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It’s official: Alto Pharmacy is a great place to work! We’re honored to join the community of Great Place to Work-Certified™ companies based on team member feedback and a rigorous assessment of our company’s culture and benefits.

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.

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

What You Should Know About the A1C Test and Diabetes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

6 Science-Backed Ideas for Healthy Living

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

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

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

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


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


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


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

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

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

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

5 Science-Backed Ideas for Healthy Living

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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.

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

Using Your Continuous Glucose Monitoring Device

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

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

The Little Device Providing Round-the-Clock Diabetes Care 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What Every Woman Should Know About Heart Health

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

7 Unusual Heart Health Risk Factors

What Science is Revealing About Heart Health

Researchers are working hard to curb the impact of heart disease, which is currently the leading cause of death in the United States. These efforts to develop new prevention strategies have led them to some surprising heart health hypotheses. You probably know that you should eat well and stay active, but these lesser-known risk factors may not be on your radar. Here are seven unconventional ways to support your heart that have sparked the interest of leading health experts. 

It turns out, brushing your teeth may have more benefits than just sparkly whites and fresh breath. Numerous studies have documented a link between poor dental health and heart disease. The verdict is still out as to why, but the prevailing theories point to inflammation. It could be that the bacteria which infect gums enter the bloodstream and cause blood vessel inflammation or that the body’s immune response is to blame. While more research is needed, it’s one more reason to brush your teeth for the recommended two minutes twice a day and get regular dental checkups. 

There have been some interesting studies exploring the connection between workplace stress and heart health. A decade-long study in Sweden found that having a bad boss increases your risk of a heart attack. Additional research has suggested that working long hours may increase your risk of cardiovascular disease and stroke. 

A key takeaway here is that stress, in general, isn’t great for your overall health. Stress causes your cortisol levels to spike, which can lead to high blood pressure, weight gain, sleep disruption, and reduced energy over time. Not to mention, your diet, exercise routine, and other healthy habits often suffer when you’re stressed out. Make sure to find ways to unwind at the end of your workday, whether that means listening to a relaxing soundtrack on your drive home or a brief meditation before you make dinner. Sometimes you can’t avoid challenging coworkers or chaotic days, but you can put strategies in place to help you feel calmer and more resilient. 

Not that you needed another reason to love your pets, but several studies have shown that pet ownership, especially having a dog, can improve heart health. According to Harvard Health, researchers have found that dog owners have lower blood pressure and cholesterol than non-owners, probably because dogs require daily walks and tend to have a calming effect on their humans. 

If you’re not a dog owner, we don’t advise adding pets to your life purely as a health strategy. Instead, you might consider stopping to meet some of your four-legged neighbors. A few studies have found that just petting a dog can lower your blood pressure. 

Sleep is the unsung hero of the health world. It allows your whole body to rest and replenish. Although your heart never stops beating, it does slow down and recover during sleep. According to John Hopkins Medicine, by depriving your heart of this crucial recovery time, lack of sleep increases your risk of heart attack and heart disease.

If you have trouble sleeping, creating a nightly ritual can help. Try to wind down at the same time every evening and create a calm, dark, and quiet environment in your bedroom. You should turn off your electronic devices at least thirty minutes before bedtime to help your body prepare for restful sleep. 

If you find yourself tossing and turning on the regular, it’s best to talk with your doctor. Various underlying and unsuspecting conditions could be causing your lack of sleep and there are many different therapies that can help.  

For more sleep-enhancing tips, read, “Too Stressed to Sleep? These Strategies Can Help.”

Bring on the oatmeal and scrambled eggs! When a panel of experts from the American Heart Association reviewed studies on eating habits and heart health, they formed an intriguing conclusion: breakfast-eaters tended to have lower instances of heart disease and were less likely to have high cholesterol and high blood pressure.

If you struggle to make time to eat in the morning, the American Heart Association suggests these breakfast hacks for some quick and easy meal ideas. Harvard Health recommends including whole grains in your morning meal to further reduce your risk for heart attack, stroke, and heart failure. They offer this menu of options full of whole grains, protein, and fruit. 

We all love a good movie marathon, but regularly sitting for hours at a stretch could be putting your heart at risk. And yes, that includes long workdays at the computer. 

The American Heart Association and the American College of Cardiology have both warned that regularly sitting for long periods is a significant contributor to heart disease. It’s not an issue of laziness—in a world full of deskjobs, car trips, and the all-important need to unwind, many of us struggle to find time to get the consistent movement our bodies need.

If you’re stuck sitting for long periods, the American Heart Association suggests finding ways to sneak movement into your day. You might try setting a timer and taking a five-minute stretch break every hour or using your lunch break to go for a walk. Every extra minute on your feet will help you get to the recommended 150 minutes of activity per week. Exercise also helps you reduce stress and sleep better, making it a true heart-health allstar. 

Several studies suggest an association between optimism and a lower risk of cardiovascular disease. A 2015 study found that those with a more positive outlook were more likely to make healthy lifestyle changes after a heart attack. And a researcher at the University of California, San Diego, found that patients with a greater sense of gratitude had lower levels of inflammation and better heart health overall.

Robert A. Emmons, Ph.D., a professor of psychology at the University of California, Davis, told the American Heart Association, “Clinical trials indicate that the practice of gratitude can have dramatic and lasting effects in a person’s life. It can lower blood pressure and improve immune function...grateful people engage in more exercise, have better dietary behaviors, are less likely to smoke and abuse alcohol and have higher rates of medication adherence.”

If optimism doesn’t always come easy to you, you’re not alone. Psychologists believe we have a natural tendency to fixate on negative information as a way to avoid it in the future. It’s a phenomenon known as “negativity bias.” Practicing gratitude is a powerful way to counteract this inclination. Best of all, it’s easy to get started. Your new habit can be as simple as writing down what you’re grateful for every day. 

When you look closely, these unconventional risk factors aren’t really that surprising. They each relate to foundational heart-healthy lifestyle choices such as managing stress, eating healthy foods, and staying active. This advice aligns with the CDC’s guidance, which outlines six essential strategies for living a heart-healthy lifestyle. 

If you’re concerned about your heart, the CDC recommends learning about your family’s health history and talking to your healthcare provider about your risk. Together you can create an action plan that’s best for you. If your doctor prescribes medication to treat high cholesterol, high blood pressure, or diabetes, the CDC stresses the importance of taking it as directed. 

Alto’s expert pharmacists will always be available via in-app message or phone to answer questions about dosage instructions or side effects, and we’d be happy to bring your medications to your doorstep for free. Your heart-healthy lifestyle does not have to include standing in line at the pharmacy or worrying about refills. We’ll take care of the details so you can focus on cooking a healthy breakfast or walking your dog. 

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. 

Following prevention guidelines like mask-wearing, social distancing, and handwashing is still the surest way to stay safe. In addition, here are seven strategies to follow during the COVID-19 pandemic if you have asthma.

Seven Strategies for People with Asthma During COVID-19

As COVID-19 infection rates surge across the country, asthma is making its way into news headlines. Research published in the Journal of Allergy and Clinical Immunology at the end of November suggests that people with asthma may be at reduced risk of contracting the coronavirus. 

The researchers stressed that further study is needed, and possible explanations are still being explored. But the news may be welcome for people with asthma—a chronic lung condition that causes inflammation in the airways—who are facing an additional threat to their lungs from COVID-19, which primarily affects the respiratory system.  

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An HIV Prevention Milestone: Truvada Goes Generic

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