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Blog | Alto Pharmacy

 Stress doesn’t simply spill into our personal lives, it affects the body in many ways. And it isn’t only short-term ailments like tension headaches or muscle pain to be mindful of — ongoing stress can take a heavy toll on your long-term heart health. In recent years, numerous research studies have found that stress can increase a person’s risk for heart disease, the leading cause of death in the United States.

Understanding the Stress-Heart Health Connection

While many people know that high blood pressure, high cholesterol, genetics, and smoking are all key heart disease risk factors, stress isn’t always included in conversations about heart health. As you prioritize a heart-healthy lifestyle, regularly evaluate your stress levels, taking steps to reduce stress and manage it positively when it does arise.

Here’s more on the stress-heart health connection, including coping strategies that will benefit your heart as much as your mind.

Stress triggers physiological changes in the body that can influence heart health. It all starts in the brain. When you encounter a stressful trigger, the amygdala — a portion of the brain responsible for emotional processing — communicates that you are in distress, activating your nervous system.

As part of this process, the stress hormones adrenaline and cortisol are released, which can temporarily increase blood pressure and insulin resistance. Sometimes the body’s experience of stress also leads to inflammation in the arteries. Over time this can affect the function of your blood vessels, potentially resulting in atherosclerosis, or the accumulation of plaque in the walls of your arteries.

Less directly, stress has a ripple effect on lifestyle factors related to heart health. Everyone responds to stress in different ways. For some, exercise might be a positive outlet during challenging times. But for others, stress makes it difficult to fit in consistent exercise. (The American Heart Association recommends 150 minutes of moderate-intensity aerobic activity per week.) And stress frequently goes hand in hand with unhealthy behaviors like smoking and heavy alcohol consumption or other substance use.

There is also the link between stress and sleep, another less discussed heart health risk factor. The overactive nervous system created by chronic stress — and its continuous output of hormones — can create a vicious cycle of anxiety-fueled insomnia and insomnia-fueled anxiety.

Stress presents differently from one person to another. If you are experiencing any of the following symptoms, talk to your doctor about stress management techniques and other resources.

Stress relief doesn’t have to be a big endeavor. Look for small opportunities, like the following, to engage the body and mind in your daily or weekly routine. (Your heart will thank you!)

Exercise is fundamental to heart-healthy living, and it also happens to be a powerful source of stress relief.

Like the stress-heart health connection itself, the soothing effects of physical activity are grounded in hormones. Exercise is known to lower your levels of adrenaline and cortisol while stimulating production of endorphins, the body’s feel-good chemicals.

Longer blocks of regular exercise are important for your long-term heart health, but in moments of high pressure you’ll feel some stress-relieving benefits from even a quick burst of movement.

As you get moving, find ways to calm the mind. Many practices fall under the umbrella of mindfulness, the cultivation of present moment awareness and shift away from reactivity. Try meditation, yoga, tai chi, walking, or even bringing a bit more attention to your morning coffee or cup of tea.

With so many options for living more mindfully, focus on finding the habits and routines that work for you, and which fit easily into your day.

Deep breathing, a proven tactic for lowering stress hormone levels, is an accessible entry point. You may also benefit from the following resources:

Insight Timer, which offers a variety of free guided meditations

What’s Up?, which uses a cognitive behavioral therapy (CBT) approach to managing stress and negative thoughts

Healthy stress management isn’t just about using positive coping mechanisms in the moment. You may be able to stop stress before it happens — without getting too far into the future, of course.

Researchers have linked workplace stress, which many U.S. adults experience, to negative heart health. One Swedish study connected a poor experience of a manager to the risk of heart attack.

There are tangible ways to make the demands of a job or responsibilities at home feel more manageable (saying no when it’s necessary for starters). Stress management is personal, so consider what you need and don’t be afraid to ask for it.

At Alto, we make it as simple as possible to manage your risk for heart health issues and follow the treatment plan your doctor recommends. We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

Reach out any time through 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.

For many Americans living with a chronic health condition, prescription medications are necessary to manage symptoms and prevent complications. But following a treatment plan can be easier said than done. There are many considerations involved, from managing medication interactions and side effects to staying on track with related testing and follow-up appointments. And of the 66% of U.S. adults who are prescribed medication, only half take their medication as prescribed.

National Pharmacists Month Spotlight: Wei-Lin Chang

At Alto, medication therapy management pharmacists like Wei-Lin Chang help patients navigate all the complexities of managing a chronic disease. As part of our coverage of American Pharmacist Month 2022, we spoke to Wei-Lin about her professional path, the challenges of retail pharmacy, and the importance of medication education.

What motivated you to pursue a career in pharmacy?

I honestly didn’t know what I wanted to do when I first entered college. My parents encouraged me to pursue a career in healthcare, but I knew I was a bit too squeamish around needles to become a doctor or nurse.

I took a chemistry class that I really enjoyed and decided to do all the pharmacy prereqs. I then did an internship with the head of pharmacy at Cook County Hospital in Chicago. Through that experience, I saw firsthand that pharmacists were a critical liaison between patients and doctors, with so much valuable information about medication strength, directions, dosing, and administration.

After that, I pretty much knew that pharmacy was for me. I’ve been practicing since 2002.

What challenges have you encountered as a pharmacist?

Before Alto, I worked in traditional retail pharmacy. In that setting, you’re so busy as a pharmacist — it’s one customer after another after another.

I worked both daytime and night shifts, and it was during the night shift, when the store was much more quiet, that I could really counsel patients without feeling so pressed for time. During the day, I simply didn’t have the free minutes to always answer patient questions or give recommendations.

Another challenge I faced was the perception of our profession. At the beginning of my career, in the early 2000s, many people I encountered didn’t know a pharmacist did much beyond putting pills in bottles and handing them off to customers. Not only did this lead to frustration from my customers, who would wonder what we were doing and why it was taking so long, it led to missed opportunities to more actively participate in a patient’s health journey. 

More medication education for patients is an urgent need within American healthcare. People taking multiple medications have to be mindful of potential side effects and medication interactions.

The growing field of medication therapy management is an opportunity for pharmacists to play an even bigger role in patient health, and I’m very proud to work for a company that prioritizes this particular area of pharmacy.

As a medication therapy management (MTM) pharmacist, I contact patients who take multiple medications — often multiple heart medications — and review their entire regimen over the phone. I make sure that they understand the purpose of each medication they’re taking and are on track with related testing.

For example, it’s important to get your liver function checked every 6-12 months if you’re taking cholesterol-lowering medications that are processed by the liver, or to get your A1C levels checked every 3-6 months if you’re taking diabetes medication.

We also discuss side effects, interactions, when to take medication, and what food to take it with. Too often, there isn’t the space for these conversations between pharmacists and patients, but they are so essential to a patient’s overall health. 

I love our pharmacy specializations. It’s unique to have a team that focuses solely on patients and another team that focuses on fulfillment. Not all pharmacies have a medication therapy management program, and it’s possible at Alto in part because of our smart allocation of resources.

Being able to use all of my time to focus on my core job functions is such a contrast to retail pharmacy, where you’re constantly bombarded from all sides at once.

As a pharmacist, what does “care” mean to you?

Care to me means going above and beyond for your patients and making sure all loose ends are tied. As an example, I recently initiated a transfer for one of the heart medications a patient takes. At Alto, we always complete every single step of the prescription transfer process on the patient’s behalf. He was so appreciative, and when I got off the phone, I could tell from his voice that he was smiling ear to ear. That’s the experience I want all of my patients to have.

This is part of a series of pharmacist profiles to recognize American Pharmacist Month 2022. To keep the Pharmacist Month celebrations going, meet patient care pharmacist Travis Allison and specialty patient care pharmacist Gabrielle Kaplan.

Despite the misconception of HIV as an illness that primarily affects young people, nearly half of all those with HIV in the U.S. are age 50 and older. This is both a testament to the effectiveness of treatment, as many of these individuals were diagnosed at an earlier age, and a reminder that people of all ages can receive an HIV diagnosis.

HIV and Aging: What to Know

As the HIV population ages, management of the condition continues to evolve, with different health challenges to navigate. Below, we highlight several important health considerations to be mindful of.

Antiretroviral therapy (ART) has been the frontline treatment for HIV since 1995. It is a combination of medications that keep HIV from replicating, stopping the progression of the virus and preventing transmission.

When all medications are taken every day as prescribed, ART can help those with HIV maintain an undetectable viral load. As a result, more than half of all individuals living with HIV in the U.S. are not at risk of transmitting the virus to others.

Regular attendance at doctor’s appointments is an important part of proactively managing HIV. Your provider needs to monitor your body’s response to your individual ART protocol, testing bone, kidney, metabolic, cardiovascular, cognitive, and liver function. (Thanks to the variety of medication options, it is easy to make adjustments as needed if you experience side effects or don’t achieve the desired results.)

For older adults with HIV, ongoing monitoring and testing is especially important, as there is a greater possibility of side effects such as impaired cognitive function and bone health issues.

It is also important to closely monitor how ART interacts with other medications. As you age, you are more likely to be prescribed multiple medications to manage several conditions.

People of all ages should be regularly tested for HIV, since a diagnosis is possible at any age. Older individuals are less likely to be tested — and more likely to receive a late diagnosis — due to the following factors:

The misconception of HIV as exclusively a young person’s illness

The overlap between HIV symptoms and typical signs of aging

Remember that getting tested is the only way to know your HIV status. Continue to stay proactive about regular testing every year. Search for an HIV testing site near you.

Older adults with HIV are more likely to also have health conditions associated with aging, including:

Here’s a quick look at how HIV intersects with several of these health issues.

The ongoing immune system activity and inflammation caused by HIV can contribute to plaque accumulation in blood vessels, a leading factor in the development of cardiovascular disease. Statins, a type of cholesterol-lowering medication, have been shown to lower the risk of heart disease in individuals with HIV.

To protect your heart health while living with HIV, stay on track with preventative care. Your provider should regularly check your cholesterol, blood pressure, and blood sugar. Additionally, maintain a heart-healthy lifestyle, with healthy habits like exercising regularly, eating a balanced diet, and refraining from smoking.

HIV has been linked to a greater risk of cancers including liver cancer, lung cancer, cervical cancer, and Hodgkin’s lymphoma. Ask your doctor about the recommended frequency of screenings for these types of cancer as well as others that are not related to HIV and AIDS.

The gradual loss of bone mass is a normal part of aging. For those with osteoporosis, a condition that weakens bones, the changes are more pronounced. HIV can increase a person's risk of developing osteoporosis. (While osteoporosis disproportionately affects women, both men and women with HIV face an increased risk.)

A simple bone mineral density test, sometimes referred to as a DEXA scan, can identify bone health issues. This screening is recommended for all women over the age of 65 and all men over the age of 70. If you have HIV, you may need earlier and/or more frequent screening. Consult with your doctor about recommended frequency.

Aging brings a risk of cognitive decline for anyone, regardless of health history. HIV has been linked to a faster decline in cognitive function. Though older individuals with HIV were once thought to have an elevated risk of dementia, the evolution of ART has helped lessen this possibility. However, a milder form of cognitive impairment called HIV-associated neurocognitive disorder (HAND) remains a health concern for older those with HIV.

Regular health exams should include screening for signs of cognitive issues including changes related to thinking or memory.

Loneliness and social isolation — factors in the development of physical health issues like dementia as well as mental health disorders — are more common among older adults. Older individuals with HIV should be even more proactive about monitoring mental health, as living with HIV at any age is linked to depression.

Make sure your doctor screens you regularly for depression and other mental health issues. If you have symptoms, ask about potential treatment options or a referral to a psychiatrist or psychologist. You may also want to explore additional resources such as virtual or in-person support groups for older adults with HIV.

Navigate HIV treatment with Alto by your side

Our pharmacists have deep expertise in HIV treatment and prevention and can help you get started with antiretroviral therapy. We will coordinate with your doctor and your insurance provider, if applicable, to ensure that you’re receiving the best option for your needs at the best price. To learn more, reach out any time via text or phone at 1-800-874-5881, or in-app messaging.

Pharmacists are one of the most accessible healthcare professionals, seeing people 5 to 8 times more frequently per year than primary care providers. Their role has become more expansive than ever, and many people don’t realize just how integral they are to a patient’s health and well-being.

National Pharmacists Month Spotlight: Travis Allison

At Alto, fulfillment pharmacists focus on dispensing medication — ensuring that the entire process is carefully monitored every step of the way — while patient advocacy pharmacists tackle anything related to a patient’s wellness, from provider communication and insurance coordination to guidance on managing chronic health conditions.

These specializations have opened up entirely new possibilities for the patient-pharmacist relationship at Alto. And this October, as we celebrate American Pharmacist Month, we’re spotlighting a few of the extraordinary Alto pharmacists who focus on patient advocacy.

To kick things off, we’re pleased to introduce Travis Allison, a patient care pharmacist based in Dallas, Texas.

I took the long and winding road here. I didn’t always know this was what I wanted to do. In college, I started off as an English major but had a change of heart after a semester or two. I went on to study agriculture, and those experiences made me believe that I could pursue a path grounded in science.

My childhood memories of visiting the pharmacist were always in the back of my mind. As a kid, I hated going to the doctor. When those dreaded appointments were over and done with, I knew I’d get to see a guy in a white coat who would give me something to feel better. I always saw pharmacists as a comfort in the often scary world of healthcare.

At any chain pharmacy — which is where I spent my career before Alto — pharmacists are inundated with so many tasks. It isn’t that these tasks are unrelated to pharmacy, but they interfere with our ability to deliver patient care.

On a typical day, I would give 100 Covid shots and fill 200 prescriptions by myself while also coordinating billing and calling doctors’ offices. We also had to think about corporate metrics. I was frequently asked to get more people signed up for text message alerts and hit specific quotas.

Patient care is always the priority, for any pharmacist, but the reality of my job made it extremely difficult, and often impossible, to give patients the time they deserved.

The first thing I noticed when I started at Alto were the specializations. We have many different team members to handle all the responsibilities that fall on a single person’s shoulders at a traditional retail pharmacy.

I’m a patient care pharmacist, which is distinct from fulfillment pharmacists who process prescriptions.

I review prescriptions for accuracy and initiate medication transfers, and I interact with both patients and doctors. I’m here to answer any questions a patient has about their medication.

In a way, I feel like I’m on the frontlines the same way that I was when I worked in a pharmacy chain. It’s all of what I liked about retail pharmacy without the distractions of retail. We’re able to practice our most important functions as pharmacists without the noise.

We’re utilizing technology in a way no other pharmacy does, which allows us to communicate with patients and providers in so many different ways — without having to rush through interactions.

And the wheels of change turn much more quickly at a tech-oriented company than they do at a massive corporation. At my previous job, you could have conversations all day about what improvements were needed, but nothing ever happened. Alto was founded by software engineers, and we’re able to easily make changes in real time.

As a digital pharmacy, we serve so many patients that only we can serve. I talk to many who are homebound without a caretaker. Because of Alto’s model, I’m able to communicate with them, and we’re often their only point of contact within the healthcare system. I don’t know of another way these patients could get pharmacy care.

The digital model also allows us to get a broader view of healthcare, and to make an impact on a larger scale. Alto was one of few places where New Yorkers could get the Covid medication Paxlovid when it was first introduced.

It was incredible to be sitting here in Texas, getting prescriptions out in New York City just as a new variant came out that was really devastating to the city. At no other pharmacy would I have been able to help out my neighbors in New York.

Those moments where you can tell in a patient’s voice that you seriously helped them. To me, that’s an indication of how well I’m doing my job, much more so than the number of prescriptions processed or dollars generated.

Recognizing and Treating Anxiety, The Most Common Mental Health Disorder

Some degree of anxiety is natural. In fact, it can even be beneficial in certain contexts, like pre-interview butterflies. Other times, however, anxiety can become so debilitating that it interferes with daily life. Frequent and intense feelings of nervousness may be indicative of an underlying mental health disorder.

Anxiety disorders are the most common type of mental health disorder in the U.S., affecting more than 40 million adults, or about 19%. It is also estimated that 7% of children and adolescents between the ages of 3-17 struggle with symptoms of anxiety.

Over the past few years, as Covid-19 brings much upheaval and change, the number of Americans suffering from anxiety disorders and depression continues to increase. As a result, the U.S. Preventive Services Task Force is now recommending that all adults under the age of 65 be screened for anxiety. 

For many of those with an anxiety disorder, treatment — in the form of medication, psychotherapy, or both — is necessary to manage symptoms and maintain an active and fulfilling life. Below, we explain more about some of the most common treatment options.

Many factors can contribute to anxiety, including genetics, environment, behaviors, and situations. Common causes and risk factors include:

Having another mental health disorder such as depression

Genetics - having a relative with an anxiety disorder is considered a risk factor

Certain personality traits such as shyness

Individual experiences of anxiety can vary, so your anxiety symptoms may be different from those of a friend or family member with the condition. Anxiety can cause physical sensations like butterflies in your stomach or a racing heart. It can also bring an overall feeling of fear or unwanted thoughts.

Digestive issues, stomach pain, or nausea

Thoughts or flashbacks of a traumatic experience

Anxiety disorders are highly treatable with medication and therapy. (A combination of both is necessary for many people with an anxiety disorder.) While it can be difficult to share your feelings with a healthcare provider, it’s an important first step in managing symptoms.

These are some indications that you may benefit from treatment for anxiety:

Anxiety, fear, or worry has interfered with work and relationships

You find it difficult to control your anxiety, fear, or worry

You are concerned about your use of alcohol or other substances

There are many options for medication to treat anxiety. Some are used on a short-term basis or as needed while others are taken daily in the long term. Your provider will make recommendations based on your specific symptoms.

Though it can be frustrating, finding the right medication for your anxiety symptoms can take some trial and error.

There are several types of medications commonly used to treat anxiety disorders.

Benzodiazepines are sedatives that induce a feeling of calm. They amplify the effects of certain chemicals that act as a messenger between brain cells.

Benzodiazepines commonly prescribed for anxiety include:

These medications are typically used for short-term treatment of acute symptoms and may be prescribed on an as-needed basis. They often cause side effects like drowsiness and difficulty with balance and memory.

While benzodiazepines are effective, they have the potential for dependence and misuse. As a controlled substance under the U.S. Drug Enforcement Administration’s guidelines, there are tight regulations for prescribing and dispensing benzodiazepines.

Benzodiazepines are not safe to abruptly discontinue. If you have been taking a benzodiazepine for longer than two weeks, speak with your doctor about slowly tapering off to avoid withdrawal symptoms and lower the risk of seizure.

Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) increase a person’s levels of serotonin, a chemical in the brain that affects mood. Increased serotonin levels can alleviate symptoms of anxiety. These medications are considered a frontline treatment option for anxiety disorders and are also used to treat depression.

SSRIs commonly prescribed for anxiety include:

While SSRIs are very effective for many people with anxiety, it typically takes several weeks to experience their benefits. Even if you don't feel like the medication is working, continue to take it as prescribed so that you can achieve a therapeutic level. If you still have concerns several weeks into treatment, speak with your doctor.

Always consult your doctor before stopping an SSRI. It is not recommended to frequently start and stop SSRIs, and they should not be taken on an as-needed basis.

SSRIs have been linked to the following side effects, though they are mild in the majority of cases. Speak with your doctor about any concerns.

Serotonin and norepinephrine reuptake inhibitors (SNRIs)

Serotonin and norepinephrine reuptake inhibitors (SNRIs) increase levels of serotonin — just like SSRIs — but they also increase norepinephrine, which boosts energy and focus. These medications may increase your energy levels in addition to alleviating symptoms of anxiety.

SNRIs commonly prescribed for anxiety include:

Venlafaxine extended-release (Effexor® XR)

There are additional medications used to treat anxiety that do not belong to the medication classes above.

The antihistamine hydroxyzine (Atarax®, Vistaril®) blocks histamine and boosts the effects of serotonin. As the only antihistamine that offers this effect, it is the only antihistamine used to treat anxiety. This is typically an option for those who experience side effects with SSRIs or SNRIs, or who have concerns about the addictive potential of benzodiazepines.

Buspirone (Buspar®) is another alternative to SSRIs and SNRIs. While it isn’t entirely understood how buspirone works, the medication likely activates certain areas of the brain to make serotonin more active.

Each person metabolizes medications differently. Open communication with your provider can help identify the medication that works best for you. Your doctor should know:

Any other medications you are prescribed and their dosages

Your experience of anxiety symptoms after taking the prescribed medication — do you feel like it’s working?

Medication for anxiety disorders is often combined with psychotherapy, which helps you understand and manage your emotional and behavioral responses to sources of anxiety.

Cognitive behavioral therapy (CBT) is considered one of the most effective types of therapy for anxiety disorders. It helps you recognize the underlying thoughts and behaviors that fuel uncomfortable or debilitating emotions. Shifting your thoughts and behaviors then alleviates symptoms of anxiety.

Finding the right therapist can take time. If you have insurance coverage of therapy sessions, check your insurance company’s provider network as a starting point. You can also look through reputable online databases like Psychology Today or the American Psychological Association (APA)’s psychologist locator. Some therapists offer sliding scale fees to make sessions more affordable.

Maintaining good mental health is easier with a reliable pharmacy on your side. Our pharmacists can answer any questions you may have about your medications, and we offer free, same-day delivery and medication management tools like reminders and auto refills in our app.

To learn more, reach out any time 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.

The thyroid may be small, but it plays a significant role in your overall health and wellness. This butterfly-shaped gland at the base of your throat produces and regulates hormones that influence your metabolism and energy level, cholesterol, heart rate, body temperature, and more.

How to Manage an Overactive Thyroid

Balanced thyroid hormones allow your body’s many systems to properly function, and issues with the thyroid can impact many aspects of your health. There are two main types of thyroid imbalances that may occur: hyperthyroidism and hypothyroidism.

Hyperthyroidism occurs when the thyroid produces too much thyroid hormone, accelerating the metabolism beyond normal.

Hypothyroidism occurs when an underactive thyroid leads to lower-than-normal levels of thyroid hormone.

Without treatment, both hyperthyroidism and hypothyroidism can lead to more serious complications. Below, we explain how to manage these disorders and maintain a balanced thyroid.

Several conditions or health factors may lead to overproduction of thyroid hormone. Graves’ disease, an autoimmune disorder in which antibodies overly stimulate the thyroid, is the leading cause of hyperthyroidism, accounting for 85% of all cases.

The development of thyroid nodules, which are typically benign lumps or growths in the thyroid that produce more hormones than needed

Thyroiditis, or thyroid inflammation, which most commonly occurs after pregnancy due to an underlying autoimmune disease or unknown cause

Excess consumption of iodine — a mineral critical to the production of thyroid hormone — through diet or medications

There are also several known factors that may increase your risk of developing the condition, including:

Health conditions including pernicious anemia, type 1 diabetes, and primary adrenal insufficiency (also known as Addison’s disease)

Hyperthyroidism is associated with a wide range of signs and symptoms such as the following:

Unintentional weight loss even with increased food intake

Enlarged thyroid gland at the base of your neck

Symptoms of hyperthyroidism may be subtle for some individuals. In addition, many common symptoms overlap with those of other health conditions. If you have any concerns about your thyroid health, consult with your provider for an evaluation.

Hyperthyroidism is associated with irregular menstrual cycles, which can lead to difficulty conceiving. Many people initially learn of a hyperthyroidism diagnosis after experiencing fertility challenges. The treatment options described in more detail below can help restore hormone levels and ovulation.

The thyroid affects so many areas of your health and wellness, and untreated hypothyroidism can lead to other health issues such as the following.

An underactive thyroid can increase levels of LDL cholesterol, leading to a greater risk of heart disease and heart failure.

Hypothyroidism is also linked to depression.

An underactive thyroid can affect ovulation, or the release of a mature egg from the ovaries during a menstrual cycle. Treatment for hypothyroidism may address fertility issues by restoring hormone levels and ovulation.

In the long term, untreated hypothyroidism can damage the peripheral nerves, which carry information from your brain and spinal cord to other parts of your body. This can lead to pain, numbness, and tingling.

There are several ways to diagnose hyperthyroidism, including a physical exam, blood tests, and imaging tests.

Your healthcare provider may check your thyroid, eyes, heart, hands, and skin during a physical exam to confirm a diagnosis of hyperthyroidism.

Your provider may recommend thyroid function testing, which consists of measuring your thyroid hormone levels via blood samples. Hyperthyroidism is characterized by elevated levels of the thyroid hormones triiodothyronine (T3) and thyroxine (T4) and lower-than-normal levels of thyroid-stimulating hormone (TSH).

Your provider may also use one or more imaging tests to more closely examine your thyroid, including a radioactive iodine uptake (RAIU) test, a thyroid scan, and a thyroid ultrasound.

There are a variety of treatment options for hyperthyroidism. Your provider will make individualized recommendations based on the cause of your hyperthyroidism and your overall health history.

The following types of medications are commonly used in the treatment of hyperthyroidism.

Anti-thyroid medications including methimazole (Tapazole®) and propylthiouracil (PTU) reduce symptoms by preventing over-production of thyroid hormones. These medications are typically taken for at least a year, though symptoms may improve within weeks or months.

Radioactive iodine is an oral medication that targets overactive thyroid cells, causing the thyroid to shrink and lowering hormone levels within a few weeks. This treatment approach permanently affects thyroid function, so symptoms of hyperthyroidism will not reappear. In most cases, the use of thyroid hormone medications is necessary after this treatment to maintain balanced hormone levels.

Beta blockers can control associated symptoms such as a rapid heartbeat, nervousness, or tremors. These medications cause the heart to beat more slowly and less forcefully. They will not change hormone levels and are typically used in tandem with anti-thyroid medications or radioactive iodine therapy. Commonly prescribed beta blockers include atenolol (Tenormin®), bisoprolol (Zebeta®), metoprolol tartrate (Lopressor®), metoprolol succinate (Toprol-XL®), acebutolol (Sectral®), and propranolol (Inderal®).

Some cases of hyperthyroidism require removal of part or all of the thyroid gland in a procedure known as a thyroidectomy. While this is effective at treating hyperthyroidism, it can result in hypothyroidism, which requires ongoing use of thyroid supplements.

Iodine consumption can contribute to the development of hyperthyroidism or worsen symptoms. Managing hyperthyroidism often includes monitoring iodine intake.

If your provider recommends following a low-iodine diet, try to avoid or limit your intake of seafood and seaweed, which have the highest iodine content of all foods. Other high-iodine foods to consume in moderation include milk and dairy products, egg yolk, and iodized salt.

Never make significant changes to your diet without first consulting your provider or a nutritionist.

The most common cause of hypothyroidism is an autoimmune disorder called Hashimoto's thyroiditis.

Other significant contributing factors include:

Thyroid surgery, which can affect hormone production

Radiation therapy to treat cancer, if targeting the head or neck

Anyone can develop hypothyroidism, but several known factors may increase your risk, including:

Sex - the condition occurs more frequently in women than in men

Age - the condition occurs more frequently in those over 60

Having another autoimmune disorder such as type 1 diabetes or celiac disease

Symptoms of hypothyroidism often develop gradually, over the course of many years. These are among the most common and significant:

If you have symptoms of hypothyroidism, your doctor will likely use a thyroid stimulating hormone (TSH) test to confirm a diagnosis. This simple blood test measures the levels of thyroid hormones in your blood.

One challenge of diagnosing hypothyroidism is that symptoms frequently overlap with those of other health issues.

Hypothyroidism is manageable. Treatment allows you to control symptoms such as elevated LDL cholesterol levels and weight gain, preventing potential health complications.

The main goal of treatment is to increase your thyroid levels. Levothyroxine (Levo-T®, Synthroid®, Tirosint®), a synthetic thyroid hormone taken orally, is often the starting point.

Another synthetic thyroid hormone, liothyronine (Cytomel®), may also help treat low thyroid levels.

There are formulations that combine levothyroxine and liothyronine.

The majority of individuals with hypothyroidism need to take medication every day on an ongoing basis, though some mild cases are resolved with short-term treatment.

How to Manage an Overactive or Underactive Thyroid

Juvenile idiopathic arthritis (JIA) is the most common form of arthritis that affects children and adolescents. Like adult rheumatoid arthritis (RA), JIA is characterized by pain and inflammation throughout the body as the result of joint inflammation and stiffness.

In contrast to the ongoing nature of RA, some children do outgrow JIA. However, it can impact a growing child’s bone development, so treatment is important.

What to Know About Arthritis in Children

Juvenile idiopathic arthritis (JIA) is the most common form of arthritis that affects children and adolescents. Like adult rheumatoid arthritis (RA), JIA is characterized by pain and inflammation throughout the body as the result of joint inflammation and stiffness.

Blog

Understanding the Stress-Heart Health Connection

National Pharmacists Month Spotlight: Wei-Lin Chang

HIV and Aging: What to Know

National Pharmacists Month Spotlight: Travis Allison

Recognizing and Treating Anxiety, The Most Common Mental Health Disorder

How to Manage an Overactive or Underactive Thyroid

What to Know About Arthritis in Children

Meet the Innovation Team Building Alto's Next Big Bets

Understanding the Diabetes-Heart Health Connection

Navigating a Diagnosis of Prediabetes

Osteoporosis, Explained

How Polycystic Ovary Syndrome (PCOS) Affects Fertility

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