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Join us in delivering our industry-leading pharmacy care to millions of people across the country. As a member of the team, you’ll play an integral role in improving our customers’ quality of life and redefining what’s possible in pharmacy. 

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Read the latest Alto blog posts covering healthcare, family health, managing diseases, and other Alto highlights.

Blog | Alto Pharmacy

Starting Friday, March 12, residents of the greater Dallas-Fort Worth metro area can now choose Alto’s same-day doorstep delivery for their pharmacy needs.

Hello, Dallas-Fort Worth!

Alto’s launch in the Dallas-Fort Worth market extends our industry-leading patient care model to even more Texans. 

Starting Friday, March 12, residents of the Dallas-Fort Worth metro area can now choose Alto’s same-day doorstep delivery for their pharmacy needs. 

At Alto, we believe it’s our job to ensure you have your medications at the best price, on time and with the support you need. We bring pharmacy to you - no more waiting in line, making an extra trip, or finding out your prescription isn’t ready to be picked up after you’ve already arrived. Our free doorstep delivery means your medications come directly to you on the day and time you select, and most medications are available the same-day. Stay up to date on your courier’s progress with text alerts or in our mobile app. 

Starting a new medication or doing an injection for the first time? Message a pharmacist with your questions, even in the evenings and on weekends. And we’re a full service pharmacy - we stock all major brand, generic, over-the-counter and specialty medications, meaning your entire family’s pharmacy needs can be managed in the Alto app and coordinated into one delivery.

Courier delivery windows
Monday - Friday: 

12:30 pm - 3:30 pm CT (1:00 pm - 4:00 pm CT for outlying areas) 

6:00 pm - 9:00 pm CT(7:00 pm - 10:00 pm CT for outlying areas)

2:00 pm - 5:00 pm CT (3:00 pm - 6:00 pm CT for outlying areas)

Walk-in hours
Monday - Friday: 9:00 am – 7:00 pm CT
Saturday - Sunday: 8:00 am - 4:30 pm CT

Dallas-Fort Worth residents interested in using Alto’s services for their medication needs can ask their doctor’s office to send all prescriptions to Alto Pharmacy (via ePrescribe, phone or fax). 

Have existing prescriptions at another pharmacy? Start a transfer online or give us a call at 1 (800) 874-5881, and we’ll handle the switch. 

Need to pick up? Our pharmacy is located at 475 State Highway 121, Suite 150, in Lewisville.

General customer support hours are Monday - Friday 9 am - 11 pm CT and Saturday - Sunday 10 am - 7 pm CT. Patients can reach out to Alto via phone/text at 1 (800) 874-5881, email or app.

Founded in 2015, Alto is a patient-centric digital pharmacy based committed to the health and wellbeing of you and your family. We provide free same-day delivery to your door seven days a week for prescriptions, but, more importantly, offer cost transparency, personalized in-app and phone support, and real-time coordination with doctors and insurance companies to get you the care that you need. Alto is headquartered in San Francisco with offices in Denver and Dallas, and currently delivers across the greater Bay Area, Los Angeles, Orange County, San Diego, Seattle, Denver, Las Vegas, New York City, Houston, Dallas and Austin.

Editor’s Note: This post was originally published in March 2020 and has been updated for accuracy and completeness.

Starting Wednesday, February 24, New York City residents can now choose Alto’s same-day doorstep delivery for all of their pharmacy needs. 

Hello, New York City!

Alto extends beyond fertility medication support to offer full-service pharmacy operations in New York City.

Starting today, Wednesday, February 24, New York City residents can now choose Alto’s same-day doorstep delivery for all of their pharmacy needs. 

12:30 pm - 3:30 pm ET (1:30 - 4:30 pm ET for outlying areas)

6:00 am - 9:00 pm ET (7 - 10 pm ET for outlying areas)

2:00 pm - 5:00 pm ET (3:00 - 6:00 pm ET for outlying areas)

Walk-in hours
Need to pick up? Our pharmacy is located at 100 Park Avenue - that's 40th between Park and Madison.
Monday - Friday: 9 am – 7 pm ET
Saturday - Sunday: 8 am - 4:30 pm ET

New York residents interested in using Alto’s services for their medication needs can ask their doctor’s office to send all prescriptions to Alto Pharmacy (via ePrescribe, phone or fax). Have existing prescriptions at another pharmacy? Start a transfer online or give us a call at 1 (800) 874-5881, and we’ll handle the switch. 

General customer support hours are Monday - Friday 9 am - 12 midnight ET and Saturday - Sunday 10 am - 9 pm ET. Patients can reach out to Alto via phone at 1 (800) 874-5881 or app.

*Weekday afternoon delivery is only available to residents of New York City's five boroughs at this time.

Starting Monday, February 1, residents of the greater Houston metro area can now choose Alto’s same-day doorstep delivery for their pharmacy needs.

Hello, Houston!

Alto’s launch in the Houston market extends our industry-leading patient care model to Texas.

Starting Monday, February 1, residents of the greater Houston metro area can now choose Alto’s same-day doorstep delivery for their pharmacy needs. 

12:30 - 3:30 pm CT (1:00 - 4:00 pm CT for outlying areas) 

6:00 - 9:00 pm CT (7:00 - 10:00 pm CT for outlying areas) 

2:00 - 5:00 pm CT (3:00 - 6:00 pm CT for outlying areas)

Houston area residents interested in using Alto’s services for their medication needs can ask their doctor’s office to send all prescriptions to Alto Pharmacy (via ePrescribe, phone or fax). 

Need to pick up? Our pharmacy is located at 4950 Terminal Street, Suite 200, in Bellaire.

General customer support hours are Monday - Friday 8:00 am - 11:00 pm CT and Saturday - Sunday 9:00 am - 8:00 pm CT. Patients can reach out to Alto via phone at 1 (800) 874-5881 or app.

Founded in 2015, Alto is a patient-centric digital pharmacy based committed to the health and wellbeing of you and your family. We provide free same-day delivery to your door seven days a week for prescriptions, but, more importantly, offer cost transparency, personalized in-app and phone support, and real-time coordination with doctors and insurance companies to get you the care that you need. Alto is headquartered in San Francisco with offices in Denver and Dallas, and currently delivers across the greater Bay Area, Los Angeles, Orange County, San Diego, Seattle, Denver, Las Vegas, New York City, Houston, Dallas, and Austin.

Chronic obstructive pulmonary disease (COPD) is a long-term inflammatory condition that obstructs the airflow from the lungs. Here’s what you need to know about keeping your lungs healthy to avoid or manage COPD. 

Understanding Chronic Obstructive Pulmonary Disease (COPD)

The delicate, branching structures of the lungs bear a striking resemblance to trees. The air you breathe travels down your windpipe, or trachea, and enters the lungs through two large tubes known as bronchi. Just like the roots and limbs of a tree, these tubes divide again and again into smaller bronchioles before finally ending in clusters of tiny air sacs called alveoli—what you might consider the leaves. 

Chronic obstructive pulmonary disease (COPD) is a long-term inflammatory condition that obstructs the airflow from the lungs and makes it difficult to breathe. Although it's the third leading cause of death in the U.S., the good news is that it can be prevented and treated to slow the progression and maintain quality of life. Here’s what you need to know about keeping your lungs healthy to avoid or manage COPD. 

COPD refers to a group of progressive lung diseases, meaning the condition becomes worse over time. The most common are emphysema and chronic bronchitis, and many people with COPD have both of these conditions. 

Emphysema destroys the fragile air sacs in the lungs, which impairs the airflow. The air carrying carbon dioxide out of the body cannot be adequately expelled and some remains trapped in the lungs. Fresh, oxygen-rich air is then blocked from entering the lungs, causing gradually worsening shortness of breath, even while at rest.

According to the Mayo Clinic, most people with emphysema also have bronchitis, which causes inflammation and narrowing of the bronchial tubes. With bronchitis, mucus builds up in the lungs, spurring a persistent cough. 

The CDC reports that sixteen million Americans have trouble breathing due to COPD. However, they estimate that the actual number includes millions more who have not yet been diagnosed. 

In the vast majority of people with COPD, lung damage is caused by cigarette smoking. According to the COPD Foundation, about 90% of people with COPD are current or former smokers. However, damage can also be caused by long-term exposure to irritating gases or particulate matter, including air pollution and workplace exposure to dust, smoke, or fumes. 

An estimated five percent of people with COPD have a deficiency in a protein known as alpha-1-antitrypsin, which causes the lungs to deteriorate and can also affect the liver. People with severe asthma can also progress into COPD. 

The most telling—and distressing—symptom of COPD is difficulty breathing. According to the Mayo Clinic, another major symptom is a constant cough that produces a lot of mucus. Additional symptoms may include chest tightness, wheezing, frequent respiratory infections, and fatigue. Severe COPD can cause swelling in the ankles, legs, and feet and weight loss. 

As a progressive disease, symptoms often begin mildly and may be confused for the common cold. But rather than clearing up after a week or two, the coughing and shortness of breath will continue to worsen over time and make daily activities more difficult. 

Unfortunately, by the time COPD symptoms appear, there may already be significant lung damage. Symptoms will continue to escalate, particularly if smoking or exposure to lung irritants continues. With proper intervention and treatment, however, most people with COPD can slow the disease’s progression and maintain their quality of life. 

People with COPD often experience flare-ups known as exacerbations. During these episodes, symptoms become much more severe for several days or weeks and may require treatment with antibiotics, oral corticosteroids, and even hospitalization. 

Respiratory infections or inflammation triggers—such as air pollution, secondhand smoke, dusts, fumes, or other toxic substances—are common causes of exacerbations. Anyone who experiences a marked increase in coughing, difficulty breathing, or mucus in the lungs should seek immediate medical attention. 

The best way to prevent COPD is to never smoke or stop smoking now. Quitting isn’t easy for most people, so it’s a good idea to enlist your healthcare provider’s support.  They may recommend nicotine replacement products or medications that can help. 

The CDC offers a variety of resources that can help you quit smoking, including a free text message program (text QUIT to 47848) and their quitSTART app, which is available for both Android and iOS. The Mayo Clinic outlines ten tips to help you resist the urge to smoke that you may find helpful as you get started. 

It’s also important to avoid secondhand smoke exposure and occupational exposure to chemical fumes and dust. If you work with any type of lung irritant, the Mayo Clinic advises talking with your supervisor about the best ways to protect yourself, like using respiratory protective equipment. 

Staying active will not only improve your overall health; it will also strengthen your lungs. The American Lung Association recommends getting thirty minutes of moderate physical activity five days a week. Both aerobic and muscle-strengthening exercises will benefit your lungs, so you can include anything from brisk walking to weight lifting to vigorous household cleaning. 

Lastly, make sure to get your annual flu vaccine each fall, as well as a pneumococcal vaccine, to prevent infections that can weaken your lungs. 

While there is no cure for COPD, treatment can ease symptoms and lower the risk of complications like heart disease, lung cancer, respiratory infections, pulmonary hypertension, and depression. 

COPD can be treated with medications, supplemental oxygen therapy, and surgery. However, many people with mild forms of the disease may only need to quit smoking and avoid other inflammation triggers. 

The most common medications used to treat COPD include: 

Bronchodilators, which usually come in inhalers and relax the muscles around the airways to make breathing easier. 

Inhaled corticosteroids, which help to reduce airway inflammation and prevent exacerbations. 

Oral steroids are sometimes used in short courses during periods of exacerbation to prevent further worsening of symptoms.

Phosphodiesterase-4 inhibitors are used for severe COPD. These medications decrease airway inflammation and relax the airways.

Theophylline may be used when other treatments are ineffective or if cost is a factor. It may help improve breathing and prevent exacerbations but can cause side effects like nausea, headache, rapid heartbeat, and tremors.

Antibiotics may also be used to treat respiratory infections but are generally not recommended for prevention. 

Often, a combination of these medications is used to treat COPD. Inhaled medications are taken using a device called an inhaler, which allows the medication to be absorbed straight into your lungs. If you’re prescribed a new inhaler, one of Alto’s pharmacists can walk you through how to use it.  Not all inhalers work the same way, so learning the proper technique is crucial for ensuring adequate therapy.

People with COPD are also generally prescribed a pulmonary rehabilitation program. These individually tailored programs combine exercise, nutrition advice, and counseling to prevent exacerbations, slow the progression of symptoms, and improve quality of life.

Those with insufficient oxygen reaching their blood may benefit from supplemental oxygen therapy. It involves using a lightweight, portable device to deliver oxygen directly to your lungs as needed.

Surgery may be an option for those with severe COPD, particularly severe emphysema. It’s usually reserved for when other types of treatment have failed. 

Because breathing is so elementary, it’s easy to take it for granted. But so many of the activities we enjoy—and life itself—depend on the healthy function of our lungs. 

When breathing becomes difficult, life can change drastically, so it’s important to find support. That may mean sharing your feelings with a close friend or family member, joining a support group for people with COPD, or enlisting the help of a mental health professional. 

Above all, it’s critical to follow your treatment to avoid worsening symptoms. At Alto, we want to make getting the COPD medications you need as easy as possible, so we offer free hand-delivery, automatic savings investigations, and user-friendly medication management through our website and app. We always have a team of pharmacists on-call to answer your questions by phone, text, or chat, and we’ll even remind you when your inhaler or other medications are due for a refill, then schedule a time to drop them off. 

If you’re interested in learning more about how Alto can support your COPD treatment plan, our team is available from 9 am – 12 midnight ET Monday – Friday, and 10 am – 9 pm ET on weekends. Download the mobile app for secure messaging or call 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 other qualified health provider with any questions you may have regarding a medical condition.

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

Using Your Continuous Glucose Monitoring Device

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

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

The Little Device Providing Round-the-Clock Diabetes Care 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.

If you’re considering fertility treatment for the first time, it’s important to understand the financial hurdles you may be facing. In this article, we’ll explore some of the financial options available and how we at Alto can help. 

Managing the Costs of Fertility Treatment | Alto Pharmacy

For hopeful parents who are struggling to conceive, the costs of pursuing fertility treatment can often seem insurmountable. Though assisted reproductive technology (ART) makes it possible for many people experiencing infertility to become parents, the emotional and financial stakes are high. 

If you’re considering fertility treatment for the first time, it’s important to understand the financial hurdles you may be facing. However, there are ways to manage or lower the costs so you can move forward on your path to becoming a parent. In this article, we’ll explore some of the financial options available to intended parents pursuing ART and how we at Alto can help. 

If You Have Health Insurance, Start There

Unfortunately, not all insurance plans cover fertility treatments. As you dig into your plan’s details, you may find that some options are covered with contingencies, while others are not covered at all. It’s best to contact your insurance provider for an in-depth explanation of your fertility coverage. 

Be prepared to ask questions about whether your plan covers diagnostic testing, medications, treatments, and consultations. Ask if there is a cap on coverage or a waiting period required to try certain treatments. You want to walk away with a comprehensive understanding of what your out-of-pocket costs might be.

Several states have enacted legislation that requires insurance providers to cover infertility treatments. The American Society of Reproductive Medicine maintains this online database with information by state.

Many fertility clinics now offer no- or low-interest financing. As you seek out the clinic that’s right for you, inquire about what cost-assistance services are available. It’s perfectly reasonable to seek out a clinic that makes you feel confident and fits your budget.

There are also companies that provide personal loans specifically for fertility treatments, with flexible monthly payment options. At Alto, we’ve worked with companies like Lending Club, CapExMD and Origin Finance to help our customers get the fertility medications they need. (Great news: the Origin application fee is waived for Alto customers!)

Most companies allow you to apply online and some even provide budgeting tools on their websites so you can get an idea of what your monthly payments might be. 

There are grants available through government programs, nonprofits, and private companies that can help cover fertility treatment costs. Many are designed to benefit intended parents who demonstrate financial need while others were created to support specific groups, such as veterans or the LGBTQ+ community. There are even some that will award money to those willing to share their infertility story. 

These grants won’t usually cover all of your costs, but they can provide a significant boost. CoFertility keeps a database of fertility grants and other funding opportunities, as does RESOLVE: The National Infertility Association. 

Fertility medications can represent a significant portion of your total treatment costs. At Alto, we’ll always advocate for you to ensure you get the lowest possible prices on your medications. We’ll run a thorough insurance benefits investigation and if your insurer requests a prior authorization, we can work with your doctor’s office to submit it on your behalf. Plus, we’ll remind you to collect any available manufacturer rebates with a monthly email.

If you’re uninsured, we can help you apply for income-based assistance programs like the Compassionate Care Program offered by EMD Serono. Even if you are still in the planning stages of your fertility journey, the earlier you can apply to the program, the better. Ideally, you will want to have approval before your fertility prescriptions are sent to your pharmacy. 

We accept ACH (direct) payments and offer a one percent discount for anyone who prefers this option over using their credit card. And don’t forget—with Alto, delivery of your medications is always completely free.

With mail-order pharmacies, you usually have to order your fertility medications all at once to ensure your precisely timed doses don’t get hung up in the mail. Because it’s difficult to predict exactly how much medication you will need, you often end up ordering excess. Not only will these leftovers add to your out-of-pockets costs, but you’ll also end up with wasted medication that you'll have to dispose of when you're done with treatment.

When you fill your prescriptions with Alto, we’ll hand-deliver your medications from our local fulfillment centers. That means we can deliver your medications every few days, avoiding overorders and minimizing how much you spend. 

Finally, we know that your time is the most valuable resource you have, so we’re focused on giving as much back to you as we can. Send us a simple message through the Alto app when you have a question, and keep all your medication information—plus expert advice—at your fingertips using our mobile app. You can also schedule refills and track your shipments from our pharmacy to your doorstep in real time. If you suddenly need to add a day of injections, there’s no need to stress or go running to the pharmacy. We’ll handle the details and coordinate delivery to your doorstep. 

If you’re interested in learning more, you can request a price quote online. Our care team and fertility specialists would be happy to answer your questions about navigating fertility medications. We know that the start of your ART journey can feel full of uncertainty, but we’re here to do whatever we can to make the process easier and more affordable. 

For more on choosing the right fertility pharmacy for your journey, read, “What to Consider When Selecting a Fertility Pharmacy.”

While it’s not always possible to predict the course of your fertility treatment, it can be helpful to set goals and parameters. Is there a maximum number of in vitro fertilization (IVF) cycles you’re willing or able to try? Are there other options you’d like to pursue first, such as intrauterine insemination (IUI)? What are the scenarios where you might try using donors or a gestational carrier, or consider fostering or adoption?

Once you have an idea of your budget, coverage options, and potential out-of-pocket costs, create a roadmap that outlines your treatment goals in relation to your financial, physical, and emotional well-being. 

Remember—dealing with infertility issues can take an emotional toll, especially if some options feel out of reach financially. Know that you are not alone, and there is a community of other hopeful parents you can lean on. Support groups like RESOLVE and The Fertility Tribe offer virtual meetups and online community groups. It’s also essential to lean on loved ones for emotional support during this time. The journey you’re taking isn’t easy, but you certainly won’t be walking it alone. 

Would you like to learn more about how Alto can help you manage your fertility treatment costs? Visit alto.com/fertility or give us a call at 1-800-874-5881. Our team is available 9 am – 12 midnight ET Monday – Friday, and 10 am – 9 pm ET on weekends. We’re ready to be your partner through it all, from your first cycle to your last. 

Managing the Costs of Fertility Treatment

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

A Guide to Year-Round Wellness

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

This October, a generic version of Truvada became available in the United States for the first time. In this article we'll explain what these means for PrEP users and how Alto can help.

An HIV Prevention Milestone: Truvada Goes Generic

The world of HIV prevention medications is still relatively new. In 2004, Truvada roared onto the scene and drastically changed the future of HIV. While the medication was initially used to treat HIV, in 2012 the FDA approved its use as a form of pre-exposure prophylaxis (PrEP), a daily prescription medication that prevents HIV infection.

When taken as prescribed, Truvada is 99% effective at preventing sexually transmitted HIV infection. It has been shown to potentially cause decreased kidney function and a small amount of bone loss in some individuals. Though studies indicate these side effects are slight, they present a barrier for people with pre-existing renal and bone density issues. Descovy, an updated form of PrEP, was introduced last year with research showing kidney and bone safety improvements over Truvada. 

Truvada and Descovy are both patented and manufactured by Gilead Sciences. Both are considered highly effective, safe, and well-tolerated by most PrEP users. While Descovy is less likely to cause unfavorable changes in kidney and bone blood tests, Truvada has been shown to have a more favorable impact on blood fat levels and lead to less weight gain. The FDA has not yet approved Descovy for cisgender women or transgender men—more studies are still needed. Those who are uncertain which medication is right for them should discuss the options with their healthcare provider. 

For more on PrEP, read “All about PrEP for HIV Prevention.”

This October, a generic version of Truvada became available in the United States for the first time. Why the delay? When a brand-name medication enters the market, it is protected by patents and granted a period of exclusivity. Now that Truvada’s exclusivity period has ended, manufacturers with generic alternatives may seek approval from the FDA. 

Teva Pharmaceuticals was the first manufacturer to receive FDA approval for a generic version of Truvada. More generic versions will likely follow in 2021, increasing competition and driving down the price. 

Curious about how medication versions work? Read “What’s the Difference between Generic and Brand-name Medications?”

By lowering the cost of PrEP, the emergence of generic Truvada will ultimately put less strain on the U.S. healthcare system and help make PrEP more widely accessible to those at risk of HIV infection. Those who switch to generic Truvada will likely see their out-of-pocket costs decrease; however, there may be consequences for people who prefer Descovy—the newer formulation of PrEP.

In the wake of generic Truvada’s arrival, some insurance companies have decided to stop covering Descovy due to higher costs. While the two forms of PrEP may well be interchangeable for many patients, Descovy is not identical to Truvada. A small subset of people may have less desirable outcomes if compelled to switch versions by their insurers. People who need or prefer Descovy, especially because of preexisting renal or bone density issues, will likely need to obtain prior authorization approval and could face higher out-of-pocket costs. 

At Alto, we specialize in handling prior authorizations and performing thorough cost savings investigations. If we notice a change in your out-of-pocket cost, we’ll let you know, and we can work to identify ways to save you money. Here’s a closer look at how your pharmacy, healthcare provider, and insurance company work together to manage your prescriptions. 

How Insurance Companies Manage Medication Costs

Unsurprisingly, insurance companies tend to favor the cheapest version of a medication with similar efficacy. One way insurers encourage less expensive alternatives is through prior authorizations—a restriction that requires doctors to request that the insurance company cover certain medications. Not every prescription is subject to a prior authorization, but it’s commonly used when a doctor prescribes a brand-name drug with a generic available. The doctor must prove to the insurer why the specific version they prescribed is medically necessary. 

In most cases, prior authorizations are intended to ensure the safest and most cost-effective medication is used. However, they often require extensive paperwork and multiple phone calls from doctors’ offices, which can become a drain on time and resources for busy offices and clinics or cause delays in getting your prescription. 

For more on how the process works, read, “What is a Prior Authorization?”

Finding out that you need a prior authorization can feel daunting, but the right pharmacy partner will navigate the complexities for you. At Alto, we proactively file prior authorizations when they’re needed, taking the weight off the shoulders of both you and your doctor. We have a dedicated support team that works closely with your doctor’s office to obtain approval from your insurance company, and we’ll keep you updated throughout the whole process. 

After securing approval, we’ll conduct a thorough price investigation to identify sources of financial assistance and ensure you're getting the lowest possible price. We do all of this at no cost to you—we believe everyone should have access to the medications they need at an affordable price.

If you’re concerned about continued coverage for your preferred form of PrEP, we’re here to offer support. Our HIV specialists and care team are available to answer your questions 9 am – 12 midnight ET Monday – Friday, and 10 am – 9 pm ET on weekends. Download the mobile app for secure messaging or call 1-800-874-5881. 

Your thyroid makes the hormones that regulate your metabolism. In this article we'll share tips for supporting your thyroid health as well as what to do when your thyroid is out of balance.

All About the Thyroid

The thyroid is a small butterfly-shaped gland located at the base of your throat. It’s part of the endocrine system—a series of glands that produce and regulate hormones. Hormones are chemical messengers that “tell” certain cells and organs what to do, influencing nearly all of the body’s functions. 

Your thyroid makes the hormones that regulate your metabolism: thyroxine (T4) and triiodothyronine (T3). Metabolism is the process by which your body converts food into energy,  facilitating vital functions such as blood circulation, breathing, and cell repair. Without the thyroid, the body could not break down protein, fats, and carbohydrates for fuel. 

The thyroid gland does not simply act on its own. It receives signals from the pituitary gland, the body’s “master gland,” which is located at the base of the brain and regulates vital body functions. The pea-sized pituitary gland sends its instructions through a hormone called thyroid-stimulating hormone (TSH). TSH levels rise and fall in the blood, telling the thyroid the exact amount of each hormone to secrete. Hormone levels within the body are a delicate balancing act, and several disorders can arise if the thyroid overproduces (hyperthyroidism) or underproduces (hypothyroidism) T4 and T3. 

With hyperthyroidism, the thyroid gland makes too many hormones, accelerating the body's metabolism, which can cause unintentional weight loss and a rapid or irregular heartbeat. According to the Mayo Clinic, other symptoms may include increased appetite, nervousness or anxiety, sweating, fatigue, and difficulty sleeping. Without treatment, hyperthyroidism can lead to serious complications, including heart conditions like congenital heart failure, eye problems, and osteoporosis. 

Hypothyroidism occurs when the thyroid isn’t making enough hormones, and symptoms may not be noticeable at first. Common symptoms of hypothyroidism may include increased sensitivity to cold, fatigue, constipation, weight gain, and dry skin. If left unchecked, the condition can eventually lead to obesity, joint pain, infertility, and heart disease.

Both conditions can be treated, often through the use of synthetic hormones or anti-thyroid medications. If you’re concerned about thyroid health, your healthcare provider can administer a blood test to check your thyroid hormone levels and recommend the appropriate treatment. 

Eating a nutritious, well-rounded diet is essential for thyroid health. Many vitamins and minerals support the thyroid, and iodine is chief among them. This trace mineral is an essential building block of thyroid hormones, but our bodies don’t produce it. Therefore, we need to consume iodine in foods such as iodized salt, seafood, seaweeds, egg yolks, dairy products, and lima beans.

It’s important not to go overboard, however. Consuming iodine in excess can negatively affect hormone levels in some individuals. Iodine deficiency is rare in the United States, so if you’re eating a varied diet, you’re likely within the range of the recommended 150 micrograms per day. 

Selenium is another critical mineral for thyroid function that can be found in brazil nuts, fish, meat, poultry, and fortified cereals and grains. Just like with iodine, selenium deficiency in the U.S. is rare, and it can be detrimental to go too far over the recommended 200 micrograms per day. 

Both the Mayo Clinic and Harvard Health recommend eating a variety of healthy foods rather than focusing too heavily on specific foods or supplements for thyroid health. If you have any concerns about your intake of essential nutrients, talk with your doctor about taking a multivitamin with minerals.

A Word of Caution about Thyroid Supplements

Your endocrine system maintains a very precise balance of hormone levels. For that reason, it’s not a good idea to experiment with your hormone health on your own. According to Cleveland Clinic endocrinologist Christian Nasr, MD, taking over-the-counter iodine supplements could result in getting more than the recommended daily value, which may leave you worse off than before. “The effect of iodine supplements can vary by person, causing the thyroid to produce either too much or too little hormone,” he cautioned.

Consumer Reports also issued a warning about thyroid supplements, reporting that many have been found to contain thyroid hormones derived from animal glands—and there’s often no indication on the labels. When researchers randomly tested ten “thyroid support” supplements, they found that nine contained “clinically relevant” levels of thyroid hormones, in some cases at levels that rivaled prescription thyroid medications. Researchers concluded that these supplements posed a “potential danger to public health.” 

Keep in mind that dietary supplements are not reviewed for safety or effectiveness by the FDA, so it’s best to talk with your healthcare provider before beginning a new over-the-counter supplement. Taking “thyroid support” supplements could alter your hormone levels in unpredictable ways and have undesirable health consequences. If you’re at all concerned about your thyroid health, consult your doctor so you can have your hormone levels tested and begin a prescribed treatment plan. 

A healthy thyroid contributes to feeling energized and ready to live life to the fullest. If your doctor determines that your hormone levels are out of balance, taking medication can restore your vitality. Once you develop a treatment plan, we’d be happy to take over the details of managing your medications. We’ll drop them off at your doorstep for free, and your prescription information will always be at your fingertips through our desktop and mobile apps. Plus, our pharmacists will only be a phone call, text message, or in-app chat away if you have questions about side effects or which foods to avoid eating around dosage time. 

Want to learn more about a better pharmacy experience with Alto? Our care team and endocrinology specialists are available to answer your questions from 9 am – 12 midnight ET Monday – Friday, and 10 am – 9 pm ET on weekends; reach out by in-app secure messaging or phone.

If you’re considering IVF or freezing your eggs and unsure of what to expect, this article will break down the basics and offer suggestions for how to prepare. 

IVF and Egg Freezing: What to Expect and How to Prepare

These days, egg freezing and IVF, or in vitro fertilization, are fairly common routes on the journey to parenthood. Yet, that doesn’t mean these fertility treatments are always an easy road. While both treatments helped millions of women conceive, they can require a significant investment of emotion, resources, and time. 

In vitro fertilization is a type of fertility treatment where:

The retrieved eggs are combined with sperm outside of the body in a laboratory 

The embryos (fertilized eggs) are then placed into the uterus with the potential outcome of a pregnancy. 

The main difference between egg freezing and IVF is the timing. Rather than attempting to get pregnant right away, egg freezing gives you the option to store your unfertilized eggs for a later time. When and if you decide you are ready to have a baby, your eggs will be thawed in the lab and the rest of the IVF process will be completed. Freezing healthy eggs at a younger age allows women more flexibility in their family-planning timelines.  

The initial screening and prescribed medications are very similar for IVF and egg freezing. After completing an initial ultrasound and bloodwork, your doctor will prescribe fertility medications to stimulate follicle growth. Follicles are fluid-filled sacs in your ovaries that potentially contain an egg. Your prescription will involve self-injecting hormones on a precisely timed schedule and regular check-ins for additional ultrasounds and bloodwork. For a more detailed understanding of the timeline and medications used during an IVF cycle, see our article,  IVF Medications: Schedule and Side Effects Explained. 

Once your follicles have reached maturity, your doctor will gently guide a thin needle through your vaginal wall and use suction to draw the eggs from the follicles. The 15-45 minute procedure is minimally invasive, and you’ll be sedated to ensure there’s no pain. The retrieved eggs are either frozen and stored for later use or placed in a petri dish with sperm cells so fertilization can take place. The fertilized eggs, or embryos, are then transferred to your uterus through a quick, non-surgical procedure using an ultrasound-guided catheter.  

IVF may include a variety of other parties at each stage. In some cases, an egg donor undergoes the egg retrieval process. The resulting embryos are then transferred to the intended parent’s uterus. Sometimes a gestational carrier carries and delivers a child for another couple or person. The embryo is created via IVF using the eggs and sperm of the intended parents or donors and then transferred into the gestational carrier’s uterus. In all of these cases, the sperm used to fertilize the eggs may come from either a male partner or donor. Your unique fertility journey may or may not include one or more of these variations.

From a biological standpoint, the American Society for Assisted Reproductive Technology recommends being at a healthy weight and avoiding smoking or alcohol use. It’s also important to mentally prepare, as this journey may take more than one cycle and be physically demanding on your body. Here are a few tips to keep in mind when it comes to your emotional well-being: 

Don’t let staying “stress-free” stress you out 

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