone levels measured through bloodwork and ultrasounds. Not only do medication protocols vary from one individual to another, they are typically adjusted throughout the course of a cycle as hormones fluctuate.

Unused medication during fertility treatment

To prevent any missed doses, providers typically prescribe all medications that could be needed in bulk at the beginning of fertility treatment. However, dosages often decrease once a cycle is underway based on a provider’s discretion, ultrasounds, and bloodwork.

At traditional pharmacies, patients undergoing fertility treatment might end up paying for unused medication, as all potential medications are filled upfront. This contributes to the $5.4 billion epidemic of medication waste in the U.S. — one that is particularly acute in fertility, leading some individuals to buy and sell excess medication to each other on social media sites.

Our approach to fertility medication management

Alto has partnered with fertility benefits manager Progyny on an algorithm-powered, app-based medication management experience that reduces unneeded fertility medications while protecting the integrity of time-sensitive and personalized treatment plans.

First, we collect fertility cycle information through the Alto app and run the data through the Progyny algorithm to determine exactly what medication volumes are needed for the next phase of treatment. We then prepare a custom order for just the medications that are immediately needed, which are then delivered directly to your doorstep by our courier team. 

You will receive multiple deliveries throughout the course of your cycle, determined by your specific dosing, trigger schedule and other inputs from your clinical team. Carefully timed check-ins and local courier delivery make last-minute adjustments possible. This approach allows you to manage your medications as your IVF cycle progresses, giving you more control over the total amount of medication that you fill.

Additional financial resources for fertility medications

Alto is committed to helping you save as much as possible on your fertility medications. In addition to our personalized medication management approach, we’ll automatically search for savings and connect you with programs that require you to apply directly, including patient assistance programs from fertility medication manufacturers.

If Alto is your fertility pharmacy, your fertility medication protocol likely includes medications manufactured by EMD Serono or Ferring Pharmaceuticals. EMD has several programs that lower the cost of fertility treatment, including the Compassionate Care program, which offers income-based assistance for fertility medications that aren’t covered by insurance, and special opportunities for military veterans and cancer survivors.

Ferring Pharmaceuticals also offers financial assistance programs to offset the cost of fertility medications, including the HeartTomorrow program for individuals who elect to freeze their eggs, and special opportunities for military veterans and cancer patients.

Read Managing the Costs of Fertility Treatment for more on Alto’s financial support for fertility treatment and medications.

Choose a flexible and reliable pharmacy partner

Fertility treatment can be challenging, but we’ll be with you every step of the way. To ensure that your treatment plan is followed correctly, we offer free same-day delivery of your medications and fertility resources like personalized injection guide videos and one-on-one consultations with fertility-trained pharmacists.

Interested in learning more about how Alto can support your fertility treatment? Request a price quote online or reach out through secure in-app messaging or by phone at 1-800-874-5881.

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.

Birth control is essential healthcare, allowing you to prevent pregnancy and take charge of your reproductive health. There are many contraceptive methods to choose from. Learning more about the available options can help you, and in some cases, your partner, make the best decisions for your needs and reproductive goals.

Choosing the Right Birth Control for You | Alto Pharmacy

Read on for an overview of some common birth control methods. Our list focuses on hormonal birth control, which contain synthetic versions of estrogen and progesterone. These two hormones play a significant role in reproduction.

There are other options for contraception that must be used every time you have sex, including condoms and diaphragms. When used correctly, condoms and diaphragms are 98% and 88% effective at preventing pregnancy, respectively.

Permanent birth control is also available in the form of surgical procedures (tubal ligation for women and a vasectomy for men). These procedures must be performed by a healthcare provider. Discuss your options for contraception with your provider.

In addition, there are two options for oral emergency contraception to be taken after unprotected sex: levonorgestrel (Plan B®, Mirena®, Kyleena®) and ulipristal (Ella®). Levonorgestrel is sometimes available without a prescription. Ulipristal is prescription-only.

Like all forms of hormonal birth control, the pill stops ovulation, which is the release of a mature egg from the ovaries during each menstrual cycle. The hormones also thicken cervical mucus, an additional layer of pregnancy prevention that keeps sperm from reaching an egg, should one be released.

There are two types of birth control pills:

Combination pills, or combined oral contraceptives (COCs), contain both estrogen and progestin. (Progestin is a synthetic form of progesterone.) COCs are the more common of the two types.

Progestin-only pills (POPs) contain only progestin.

In both cases, the pills come in a pack and you take one every day.

Many individuals choose the pill for its affordability and effectiveness. However, it must be taken on time every day in order to prevent pregnancy. You may find it helpful to combine taking your birth control with another daily habit such as brushing your teeth, or to set a reminder on your phone. The Alto app has medication management reminders to help you continue with your treatment.

While the pill is 91% effective at preventing pregnancy when taken as prescribed, it does not offer protection against sexually transmitted infections (STIs). If you have an STI or are unsure about a sexual partner’s health history, use condoms every time you have sex to protect your health and your partner’s.

The birth control ring, also referred to as the vaginal ring, consists of a small, flexible ring worn inside of your vagina. It releases hormones, which are absorbed through the vaginal lining, for ongoing pregnancy prevention. Like birth control pills, these hormones prevent ovulation and thicken cervical mucus.

There are two types of birth control rings. NuvaRing® lasts for up to five weeks. It is worn continuously and typically replaced about once a month. It may also be used to skip your period.

An Annovera® ring lasts for a year. You wear it in your vagina for 21 days, take it out for seven days, and then put it back in your vagina to restart the cycle.

A vaginal ring must be used correctly to offer full benefits. That includes replacing it when needed and, in the case of an Annovera ring, taking it out and putting it back in on time. To stay on schedule, set reminders or alarms on your phone, or keep track on a calendar. You can also check out Planned Parenthood’s free birth control reminder app, Spot On.

The birth control ring is prescription-only. It does not offer protection against STIs.

The transdermal contraceptive patch releases estrogen and progestin through the skin and into your body to prevent pregnancy. There are two branded options available in the U.S.: Xulane® and Twirla®. Both patches may be worn on your belly, butt, or back. The Xulane patch can also be worn on your upper arm.

The birth control patch is worn for a total of 21 days. You will need to replace the patch during that time, wearing a new patch each week for three weeks. During the fourth week, you will not wear a patch so that menstrual bleeding may occur. The cycle then restarts.

A patch must be used correctly and on schedule to offer effective pregnancy prevention. Set reminders or alarms on your phone, keep track on a calendar, or use a birth control reminder app.

The birth control patch is prescription-only. It does not offer protection against STIs.

The birth control shot, also referred to as the depo shot or Depo-Provera®, is an injection administered about every three months. It contains progestin and works similarly as the above forms of hormonal birth control to prevent pregnancy.

Many individuals choose the shot for the convenience of the injection schedule and privacy. In order to experience the benefits of the birth control shot, you must stay on track and get a new shot every 12-13 weeks. In most cases, a doctor or nurse will give you the shot. In some cases, you may be able to get a supply of shots from a health center to self-administer.

Use a birth control reminder app or a calendar to stay on track with your injections.

Long-term use of the Depo-Provera shot may increase an individual’s risk for significant and potentially irreversible bone mineral loss. Additionally, it has been associated with an increased risk of breast cancer and is not recommended for those with a known or suspected breast malignancy.

There are two types of longer-term birth control: intrauterine devices (IUDs) and birth control implants. Both methods release hormones into your body to prevent pregnancy.

The implant (Nexplanon®) is a tiny, thin rod implanted into your arm that offers pregnancy prevention for up to five years. It must be implanted in a doctor’s office. If your family planning goals change, a doctor can easily remove the implant before it expires.

The IUD is a small device implanted into your uterus that prevents pregnancy. There are different types of IUDs that offer protection for varying amounts of time.

Hormonal IUDs release progestin to prevent pregnancy. There are four FDA-approved hormonal IUDs in the U.S.:

Paragard® is a copper IUD that does not contain hormones. It prevents pregnancy for up to 12 years.

An IUD must be implanted by a healthcare professional. It is reversible and can be easily removed.

There are many factors to consider when choosing a birth control method. While many individuals find these forms of longer-term birth control more convenient, they are typically more expensive than other forms of contraception.

Timing is essential with many forms of hormonal birth control. We make it easy to stick to the schedule, with free same-day delivery and medication management reminders in the app. In addition, our pharmacists are available until 9 pm PST (12 midnight EST) on weeknights to answer any questions you may have.

Osteoporosis is a condition that weakens bones, increasing your risk for unexpected bone fractures, often of the hip, wrist, or spine. It affects an estimated 200 million people around the world, including 54 million individuals in the U.S. Though it isn’t curable, there are a variety of treatment options that can help protect and strengthen your bones. Read on to learn about the leading causes and treatment options of osteoporosis.

Osteoporosis, Explained | Alto Pharmacy

Your bones are constantly changing. When you’re young, new bone forms more quickly than old bone is lost, increasing your overall bone mass. This process starts to slow over time — typically beginning in your early 20s — and as you age, the reverse happens. Old bone disintegrates more quickly than new bone develops, decreasing your overall bone mass.

For those with osteoporosis, these changes are more pronounced, with lower than average bone mass and density. The inside of healthy bone resembles a honeycomb or a sponge, with many tiny holes. Osteoporosis, which means “porous bone,” gradually increases the size of these holes, lowering bone density and strength. As bones grow weak, brittle, and more porous, they become increasingly susceptible to fractures.

The condition is progressive. Without effective treatment, it may worsen, increasing your risk of a fracture. In cases of severe osteoporosis, even sneezing or minor bumps can fracture bone.

Osteoporosis is often preceded by a condition called osteopenia, which is characterized by less severe loss of bone density. Not all cases of osteopenia progress into osteoporosis, and simple lifestyle changes can help protect your bones and preserve bone mass. Regular bone density tests every two to three years are also an important component of osteoporosis prevention.

Sometimes referred to as a silent disease, osteoporosis often presents without noticeable symptoms. When symptoms do appear, they may include the following:

Posture changes such as stooping or bending forward

Since osteoporosis isn’t always accompanied by symptoms, it’s important to stay on track with bone density screenings as you age, especially if you are at increased risk for the condition. Many people first learn that they have osteoporosis after a fracture. If you have a family history of osteoporosis or a related health condition (see below), speak with a healthcare provider about your risk and recommended screenings.

Osteoporosis may be caused by a variety of factors, both preventable and non-preventable. Age and sex play the greatest role in the condition’s development. The condition affects women four times more often than men, and postmenopausal women have the highest risk of developing osteoporosis. This is due to how decreased estrogen levels after menopause alter the rhythm of bone remodeling, in addition to the overall aging-related loss of bone mass.

Though osteoporosis affects more women than men, everyone’s risk increases with age. Men over the age of 50 are significantly more susceptible to osteoporosis-induced bone breaks or fractures than those of a younger age.

The following factors may also contribute to the development of osteoporosis:

Bone structure and body weight — those with less body weight don’t have as much bone to lose and face a higher risk for osteoporosis.

Other health conditions including overactive thyroid, parathyroid, or adrenal glands; celiac disease; and inflammatory bowel disease

Previous hormone treatment, including for breast or prostate cancer or an irregular menstrual cycle

Previous bariatric surgery or organ transplant

Lifestyle factors including a history of smoking, alcohol use, a sedentary lifestyle, or calcium or vitamin D insufficiency

Bone mineral density (BMD) tests — also known as dual-energy X-ray absorptiometry (DEXA or DXA) scans — are used to identify bone health issues in advance as well as to diagnose osteoporosis. 

A DEXA scan uses small amounts of radiation to assess the solidity of spine, hip, and wrist bones. Regular X-rays can only detect osteoporosis in more advanced stages.

This screening is recommended for all women over the age of 65 and all men over the age of 70, regardless of other risk factors. It may be recommended for postmenopausal women and men between 50-70 years old if other risk factors are present. Consult with your doctor about your preventative health needs and recommended screenings.

Treatment for osteoporosis varies by individual. Your doctor will make tailored recommendations about medications, diet, and exercise based on your needs. A treatment plan may include the following components.

Oral and injectable bisphosphonates, which prevent the loss of bone mass, are commonly prescribed for osteoporosis. Examples include:

Hormone therapy including estrogen and testosterone can also stop bone density loss. Estrogen has been associated with an increased risk for blood clots, certain cancers, and heart disease, and is typically reserved for younger women or women with menopause symptoms.

A medication called raloxifene (Evista®) offers similar benefits as estrogen therapy, but without many of the above risks. However, it is also associated with a higher risk of blood clots.

Three anabolic agents — romososumab-aqqg (Evenity®), teriparatide (Forteo®), and abaloparatide (Tymlos®) — are FDA-approved to treat osteoporosis. These medications support new bone formation and are administered as injections.

A biologic called denosumab (Prolia®) may be prescribed if other treatments aren’t effective. It is administered as an injection every six months.

There’s anecdotal evidence that some supplements can support bone health, however, research is still evolving, and few studies formally support the effectiveness of supplements. Speak with your doctor before taking supplements, as they may cause side effects or interact with other medications.

Nutrition significantly affects bone strength and health. Calcium and vitamin D are the two most important nutrients for managing osteoporosis. Calcium helps maintain strong bones and vitamin D allows your body to absorb calcium.

Nutritious sources of calcium include low-fat dairy products and dark green leafy vegetables. Vitamin D can be found in trout, salmon, and vitamin D-fortified milk and cereal. Some individuals get some of their vitamin D from sunlight, though this depends on your location and exposure to sunlight.

The recommended daily intakes for calcium and vitamin D vary by individual. General guidelines are below, but always check with your provider about your recommended intake.

Women with postmenopausal osteoporosis: 1200 mg of calcium and 800 international units of vitamin D

Women with premenopausal osteoporosis or men with osteoporosis: 1000 mg of calcium and 600 international units of vitamin D

Some evidence suggests that excess calcium consumption may cause kidney stones, calcium accumulation in blood vessels, and constipation. Always consult with your healthcare provider before taking supplements.

Other nutrients that promote bone health include:

Magnesium - found in whole grains and dark green leafy vegetables

Vitamin K - found in dark green leafy vegetables and canola oil

Zinc - found in whole grains, poultry, and nuts

Exercise is also part of living with osteoporosis. While certain types of exercise should be avoided given the risk for injuries, others offer many benefits for those with the condition.

Weight-bearing aerobic activities — performed on your feet — strengthen bones in your legs, hips, and lower spine. This includes walking, dancing, and low-impact aerobics.

It’s important to maintain good stability and balance. Try simple balancing exercises like standing on one leg or movement-based stability exercises, such as tai chi.

Unless otherwise informed by your doctor, avoid high-impact exercises and activities that involve frequent bending or twisting, as they may increase your risk of fractures. Always check with your doctor about which exercises are appropriate for you.

Take precautions to prevent falls both inside and outside of your home. You may wish to consult with your provider about whether or not they recommend an assistive device to improve balance and increase mobility.

Use the tips below as a starting point to prevent indoor and outdoor falls.

Avoid cleaning products that leave the floor slippery

Keep the area surrounding your house or apartment in good condition and free of clutter

The Bone Health & Osteoporosis Foundation (BHOF) and American Bone Health offer support and community for individuals living with osteoporosis.

Life with osteoporosis is easier with a reliable pharmacy partner by your side. Our pharmacists can answer any questions you may have, from medication side effects to 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.

Alto’s board of advisors was formed in 2020 to deliver strategic guidance as we work toward a better healthcare system for all. With diverse leadership experience in the industry, our board of advisor members ensure that our efforts are both impactful and efficient, with services grounded in the highest standards of operational excellence.

Meet the Newest Members of our Advisory Board | Alto Pharmacy

Today we’re thrilled to welcome three new members to the board of advisors: Adam J. Fein, Harry Leider, and Brad Fluegel. Their passion and expertise will no doubt be an asset as we focus on reaching even more patients — and delivering even more comprehensive care — in service of our mission.

Read on to learn more about their backgrounds in the industry and join us in giving them a warm welcome!

Adam J. Fein, PhD, is the CEO of Drug Channels Institute, a leading source of industry research about pharmaceutical economics and the drug distribution system. Widely published in academic and industry publications, he also heads the Drug Channels website, praised by readers for its comprehensive and witty coverage of pharmacy benefit managers (PBMs), medication pricing, and other industry topics.

Delivering medications to our patients at the lowest price possible is central to our mission. Dr. Fein’s deep expertise in pharmacy economics supports our ongoing commitment to improve adherence rates by way of more affordable medication options and total price transparency.

“The pharmacy industry has entered a period of structural change. There’s a tremendous need for the cost transparency, efficiency, and commitment to patient well-being that Alto delivers. I’m thrilled to support Alto in building innovative solutions to foundational issues within the industry,” Dr. Fein said.

Dr. Fein holds a doctoral degree in managerial science and applied economics from the University of Pennsylvania’s Wharton School of Business.

Harry L. Leider, MD, MBA brings more than 25 years of experience as a senior healthcare executive to our board of advisors. Since 2018, he’s served as Chief Medical Officer and Executive Vice President of Gelesis, an innovative biopharmaceutical company.

In addition to his current leadership in the biotherapeutic space, Dr. Leider has broad experience in telemedicine, retail healthcare, laboratory medicine, and payor strategies, as former Chief Medical Officer of Walgreens Boots Alliance, Ameritox, and Care Improvement Plus.

Dr. Leider shares Alto’s commitment to driving lasting change within the healthcare system for better patient health. With both clinical expertise and executive experience, he’s spent his career designing programs, services, and intellectual property that improve health outcomes.

“Alto’s pharmacy model brings us closer to a future where everyone can receive the highest standard of care and is equipped to manage their health. I’m personally inspired by Alto’s bold vision for healthcare and look forward to what we can accomplish together,” Dr. Leider said.

Dr. Leider has served on the faculty of Harvard Medical School and the Johns Hopkins Carey School of Business and holds five patents in laboratory medicine.

Drawing on more than three decades of healthcare experience, Brad Fluegel is a strategic advisor to organizations, entrepreneurs, and other industry participants. Most recently he served as Senior Vice President and Chief Healthcare Commercial Market Development Officer for Walgreen Co, where he managed all commercial healthcare activities, from sales and contracting to biopharma relationships and market planning.

Previously, Brad oversaw Walgreens’ corporate strategy and business development as Chief Strategy and Business Development Officer. He also led Elevance (then Wellpoint)’s strategic planning and corporate communications as Executive Vice President and Chief Strategy and External Affairs Officer.

His expertise in strategic planning and operations will allow us to deliver an exceptional patient experience as we continue to grow.

“Since 2015, Alto has proven itself to be a leader in the rapidly evolving digital pharmacy space. It’s a privilege to support their efforts to redefine what’s possible in healthcare, and together we can deliver industry-leading care to more patients,” he said.

Brad earned a master’s degree in public policy from Harvard University’s Kennedy School of Government and a bachelor of arts in business administration from the University of Washington. He also serves as a lecturer at the Wharton School of Business.

Dr. Fein, Dr. Leider, and Brad join three other advisory board members: Dr. James Hildreth, the President and Chief Executive Officer of Meharry Medical College; Jennifer Kent, previously the Director for the California Department of Health Care Services; and Ajay Khatri, previously Alto’s Chief Strategy Officer. 

Dr. Hildreth, Jennifer, and Ajay have offered invaluable guidance as we’ve grown throughout the past two years, and we couldn’t be more grateful for their partnership and support.

Learn more about Dr. Hildreth and Jennifer’s healthcare experience.

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