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

Managing the Costs of Insulin

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

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

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

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

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

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

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

The Lilly Cares® Foundation Patient Assistance Program

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

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

The Novo Nordisk® Patient Assistance Program

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

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

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

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

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

Your financial well-being is our priority

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

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

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

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

While many heart conditions develop gradually over time, there are others that start before birth. Congenital heart disease refers to a variety of structural problems with the heart that happen while a fetus is still developing. (An individual type of congenital heart disease may also be referred to as a congenital heart defect.) It is the most common birth disorder in the U.S., affecting about 40,000 babies each year, with 800,000 adults living with the condition.

Congenital Heart Disease, Explained

There is a spectrum of severity of congenital heart defects. While about 25% of all babies born with congenital heart disease have a critical heart defect (CHD) that requires surgery or other medical treatment, other types are mild. Take a look at some of the most common congenital heart defects.

In some types of congenital heart disease, the specific causes are unknown. Others have a genetic component and are passed through families. A mother’s health history and lifestyle habits can also affect how a baby’s heart develops in the womb. The following risk factors in a mother have been linked to a baby’s development of congenital heart disease.

Having type 1 or type 2 diabetes, hypertension, obesity, thyroid disorders, or epilepsy

Taking certain medications such as phenytoin and retinoic acid

If you are considering starting a family and have concerns about your baby’s risk of a genetic heart defect, ask your doctor about testing options that may detect a congenital heart disorder during pregnancy. In addition, consult with your doctor if you are unsure if a medication is safe to take during pregnancy.

Congenital heart disease may affect any of the following heart structures:

The right atrium, one of the heart’s two upper chambers which receives blood without oxygen from other parts of the body

The left atrium, the heart’s other upper chamber which receives oxygen-rich blood from the lungs

The right ventricle, one of the heart’s two lower chambers which pumps blood without oxygen from the right atrium to the lungs

The left ventricle, the heart’s other lower chamber which pumps oxygen-rich blood to the rest of the body

Coronary arteries, which supply your heart with oxygen-rich blood

The heart’s four valves, which keep blood flowing properly through the heart

The septum, the wall of tissue separating the left and right sides of the heart

These are the most common types of congenital heart disease affecting U.S. adults. Symptoms, treatment, and diagnostic tests vary by heart defect.

Comprising about 20% of all congenital heart disease cases, ventricular septal defect is the most common congenital heart defect in babies. It is a small or large hole between the ventricles. Treatment depends on the size of the hole. If a hole is larger, surgery may be required within a baby’s first four to six months of life. There is often no additional treatment needed after surgery.

Most infants with ventricular septal defect also have a heart murmur, a swishing sound that is audible with a stethoscope. Other symptoms include fast breathing, high heart rates, frequent sweating, even while at rest, and poor weight gain.

Another common type of congenital heart disease, atrial septal defect is a hole between the atria. Many infants with this defect do not have any symptoms.

In about 80% of cases, the hole closes naturally. If the hole does not close, a child may need surgery or a non-surgical procedure known as an interventional cardiac catheterization. As with ventricular septal defect, this condition typically does not require additional treatment after the first procedure.

Tetralogy of fallot (TOF) is a congenital heart defect in which the wall that separates the ventricles — the ventricular septum — is abnormally positioned, with a hole. It can obstruct the flow of blood through the heart, in some cases causing heart muscle to thicken. All TOF cases require surgery, typically within a baby’s first year of life.

Patent ductus arteriosus involves the connection between the aorta and the heart’s pulmonary artery. While in the womb, a baby’s aorta and pulmonary artery are linked by a blood vessel called the ductus arteriosus, which allows blood to flow directly to the aorta. In healthy babies, the ductus arteriosus naturally closes not long after birth. In babies with this heart defect, the blood vessel remains open, potentially causing heavy blood flow to the lungs. 

There are a variety of treatment options for patent ductus arteriosus, including medications, non-invasive procedures, and surgery. Nonsteroidal anti-inflammatory drugs (NSAIDs) may help close a premature baby’s patent ductus arteriosus but typically aren’t effective for full-term babies, children, or adults. If a baby has minimal symptoms, surgery is often delayed until they are between 6 to 12 months old. However, if a baby is experiencing poor weight gain or rapid breathing, surgery may be recommended during their first six months.

Transposition of the great arteries (TGA)

About 10% of all babies with congenital heart disease have transposition of the great arteries (TGA), a problem with the positioning of the two main arteries that carry blood away from the heart to other organs. Babies born with this condition have low oxygen levels, which may cause a bluish tint to the skin. The condition requires a surgical procedure called an arterial switch operation shortly after birth. In most cases, heart function is restored to normal after surgery.

Aortic valve stenosis is an issue with the aortic valve, from which oxygen-rich blood travels to other parts of the body. In healthy babies, the aortic valve has three flaps that open and shut to accommodate the flow of blood. Babies with this defect may have a small aortic valve or the flaps may not function properly. This structural problem can block the flow of blood from the heart, which can put additional pressure on the left ventricle. Treatment depends on the specific issue with the aortic valve and may include a non-invasive procedure or surgery.

Living with congenital heart disease as an adult

Living with congenital heart disease as an adult varies significantly by individual and by condition, given the wide spectrum of these defects. Most adults with a congenital heart defect are regularly monitored by a cardiologist who specializes in congenital heart disease throughout their lives. In some cases, you may have to take additional precautions to prevent complications related to certain types of congenital heart disease such as the following:

Infective endocarditis, an infection caused by bacteria in the heart lining, or in a heart valve or blood vessel. If untreated, it can lead to a blood clot, heart valve damage, or heart failure

Arrhythmia, an irregular heartbeat which can affect the heart’s ability to pump blood and increase your risk of developing a blood clot

Pulmonary hypertension, high blood pressure in the arteries that run from the heart to the lungs

Care for your heart with support from Alto

At Alto, we make it as simple as possible to manage 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 secure messaging or by phone at 1-800-874-5881.

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

Managing Type 2 Diabetes at Any Age

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Understanding Rheumatoid Arthritis

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Heart failure, which affects approximately 6.2 million U.S. adults, can be a confusing term. Contrary to what many people assume, it does not mean that your heart no longer works, or has stopped beating, but rather that this vital organ cannot pump blood and oxygen as well as a healthy heart.

What to Know About Heart Failure

Heart failure, which affects approximately 6.2 million U.S. adults, can be a confusing term. Contrary to what many people assume, it does not mean that your heart no longer works, or has stopped beating, but rather that this vital organ cannot pump blood and oxygen as well as a healthy heart. While heart failure is a progressive condition with the potential for serious health complications, it can be managed through lifestyle changes and medication. Read on to learn about heart failure symptoms, causes, and treatment options.

In all cases of heart failure, the heart cannot deliver enough blood and oxygen to the rest of your body. Sometimes this is because weakened heart muscle leaves the heart’s main pumping chambers — the ventricles — unable to carry out their pumping function. This type of heart failure is called heart failure with reduced left ventricular function (HF-rEF). In other cases, the ventricles are too stiff to fill with enough blood between beats. This type of heart failure is called heart failure with preserved left ventricular function (HF-pEF).

Ejection fraction (EF) is an important measurement of heart function for those who have heart failure with reduced left ventricular function. Expressed as a percentage, EF measures the amount of blood pumped from the left ventricle when it contracts. An EF of 55 to 70% is considered a healthy range.

Since heart failure is a progressive condition, your EF gives your doctor insight into any changes in your heart function. An echocardiogram is the most common way to measure your EF, but a magnetic resonance imaging (MRI) scan or nuclear stress test may also be used.

Despite the importance of EF, it is not the sole determinant of heart function. Those who have heart failure with preserved left ventricular function may have a normal EF. These cases of heart failure are often caused by high blood pressure, which gradually thickens the ventricles. Stiff ventricles cannot relax enough to fill to their full capacity, which is why they do not pump out enough blood.

Heart failure can affect many other organs, including the lungs, liver, and kidneys. The potential for additional health complications increases as heart disease progresses, which is why it’s important to stay proactive about your health and follow your doctor’s recommendations for treatment.

Heart failure primarily occurs as the result of other health conditions that weaken or stiffen the heart. Coronary artery disease, the most common type of heart disease, is the leading cause of heart failure. The condition gradually narrows and thickens the arteries that supply your heart with blood and oxygen. Severe blockages in the arteries can prevent the heart from pumping enough blood, leading to the development of heart failure.

High blood pressure is another common cause of heart failure, particularly cases of heart failure with preserved left ventricular function (HF-pEF). If you have high blood pressure, your heart has to work harder to deliver blood to the rest of your body. Over time, this can make your left ventricle too stiff to properly pump out blood.

Both type 1 and type 2 diabetes are linked to heart failure, as high blood sugar can affect your blood vessels and cardiac nerves. Heart failure may also be caused by a variety of heart health conditions including cardiomyopathy, congenital heart disease, heart valve disease, and arrhythmias.

Lifestyle factors such as smoking, eating a high-cholesterol or high-sodium diet, heavy alcohol consumption, and a lack of physical activity may increase your risk for heart failure, especially if you have one of the conditions above.

These are some of the most common symptoms of heart failure:

Shortness of breath when exercising or lying down

Fatigue and a feeling of weakness in your legs

Swelling in your ankles, legs, and abdomen

A persistent dry, hacking cough or wheezing

There is a spectrum of severity of heart failure cases, and treatment varies by individual depending upon symptoms and heart function, as well as the underlying cause. If you have early-stage heart failure, your doctor may recommend lifestyle changes and prescribe medications that can alleviate symptoms and prevent the condition from progressing.

The following medication classes, many of which lower blood pressure, are commonly used to treat early stages of heart failure.

Angiotensin converting enzyme (ACE) inhibitors

Often used to treat high blood pressure, ACE inhibitors block production of a hormone that causes blood vessels to narrow, helping constricted blood vessels expand so that more blood can flow through.

Like ACE inhibitors, ARBs protect blood vessels from a hormone that causes them to narrow, lowering blood pressure.

Another medication class commonly used in the treatment of high blood pressure, beta blockers cause the heart to beat more slowly, which lowers your blood pressure and opens up your veins and arteries.

Calcium channel blockers prevent calcium from entering the smooth muscle cells of the heart and blood vessels so that the heart can beat with less force. This opens up narrowed blood vessels and lowers blood pressure.

If you have atrial fibrillation — an irregular heart rate condition — or another heart health condition, your treatment plan for heart failure may include anticoagulants, medications that reduce the blood’s ability to form new clots and prevent existing clots from growing.

Cholesterol-lowering medications such as statins may be used to treat those who have early-stage heart failure and high cholesterol.

Many people with heart disease retain fluid. Diuretics, also referred to as water pills, can help eliminate excess water and sodium, which reduces the heart’s workload.

Small lifestyle changes are an important part of managing mild to moderate cases of heart failure. They can help alleviate symptoms and slow the progression of the condition. Here are some of the lifestyle changes your doctor may recommend.

Avoiding or limiting your caffeine intake

Anyone can benefit from these lifestyle changes, even those who do not have heart failure. Heart-healthy living is a lifelong practice, and the best way to prevent health issues like heart failure in the future is to prioritize your heart health today.

Some individuals with more advanced heart failure may need a procedure such as coronary bypass surgery or an angioplasty, both of which target a blocked coronary artery. Pacemakers may also be used to help control the rhythm of their heart, often in tandem with a bypass surgery and medications. 

Protect your heart with support from Alto

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.

Alto’s mission is to improve the quality of life for all who need medicine, building a pharmacy experience that serves people of all backgrounds. As we work toward a more inclusive and accessible healthcare system, we recognize the importance of diversity among physicians, pharmacists, nurses, and other public health figures. In honor of Black History Month, take a moment to learn about five influential Black healthcare leaders past and present — those who paved the way and those who continue to break barriers today

Five Black Healthcare Leaders to Celebrate

Alto’s mission is to improve the quality of life for all who need medicine, building a pharmacy experience that serves people of all backgrounds. As we work toward a more inclusive and accessible healthcare system, we recognize the importance of diversity among physicians, pharmacists, nurses, and other public health figures. In honor of Black History Month, take a moment to learn about five influential Black healthcare leaders past and present — those who paved the way and those who continue to break barriers today. (For additional inspiration, revisit the first post in this series.)

Dr. M. Jocelyn Elders: the first Black U.S. surgeon general

As a Black woman born to farmers in a rural, poverty-stricken area of Arkansas, M. Jocelyn Elders encountered numerous obstacles on her path to becoming the first Black U.S. Surgeon General in 1993. At 16, she met a doctor for the first time, but she didn't consider a profession in healthcare until she connected with Edith Irby Jones, the first Black person to attend the University of Arkansas Medical School, during college.

Throughout her career, Dr. Elders balanced clinical practice and research, increasing the public’s awareness of adolescent health issues. In 1987, Bill Clinton, then the governor of Arkansas, appointed Dr. Elders as head of the state’s Department of Health. The Arkansas state legislature mandated sexual education and substance misuse prevention programs in the K-12 curriculum in 1989 in large part because of Dr. Elders’ advocacy. During her tenure as Surgeon General, Dr. Elders continued to champion progressive policies, advocating for better sexual education programs, distribution of condoms in schools, and abortion rights. She remains active in the field of public health as a professor emeritus at the University of Arkansas School of Medicine.

Bernard J. Tyson: former CEO of Kaiser Permanente

As chairman and CEO of Kaiser Permanente, Bernard Tyson transformed the company’s services to account for social determinants of health like food access and affordable housing as well as the importance of mental health and wellness. He was also instrumental in the development of the Kaiser Permanente School of Medicine, which trains physicians to be not only clinicians, but patient advocates and innovators, too. By shining a spotlight on how social determinants of health contribute to disparities in health outcomes, Tyson leaves behind a legacy that reaches far beyond Kaiser’s services.

Nadine Burke Harris: first surgeon general of California

A physician, researcher, advocate, and California’s first surgeon general, Dr. Nadine Burke Harris has transformed how our society responds to childhood trauma. While running a health clinic in an underserved San Francisco neighborhood, she observed that preventative health practices and quality treatment didn’t resolve her patients’ risk for poor health outcomes. Drawing upon research from the CDC and Kaiser Permanente on adverse childhood experiences (ACEs), which linked early adversity to higher rates of chronic illness later in life, Dr. Burke Harris studied her own patients and found that more than 67% had experienced at least one ACE. She has helped increase public awareness of ACEs and toxic stress, advocating for universal screening of children and adolescents for signs of trauma. Her 2014 TED Talk, “How Childhood Trauma Affects Health Across the Lifetime,” has been viewed more than 7.5 million times, and she published The Deepest Well: Healing the Long-Term Effects of Childhood Adversity in 2018.

Dr. Patrice Harris: first Black female president of the American Medical Association

Despite not knowing any doctors while growing up in West Virginia, Dr. Patrice Harris’ passion for medicine started early. The board-certified psychiatrist initially planned to pursue pediatrics but shifted her focus after discovering an interest in psychiatry during medical school. Her focus on child psychiatry allows her to merge her passion for children with her expertise in mental health. Throughout her career, Dr. Harris has focused on the role of implicit bias within the medical profession and how unconscious biases among healthcare workers influence health disparities.

Dr. Harris’ involvement in the professional healthcare community spans many leadership positions at state and national organizations. She became the first Black woman elected as president of the American Medical Association in 2020. During her tenure, she focused on a variety of health issues, from opioid addiction to COVID-19. She previously chaired the AMA’s Opioid Task Force, providing evidence-based recommendations to clinicians with the goal of ending the opioid epidemic.

Betty Smith Williams: first Black graduate of the Frances Payne Bolton School of Nursing

Betty Smith Williams was the first Black student to earn a nursing degree from Cleveland’s Frances Payne Bolton School of Nursing, in 1954, and the first Black individual to teach at a higher education institution in the state of California, but her individual accomplishments are only a part of her legacy. Williams has helped ensure that today’s aspiring Black healthcare professionals have the opportunities and support to break down barriers of their own. She was instrumental in developing the National Black Nurses Association and the National Coalition of Ethnic Minority Nurse Associations, Inc. — initiatives that have elevated the voices of Black nurses within the profession. In uniting Black nurses, Williams hoped to create better health outcomes among the Black community. In her own words: "We had no voice, but we understood our culture and our unique needs better than anyone else.”

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

Understanding Cystic Fibrosis

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

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

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

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

A persistent cough, often with thick mucus or blood

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

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

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

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

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

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

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

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

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

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

The right pharmacy for your cystic fibrosis treatment

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

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

Skin, the body’s largest organ, protects you against disease and infection and regulates your body temperature, among other crucial functions. It’s important to take good care of this vital and complex organ, as there are a variety of skin problems that can occur, including serious issues like skin cancer. Here’s what to know about the structure of your skin and how you can protect it.

An Introduction to Skin Health

Your skin is composed of three layers: the epidermis (top layer), the dermis (middle layer), and the hypodermis (bottom layer). Each layer has an important purpose.

The epidermis is what you see when you look at your skin. It prevents infections by blocking bacteria and germs from entering your bloodstream. There are three types of cells in the epidermis:

Squamous cells, which form the top layer of the epidermis

Basal cells, which sit beneath the squamous cells

Melanocytes, which produce melanin — the pigment that gives skin its color — and are located at the bottom of the epidermis

Skin cancer first develops in the epidermis, with the three most common types of skin cancer affecting one of the three cells above.

The dermis, the middle layer of skin, plays an important role in your overall skin health. It contains collagen, a protein that keeps skin cells strong and healthy, and blood vessels that deliver nutrients to the epidermis. In addition, its sweat glands help regulate your body temperature, its hair follicles stimulate hair growth, and its nerves allow you to experience the sensation of touch.

The bottom layer of your skin is the fattiest, cushioning your muscles and bones when you fall and protecting you from the cold or extreme heat. The dermis’ nerves and blood vessels continue in the hypodermis, where they expand and reach the rest of your body.

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