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Allergies, the immune system’s response to foreign substances, can take numerous forms, from hay fever and allergic asthma to food allergies, medication allergies, and more. For those with allergic contact dermatitis — also referred to as allergic eczema — contact with an allergen causes skin inflammation and a rash.

Common Treatments for Allergic Rashes

While allergic contact dermatitis can be uncomfortable, painful, or itchy, a healthcare provider can help you identify the underlying trigger and manage symptoms. Read on for more about the condition.

Allergic contact dermatitis occurs when exposure to an allergen causes a skin rash. The condition can take different forms, and skin may appear red, swollen, blistering, flaky, or scaling. Many people experience pain or itchiness. There may also be a burning or stinging sensation. 

Common allergens that trigger allergic contact dermatitis include:

Poison ivy, poison oak, poison sumac, and other plants

Certain metals used to make jewelry such as nickel

Certain medications including antibiotics

Preservatives used in cosmetic products and household products

Symptoms typically take 24-48 hours to develop, though they may appear within minutes or hours of exposure in some cases. You may be more susceptible to the condition if you have sensitive skin or chronic skin issues that aren’t caused by allergies.

It takes time to develop an allergy, and you likely will not have a reaction to an allergen after a single exposure. Many people become more sensitive to an allergen with each subsequent exposure.

If you develop contact dermatitis several times and are unsure of the trigger, keep a diary of potential factors to identify the allergen.

In rare cases, allergic contact dermatitis overlaps with anaphylaxis, a severe and potentially life-threatening reaction that swells the airways and blocks breathing. This reaction may occur within seconds or minutes of exposure to an allergen.

The signs and symptoms of anaphylaxis include:

Respiratory symptoms including wheezing and a persistent cough

In addition, anaphylaxis is frequently accompanied by hypotension, or low blood pressure, defined as blood pressure under 90/60 mm/Hg or a 30% reduction from your baseline blood pressure.

Anaphylaxis must be treated with epinephrine, a hormone and medication used in emergency treatment. Many people with severe allergies carry injectable epinephrine in a pen. If you experience anaphylaxis and do not have epinephrine, go to an emergency room as soon as possible. If you do not have someone to accompany you to the emergency room, call 911 first.

Allergic contact dermatitis vs irritant contact dermatitis

Allergic contact dermatitis is one of two main types of contact dermatitis. Irritant contact dermatitis is a rash that develops quickly in response to a chemical substance, or irritant, including harsh soaps and detergents, hair dyes, certain household products, and acids. 

Symptoms of irritant contact dermatitis are similar to those of allergic contact dermatitis, however the reaction forms more quickly and is often more painful than itchy.

If it is possible to avoid an allergen or irritant, you may be able to identify the trigger of your contact dermatitis and prevent a reaction. If this is not possible, additional steps are often required for an official diagnosis.

If your doctor believes that you may have allergic contact dermatitis, patch testing may be used to identify the underlying cause. During a patch test, you’ll wear adhesive patches containing common allergens known to trigger reactions. Your provider will check your skin after 48 hours and again after an additional 48-96 hours to check for a reaction.

If your doctor is unable to confirm a diagnosis of allergic contact dermatitis after patch testing, they may order a biopsy — a procedure that removes a small sample of your skin — to determine if another condition is responsible for symptoms.

There is not a similar test to diagnose irritant contact dermatitis, but a doctor may be able to identify the triggering irritant based on the chemicals you regularly come into contact with.

Read When to See a Healthcare Specialist for Allergy Treatment

A variety of treatment options may be used to help you manage allergic or irritant contact dermatitis. Individual treatment plans depend on the severity of symptoms.

As a first step, wash irritated skin with mild soap and water after exposure to an allergen to remove traces of it. In mild cases, this may be sufficient to address symptoms.

If symptoms persist, your doctor may recommend one or more of the following treatments:

Moisturizing creams to hydrate and repair irritated skin

Over-the-counter corticosteroid-based creams to ease itching and inflammation

Colloidal oatmeal-based products to ease itching and inflammation

Calamine lotion to ease itching and discomfort

Over-the-counter oral antihistamines such as Benadryl® or Zyrtec®

Oral steroids such as prednisone to relieve symptoms that don’t respond to over-the-counter medication

Additional immunosuppressive medications including JAK inhibitors — which block immune responses to prevent inflammation — and off-label systemic medications including cyclosporine and methotrexate may be used in severe cases that require multiple rounds of oral steroids.

With effective treatment, symptoms of allergic contact dermatitis are typically resolved within two to three weeks. However, to prevent future reactions, it’s important to identify the underlying cause of your symptoms so that you can avoid it.

Managing allergic rashes is easier with a reliable pharmacy partner by your side. Our pharmacists can answer any questions you may have about treatment, and we offer free, same-day delivery and medication management tools like reminders and auto refills in our app.

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

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

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

The HIV prevention medication PrEP — short for pre-exposure prophylaxis — has played a critical role in reducing the number of new HIV infections in recent years. It is highly effective when taken as prescribed every day, lowering the risk of sexual transmission and intravenous drug transmission by 99% and 74%, respectively.

What to Know About PrEP Follow-Up Appointments and Testing

Staying on track with PrEP treatment includes not only taking the medication as prescribed, but also regularly attending all follow-up appointments and completing recommended lab tests. Here’s an overview of ongoing medical care related to PrEP.

Note that PrEP is distinct from PEP — post-exposure prophylaxis — a prevention medication for emergencies and accidental exposures. Learn more about PEP.

If you think PrEP may be right for you, make an appointment with your doctor or other healthcare provider as a first step. (Check with your provider about the possibility of telehealth appointments, if interested.) They can write you a prescription for PrEP and conduct an HIV test, which is required to begin taking the medication.

If you do not have a provider or are unable to get a prescription from your doctor, the following resources can connect you with a provider who will prescribe PrEP for you:

There are several FDA-approved oral medication options — Truvada®, Descovy®,  and a generic for Truvada — and as of December 2021, PrEP is now available as an injectable treatment option called cabotegravir (Apretude®).

For those who find it difficult to remember to take a pill every day, the injectable form may make it easier to stay on track with PrEP treatment. However, oral PrEP continues to offer highly effective prevention for anyone at risk of HIV infection.

Always consult with a doctor if you are interested in switching from one form of PrEP to another.

What is the typical schedule of medical appointments when taking PrEP?

Work with your provider to determine the frequency of your follow-up appointments. A typical schedule often consists of the following:

First follow-up appointment between 2-4 weeks

Ongoing follow-up appointments every three months

What happens at the initial intake appointment?

If you are interested in getting started with PrEP, the first appointment will include an overview of PrEP as well as HIV testing and other lab work. If you qualify for PrEP and can commit to start taking the medication as prescribed, your doctor can write a prescription right away.

The baseline lab work includes the following:

An HIV test, to confirm that you do not have HIV at the beginning of your PrEP treatment

Testing to screen for other sexually transmitted infections (STIs), including chlamydia, gonorrhea, and syphilis

A blood test to measure kidney function (for those prescribed oral PrEP medications)

A blood test to measure cholesterol and triglyceride levels (for those prescribed oral PrEP medications)

What happens at the first follow-up appointment?

Your provider will have you come in for a follow-up appointment between 2-4 weeks. This appointment is an opportunity to discuss your experience with the medication so far, including side effects. It’s also a good time to share any other concerns, such as financial difficulties or medication adherence. Your provider will likely be able to refer you to resources.

What happens at ongoing follow-up appointments?

If you are taking oral PrEP, you will have follow-up appointments every three months. At these appointments, your doctor will:

Conduct an HIV test and assess you for symptoms of acute HIV infection to confirm that you still do not have HIV.

Provide a prescription or refill authorization of daily oral PrEP medication for no more than 90 days.

Discuss any challenges with medication adherence and answer any questions you may have.

Conduct screening for other STIs including syphilis, gonorrhea, or chlamydia.

At the six-month mark, your doctor will likely measure kidney function. (Kidney testing may be more frequent depending on individual health factors.)

They may also ask about your interest in continuing with or stopping the medication. It is important to always consult with a provider before discontinuing or restarting PrEP so that they can evaluate your overall health and review lab work.

What if I have difficulty affording PrEP or related medical care?

PrEP continues to become more accessible. In addition to the availability of generic PrEP options and expanded health insurance coverage of PrEP, the following resources can help lower the costs of HIV prevention medication.

Many states have patient assistance programs to help people with a variety of insurance statuses access PrEP and related medical services at little to no cost. Read our previous blog for more on how to apply for state-funded PrEP assistance programs.

Many medication manufacturers offer patient assistance programs to offset the cost of medication. For example, Gilead, the manufacturer of brand-name Truvada, has the Gilead Advancing Access® program, which offers a copay card for those with insurance and a Medical Assistance Program for those who are uninsured.

The Ready, Set, PrEP program provides PrEP at no cost to eligible individuals without insurance coverage of prescription medications.

Alto is here every step of the way to make it as easy as possible to follow the treatment plan your doctor recommends. Our pharmacists have deep expertise in HIV treatment and prevention and can help you get started with oral PrEP and continue treatment.

We’re available to answer any questions you may have between your follow-up appointments. In addition, we will coordinate with your doctor and your insurance provider, if applicable, to ensure that you’re receiving the best PrEP option for your needs at the best price.

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

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

How to Manage an Overactive Thyroid

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

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

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

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

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

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

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

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

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

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

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

Unintentional weight loss even with increased food intake

Enlarged thyroid gland at the base of your neck

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

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

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

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

Hypothyroidism is also linked to depression.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Other significant contributing factors include:

Thyroid surgery, which can affect hormone production

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

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

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

Age - the condition occurs more frequently in those over 60

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

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

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

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

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

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

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

There are formulations that combine levothyroxine and liothyronine.

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

How to Manage an Overactive or Underactive Thyroid

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

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

What to Know About Arthritis in Children

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

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

Here’s what to know about the causes, symptoms, and treatment options of JIA.

Juvenile idiopathic arthritis affects children and adolescents age 16 and under. It may cause joint pain and inflammation anywhere in the body, but most commonly in the hands, knees, ankles, elbows, and wrists.

If untreated, JIA can lead to health complications, including:

Eye health issues such as cataracts or glaucoma, as JIA can cause inflammation in the eyes

More rarely, issues with the kidneys, heart, or endocrine system

The prognosis of JIA varies by individual. About 50% of children and adolescents with the condition fully recover while others continue to experience arthritis symptoms in adulthood. 

All forms of arthritis including JIA fall under the umbrella of autoimmune diseases. These conditions occur when the immune system mistakenly attacks healthy cells and tissues. With arthritis, the immune system acts on the lining of your joints.

The causes of JIA aren’t fully known (idiopathic means unknown). Genetics likely play a component. Some evidence suggests that some children have a gene that leads to the development of JIA when activated by external factors such as a virus or bacteria.

Symptoms of juvenile idiopathic arthritis

Symptoms of JIA can vary from one child to another. Some individuals experience flare-ups, or periods when symptoms intensify, while others have a more chronic experience of the condition.

Pain and inflammation in the joints, most commonly in the hands, knees, ankles, elbows, and wrists. (For many, this symptom frequently occurs in the morning or after sleeping.)

The process of diagnosing JIA often involves several steps, as symptoms may resemble those of other conditions.

A physical exam is typically the starting point, after which a doctor may recommend one or more of the following blood tests to confirm a diagnosis of JIA: 

Antibody tests such as the antinuclear antibody (ANA) test, which measures blood levels of antibodies linked to rheumatic disease

Tests that check for levels of red and white blood cells and platelets - lower levels of red and white blood cells may be indicative of JIA

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

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

A creatinine test, which checks for kidney disease

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

Imaging tests such as X-rays, CT scans, MRIs, and bone scans may also be used to support a JIA diagnosis.

Treatment for JIA encompasses medications, lifestyle changes, and physical and occupational therapy, with the goal of reducing symptoms and supporting an active life.

Individual treatment plans depend on a child’s symptoms, age, and overall health history.

The following types of medications may be included in a JIA treatment plan:

Nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil®) and naproxen (Aleve®) may be used to reduce pain and inflammation during flare-ups. While these medications are available over the counter, your child may need a prescription for a higher dose.

Oral corticosteroids such as prednisone may also be used to reduce inflammation in children with JIA.

Disease-modifying antirheumatic medicines (DMARDs) such as methotrexate (Rheumatrex®) reduce the immune system’s response to triggers, easing inflammation and controlling JIA symptoms.

Injectable biologic DMARDs — which target more specific pathways in the immune system — are also used in the treatment of JIA, typically after other treatments have proven ineffective. Commonly prescribed biologics include abatacept (Orencia®), adalimumab (Humira®), canakinumab (Ilaris®), etanercept (Enbrel®) and tocilizumab (Actemra®).

Sugars, refined carbohydrates, and gluten can contribute to joint pain and inflammation, so it is often recommended for those with any type of arthritis to reduce their intake of these foods. With JIA, there is the additional consideration of incorporating nutrient-rich foods to support a child’s healthy growth and development. Consider speaking with a nutrition specialist to develop a balanced meal plan.

Regular physical activity is another component of managing JIA. Swimming and other water exercises, yoga, and cycling may be a good fit for children and adolescents with the condition. Physical therapy may be involved in treatment to help a child improve muscle and joint function. 

Lastly, it’s important for a child with JIA to get plenty of rest.

JIA is linked to eye inflammation, which can cause more serious eye problems later in life. Staying on track with regular eye exams can prevent and detect potential problems.

Life with juvenile idiopathic arthritis is easier with a reliable pharmacy partner by your side. Our pharmacists have specialized training in arthritis treatment and can answer any questions you may have, from medication side effects to navigating lifestyle changes.

In addition, we offer free, same-day delivery and medication management tools like reminders and auto refills in our app to make it as simple as possible to stay on track with your treatment.

An asthma attack is an acute flare-up of symptoms defined by sudden shortness of breath and difficulty breathing. Managing asthma attacks includes both proactively responding to symptoms when they arise and staying on track with treatment in the long term. Learn more here.

Treatment and Prevention of Asthma Attacks | Alto Pharmacy

Many individuals with asthma are familiar with the experience of an asthma attack — an acute flare-up of symptoms defined by sudden shortness of breath and difficulty breathing. These exacerbations vary in intensity and require efficient and prompt treatment.

Management of asthma attacks is twofold. To immediately address symptoms in the moment, work with your provider to identify your asthma attack warning signs and establish a treatment strategy. In the longer term, identify and avoid triggers and stay on track with treatment, so as to reduce the frequency and intensity of these flare-ups.

Here’s more on recognizing, treating, and preventing asthma attacks.

Effective management of an asthma attack starts by recognizing the signs and symptoms and understanding what to do when they occur.

While individual experiences of an asthma attack may vary, these are some common signs and symptoms. Your doctor can help you in identifying your individual warning signs of an asthma attack.

The following symptoms of a severe asthma attack warrant immediate medical attention:

Severe breathlessness or wheezing, especially at night or in the early morning

Difficulty speaking due to shortness of breath

No improvement from quick-relief medication

Everyone with asthma should have an asthma action plan that documents their treatment needs, including what steps to take when asthma symptoms intensify. Work with your doctor to create your individual asthma action plan.

If and when you experience a flare-up of asthma symptoms, follow the steps in your treatment plan. If your PEF readings fall between 51% to 79% of your baseline, a common first step is to take quick-relief or “rescue” asthma medications.

These medications are taken on an as-needed basis, as prescribed by your doctor, and relax airway muscles to open the lungs. They relieve shortness of breath and wheezing within minutes and can stop an asthma attack in progress.

Common quick-relief asthma medications include:

Albuterol (ProAir® HFA, Proventil® HFA, and Ventolin® HFA)

Inhalers are the most common form of quick-relief asthma medications. Albuterol and levalbuterol are also available as a liquid solution for nebulizer use.

A quick-relief medication may sufficiently relieve symptoms and improve PEF readings. If symptoms do not improve, emergency medical care may be necessary. Your asthma action plan should help you determine when to seek emergency care.

In many cases, asthma attacks may be preventable. When followed on an ongoing basis, the steps below can help lower your chances of experiencing an asthma attack.

1. Follow your treatment plan and take maintenance medications as prescribed (if applicable).

Many individuals with moderate to severe asthma take long-term maintenance medication in addition to a quick-relief medication.

These medications ease inflammation in the airways, preventing exacerbations and controlling symptoms. You must take them as prescribed every day to experience their benefits.

There are two main types of long-term asthma control medications:

Inhaled corticosteroids including Flovent® HFA and Qvar Redihaler® 

Blog

Common Treatments for Allergic Rashes

What to Know About PrEP Follow-Up Appointments and Testing

How to Manage an Overactive or Underactive Thyroid

What to Know About Arthritis in Children

Treatment and Prevention of Asthma Attacks

Psoriasis, Explained

Endometriosis: A Leading and Treatable Cause of Female Infertility

Understanding the Diabetes-Heart Health Connection

How to Improve Indoor Air Quality at Home

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

Choosing the Right Birth Control for You

Osteoporosis, Explained

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