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

Understanding Rheumatoid Arthritis

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.

Vaccines — which were first developed in 1796 for smallpox and continue to evolve with new research and technology — build on your immune system’s natural function to protect you from serious diseases. Just like white blood cells and the other components of your immune system, vaccines help you develop immunity, but without the initial illness and risk of health complications. Here’s a look at how vaccines work.

The Science Behind Vaccines

Your immune system has a natural way of defending you from the viruses and bacteria that cause illness. As these germs multiply rapidly and infect your body, an army of white blood cells fights back, producing antibodies that attack the invaders.

The first time you are infected by a specific virus or bacteria, your immune system often cannot destroy the germ quickly enough to prevent you from becoming sick. After you’ve recovered, certain immune cells hold onto the memory of the infection. This allows them to mobilize quickly if they encounter the same germ again, preventing illness in the future. Immunity, your body’s resistance to certain types of infection, is the outcome of this process.

To understand how vaccines work, it’s helpful to know how your immune system naturally fights an infection. B-lymphocyte white blood cells produce blood proteins called antibodies, which attack antigens — the part of the invading germ that triggers an immune response. T-lymphocyte white blood cells attack already infected cells in the body. After the infection has ended, a few T-lymphocytes, or memory cells, remain to ensure a fast immune response should the same germ reappear.

Vaccines imitate infections, triggering the process of building immunity to a specific disease without causing illness. Your immune system responds to these imitation infections the same way it would to an actual infection. Detecting antigens from the vaccine, your immune system produces antibodies and T-lymphocyte cells. The imitation infection leaves your body with T-lymphocyte memory cells and B-lymphocytes, which will know how to quickly fight that antigen in the future. This prevents you from becoming sick if you are exposed to the virus or bacteria that cause the disease.

It typically takes several weeks for your body to produce T-lymphocyte and B-lymphocyte cells in response to a vaccine, which is why in most cases you will not immediately develop immunity. This means that you could become infected with a disease and develop symptoms shortly after vaccination, so it’s important to take necessary precautions until you become fully immune to the virus or bacteria. The healthcare professional administering your vaccine will inform you of the anticipated timeline for immunity.

Sometimes the imitation infection created by a vaccine causes mild symptoms such as a fever. These side effects are normal and indicate that your body is building immunity.

While all vaccines arrive at the end result of immunity, there are several paths for getting there. When deciding which type of vaccine to create for a disease, researchers consider a variety of factors, including the immune system’s response to the germ that causes the disease, the population likely to receive the vaccine, and the regions of the world where it will be used. These are the seven types of vaccines commonly used in the U.S.

Live vaccines use a weakened version of the living virus or bacteria that causes a disease. They are most similar to the natural infection and produce long-lasting immunity. The weakened form of the germ does not lead to serious disease, like that caused by the wild form of the germ, for most individuals with strong immune systems. However, live vaccines aren’t safe for those who are immunocompromised, including children undergoing cancer treatment. Examples of live vaccines include the measles, mumps, and rubella (MMR) vaccine and the chickenpox vaccine.

Inactivated vaccines are produced by inactivating, or killing, the germ that causes a disease. Examples include the polio, hepatitis A, and flu vaccines. They don’t provide as strong of immunity as live vaccines, so additional doses, also referred to as booster shots, are often needed for ongoing protection.

Toxoid vaccines target a toxin, a harmful substance produced by a germ, rather than the entire germ itself. They contain a weakened version of the toxin to be targeted called a toxoid, which teaches your immune system how to fight off the natural toxin. Similar to the germs used in live vaccines, toxoids are weakened to a point where they do not cause illness. These vaccines are used to prevent diseases caused by toxin-producing bacteria such as diphtheria and tetanus.

Subunit vaccines use portions of a virus or bacteria called subunits rather than the entire germ. Vaccines for diphtheria, tetanus, and pertussis, or whooping cough, are combined into the DTaP vaccine. The pertussis component is a subunit vaccine.

Conjugate vaccines fight a specific type of bacteria whose antigens are more difficult for a child’s immune system to detect due to their outer coating. The vaccines link the coating to stronger antigens that the immune system can more easily respond to. Like subunit vaccines, these vaccines are more targeted and only use part of the germ. Examples of conjugate vaccines include the haemophilus influenzae type B (Hib) vaccine.

Viral vector vaccines produce immunity to a virus by using a modified version of a different virus to deliver instructions to your immune cells. The modified version of the other virus is referred to as a vector virus. Recent Ebola vaccines have used this technology, and the Johnson & Johnson COVID-19 vaccine is also a viral vector vaccine.

mRNA vaccines help your body produce a protein that triggers an immune response and the development of antibodies. This technology was used to create the Pfizer-BioNTech and Moderna COVID-19 vaccines.

Read ‘What the COVID-19 Vaccine Means for Those With HIV’

All vaccines in the United States require approval by the Food and Drug Administration (FDA) and are held to rigorous safety and effectiveness standards. The vaccine approval process starts with lab tests, which may take years in some cases. The FDA analyzes the results to determine if the vaccine should be tested with people. If the vaccine moves forward, the next step is clinical trials where the vaccine is tested on volunteers.

Clinical trials typically begin with a smaller group of 20 to 100 volunteers before including thousands more. The trials gather information about vaccine safety, the typical immune response, and dosing. If any safety concerns emerge during this stage, the FDA must address them before it can authorize the vaccine.

Vaccine manufacturers are required to continuously monitor vaccine safety after approval and test every batch produced to ensure effectiveness, quality, and purity. These test results are reviewed by the FDA, which also conducts an inspection of the factory where the vaccine was produced. If you experience severe side effects after vaccination, contact your healthcare provider so that they can report potential concerns to the Centers for Disease Control and Prevention (CDC)’s vaccine monitoring database.

COVID-19 mRNA vaccines were developed and approved more quickly than a typical vaccine given the urgent nature of the pandemic. This expedited timeline was made possible by significant investment from governments and companies in the vaccine development process and decades of research on mRNA vaccine technology. These vaccines were as thoroughly vetted for quality and safety as any other vaccine.

Many vaccines are received during childhood, like the polio, chickenpox, and MMR vaccines, but there are others you may need as an adult. The CDC recommends the zoster vaccine, which prevents shingles, for adults ages 50 and older and the pneumonia vaccine for those over 65. Other vaccines may be recommended based on additional factors including job or school requirements, travel, and health conditions. Check in with your doctor about which vaccines you need.

The CDC also recommends an annual flu vaccine for everyone 6 months and older. New versions of flu vaccines are developed annually in anticipation of circulating flu virus strains, so health experts recommend getting one every year to prepare for cold and flu season. It’s especially important to be proactive about flu vaccination if you are over the age of 65 or have a chronic condition such as COPD or diabetes.

For detailed vaccine recommendations by age group, reference the CDC’s recommended immunization schedules for children and adolescents and adults.

At Alto, a pharmacist is your partner in health. If you take medication, we will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to make your medications as affordable as possible. And our team of pharmacists is available to chat whenever questions come up. 

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

From vigilant hand-washing to getting enough vitamin C and D, here are a few ways to give yourself an immunity boost in advance of cold and flu season.

How to Prepare for Cold and Flu Season

The leaves are turning and the days are getting shorter, which means it’s time to start preparing for cold and flu season. The flu — shorthand for influenza — is a respiratory illness caused by viruses that affect your nose, throat, and lungs. In the U.S. and the rest of the Northern Hemisphere, flu cases typically ramp up toward the end of October and peak between December and February.

One reason the flu spreads more easily during the winter months is that cold air protects the virus as it travels through the air in the form of tiny droplets. The other main reason is that people socialize indoors more frequently, where it’s easier for the flu to spread when someone affected by the virus coughs or sneezes.

The good news is that there are simple steps you can take to strengthen your immunity. From vigilant hand-washing to getting enough vitamin C and D, here are a few ways to give yourself an immunity boost in advance of cold and flu season.

The number one thing you can do to protect your health and that of your loved ones is to get an annual flu shot, which will prompt your immune system to create antibodies that will defend you against the flu. Medical experts recommend getting the vaccine each and every year. every year.

Keep in mind it can take up to two weeks for the antibodies to provide sufficient protection. Given that flu season often peaks around December, the best time to get vaccinated is during September and October, and ideally no later than the end of October.

The flu can cause more serious health problems for people over the age of 65 and individuals living with chronic conditions such as COPD or diabetes, so it’s even more important to be proactive about flu vaccination if you fall into one of these groups.

Good personal hygiene can lower your risk of getting the cold or flu and spreading it to others. Practice simple preventative measures like frequently washing your hands, disinfecting frequently touched surfaces, and keeping a healthy distance from anyone who isn’t feeling well.

And yes, there is a “right way” to wash your hands when it comes to cold and flu prevention. The CDC recommends following the simple steps below to stay healthy and avoid spreading germs.

1. Wet your hands with warm or cold running water and apply soap.

2. Lather your hands, including the backs of your hands, between your fingers, and beneath your nails. 

3. Scrub your hands for at least 20 seconds. (Singing “Happy Birthday” twice is one option for timing yourself.)

Get a good night’s sleep and regular exercise

Your body is better prepared to defend against infectious diseases when it’s well-rested. Research has found that sleep can strengthen your T cells’ ability to help you fight infection. (T cells are a specific type of white blood cell and an important part of your immune system.)

To strengthen your immunity, aim for 7 to 9 hours every night. If you’re having difficulty falling asleep or sleeping through the night, there are some steps you can take to improve the quality of your sleep. Try to follow a consistent schedule: go to bed at the same time each night and wake up at the same time each morning, even on the weekends. And avoid consuming heavy meals or caffeine or using electronic devices close to your bedtime.

Staying physically active can also help you sleep better. In fact, exercise may boost your immunity in other ways, too, such as increasing your circulation, which helps white blood cells and antibodies travel to parts of your body where they’re needed. 

Studies have found that U.S. adults tend to exercise less during winter and fall than they do during spring and summer, so be sure that your calendar can still accommodate your fitness routine during the colder months. Whether you explore virtual workout classes or bundle up to brave the cold, aim for about 150 minutes of exercise a week or 30 minutes per day.

Your dietary choices can strengthen your immune system, not only during cold and flu season but all year round. 

Probiotics are tiny organisms that can help you maintain a healthy balance of bacteria in your digestive system, which will also support your immune system. Fermented foods like kimchi, sauerkraut, and kefir all contain live probiotics, as does greek yogurt. In addition, legumes like chickpeas and lentils contain prebiotics, a type of fiber consumed by probiotics which also contributes to a healthy digestive system.

Oranges, tomatoes, and spinach each offer up plenty of Vitamin C, a powerful nutrient with many health benefits, including the ability to boost immunity and fight inflammation.

You’re automatically exposed to Vitamin D — another crucial immunity-related nutrient — on hot, sunny days, but during winter, it’s extra important to add it to your diet. Sources of Vitamin D include egg yolks, mushrooms, canned tuna, and salmon, which also contains other immunity-boosting nutrients like zinc and omega-3 fatty acids. There is evidence that taking Vitamin D daily can significantly lower your risk of getting sick with the cold or flu, and you may also consider taking Vitamin D supplements.

Lastly, if you’re feeling under the weather, be sure to drink 6-8 cups of water a day, as you can become dehydrated more easily when sick.

When you’re chronically stressed, your body releases a hormone called cortisol very frequently. Cortisol helps the body fight inflammation and infection, but its continual release can lessen its effectiveness as part of your immune system. 

Some degree of stress is inevitable, but there are healthy ways to keep it under control, like practicing meditation, exercising, and staying connected to family and friends. If stressors at work or at home feel difficult to manage, your primary care provider can help you find mental health resources. 

In addition, check out 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.

We’re here to help you navigate this year’s cold and flu season

We hope that the immunity-boosting tips above will help you enjoy a healthy fall and winter. If you do develop flu symptoms, remember to keep others safe by staying home and reporting your symptoms to a doctor as soon as possible (ideally within 48 hours to reduce the severity and duration of your illness). And with a strong immune system, you’re likely to be on the mend in no time at all.

Many mild cases of the cold or flu can often be treated with rest and extra self-care, but if your doctor prescribes an antiviral medication, we’ll hand-deliver it to your door for free. 

Proactively managing COPD with medication and lifestyle changes can help prevent periods of intensified symptoms, referred to as exacerbations or flare-ups. Here’s more on how to recognize, treat, and prevent COPD flare-ups.

How to Manage and Prevent a COPD Flare-Up

Proactively managing chronic obstructive pulmonary disease (COPD) with medication and lifestyle changes can help slow the progression of the chronic lung disease and prevent periods of intensified COPD symptoms, commonly referred to as exacerbations or flare-ups. 

However, these flare-ups may occur even when closely following your doctor’s individualized treatment plan, especially during the more advanced stages of COPD, so it’s important to have a plan in place to quickly address symptoms. Here’s more on how to recognize, treat, and prevent COPD flare-ups.

Recognizing the symptoms of a COPD flare-up

During a COPD flare-up, symptoms like shortness of breath and wheezing quickly intensify and lung function significantly changes. (Lung function refers to how well your lungs work, specifically how much air they can hold and how easy it is for them to empty air.)

Individual experiences of a COPD flare-up may vary, but many people often notice greater amounts of mucus clogging the bronchial tubes in their lungs and sudden tightening of muscles around their airways. Here are key signs and symptoms to be aware of.

More frequent or more intense coughing, wheezing, or shortness of breath

Changes in the color, thickness, or amount of mucus

Using more oxygen than usual, if your treatment plan includes supplemental oxygen

If you experience any of the symptoms above, the best step is to call your doctor right away. Each COPD flare-up can affect your long-term lung function, so it’s important to address symptoms as quickly as possible.

To effectively manage a COPD flare-up, you’ll want to create a COPD action plan with your doctor. Then, if you experience the signs of a flare-up, you’ll have a specific outline of the actions and medications that can help restore your breathing. Here are some of the medications your doctor may include in your individualized COPD treatment plan.

Short-acting medications like bronchodilators relax your airway muscles and open your lungs to quickly reduce discomfort. Albuterol (branded options include ProAir® HFA, Proventil® HFA, Ventolin® HFA) is commonly used to treat COPD exacerbations. This medication is typically taken through an inhaler, but can also be taken as a liquid solution for nebulizer use. (A nebulizer is a device that turns a liquid medication into a mist that you can inhale through a face mask. It allows the medication to travel quickly to your lungs.)

Although not common, potential side effects of bronchodilators include nervousness or shakiness, headache, throat or nasal irritation, and muscle aches. Your doctor can explain more about the risks and benefits of using a bronchodilator to treat COPD exacerbations when building your treatment plan.

Your doctor may also recommend oral corticosteroids, which are fast-acting medications that reduce swelling in your lungs and open your airways so that more air can move in and out of your lungs. They are primarily prescribed for short-term use, typically five to seven days.

Oral corticosteroids commonly used to treat COPD exacerbations include:

Prednisone (Prednisone Intensol®, Rayos®)

Some people experience mild side effects from short-term corticosteroid use, including swollen hands and feet, elevated blood pressure, increased appetite, and shifts in mood.

Many people with more advanced COPD use supplemental oxygen to increase their tolerance for physical activities, while others use it only to relieve shortness of breath during an exacerbation.

If your flare-up is more mild, you may take oxygen at home. When writing your prescription for oxygen therapy, your doctor will explain how and when to use the oxygen. It is important to follow all of your doctor’s instructions, including the flow rate setting (how much oxygen you’ll need per minute). The American Lung Association has resources for anyone starting oxygen therapy.

If your COPD has progressed to a later stage, some flare-ups may require treatment in a hospital setting. This allows healthcare professionals to more closely observe your symptoms and monitor vital signs like your pulse, temperature, and blood pressure. Consult with your doctor about specific symptoms to look out for that may indicate a need for more intensive treatment or monitoring.

How to lower your risk of COPD exacerbations

There are many steps you can take to lower your risk of a COPD exacerbation and reduce the frequency of COPD-related hospitalizations.

First, it’s important to closely follow your doctor’s recommendations, including taking any maintenance medications exactly as prescribed. (We designed our app to make it as simple as possible to do so, with medication management tools like reminders and auto refills that help you stay on track.)

In addition, try to limit your exposure to leading triggers of COPD exacerbations, including cigarette smoke (this includes secondhand smoke), indoor and outdoor air pollution, cold air, and household dust.

To keep the air inside your home as clean as possible, avoid perfumes and cleaning and hygiene products with strong odors. Use air purifiers and vacuum cleaners with a high-efficiency particulate air (HEPA) filter.

Lastly, the flu and pneumonia can worsen COPD symptoms and potentially lead to a flare-up, so it’s important to get your yearly flu shot and ask your doctor or pharmacist if you are eligible for the pneumonia vaccine.

We’re here to support your COPD treatment

COPD flare-ups can cause discomfort, but we’re here every step of the way to help you manage symptoms and get the medications you need, with free same-day delivery and easy-to-use medication management reminders in our app.

And our team of pharmacists are always here to answer your questions by phone or through the Alto app. Reach out any time by phone at 1-800-874-5881 or in-app messaging.

Practicing preventative health is critical to detecting health issues early on, when they are more treatable, and lowering your risk of developing conditions that are otherwise avoidable.

Prioritize Your Health with Preventative Care

If you’ve ever waited until you’re sick to see a doctor, you’re not alone. Many adults in the U.S. put off routine doctor’s appointments — sometimes even when they don’t feel well. 

These delays can be serious: according to the Centers for Disease Control and Prevention, up to 40% of all fatalities linked to the five leading causes of death in the U.S. — heart disease, cancer, chronic lower respiratory diseases, stroke, and unintentional injuries — could have been prevented. Untreated blood pressure or cholesterol and unhealthy lifestyle habits factors heavily into many of these cases.

Practicing preventative health is critical to detecting health issues early on, when they are more treatable, and lowering your risk of developing conditions that are otherwise avoidable. Preventative care involves a combination of annual check-ups, vaccinations, screenings, and healthy lifestyle habits. 

If you haven’t been to the doctor in a while, don’t get discouraged. The important thing is to get back in the habit. Below is an overview of preventative care for both men and women, with recommendations from our pharmacists for how to ensure you’re prioritizing your health.

There are several important numbers that help your doctor understand your risk for health conditions such as heart disease and diabetes: your body mass index (BMI), blood pressure, cholesterol, and glucose levels.

Being overweight or obese increases your risk for many different health conditions, including high blood pressure, unhealthy cholesterol levels, type 2 diabetes, heart disease, and stroke. 

Body mass index (BMI) is a screening tool that doctors use for obesity. A healthy BMI is typically between 18.5 to 24.9, while a BMI between 25 to 29.9 is considered overweight and a BMI of 30 or higher is obese.

Keep in mind that while a BMI does help doctors understand your general risk for the chronic conditions mentioned above, it is merely a snapshot of your health and doesn’t account for other important health factors including age and genetics. Your healthcare provider can help you understand your overall priorities with preventative care beyond any single number, which is another important reason to stay up to date with doctor’s appointments.

Your blood pressure numbers are one of several factors that can help your doctor predict your risk for heart disease and cardiac events like a heart attack or stroke. There are five different blood pressure ranges recognized by the American Heart Association:

If your blood pressure is in the normal range, you should get screened at least once per year. If your blood pressure is in a higher range, consult with your doctor about recommended screening frequency.

Read our previous blog to learn more about managing blood pressure.

A cholesterol blood test, also called a lipid profile or lipid panel, gives results for several different readings: HDL (good) cholesterol, LDL (bad) cholesterol, triglycerides, and total blood (or serum) cholesterol. Your total cholesterol and HDL cholesterol levels are particularly important in helping your doctor identify if you are at risk for a heart attack or stroke.

A healthy range for total cholesterol is considered to be less than 200 mg/dL

A healthy range for HDL cholesterol is considered to be higher than 40 mg/dL for men and higher than 50 mg/dL for women

A healthy range for LDL cholesterol is considered to be less than 100 mg/dL

These targets are intended to be general guidelines, and each individual’s health needs are different. Having type 2 diabetes, smoking, being overweight, and not getting enough physical activity can affect your cholesterol levels. Your healthcare provider can help you determine your personal targets.

If your total cholesterol is under 200 mg/dL, you can have your cholesterol checked every 4-6 years. If you are at higher risk for heart disease and stroke, consult your doctor about recommended screening frequency.

Your blood glucose numbers can help your doctor determine if you have diabetes or are at risk for developing it. A blood sugar level under 140 mg/dL (7.8 mmol/L) is typical considered healthy, while a reading between 140 and 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) may indicate prediabetes and a reading over 200 mg/dL may indicate diabetes. A discussion of these numbers with your healthcare provider is required for an official diagnosis of diabetes.

Generally speaking, if your blood glucose numbers are under 140 mg/dL, you should get screened at least every three years. If you have prediabetes you will need more frequent screening.

If you have diabetes, your healthcare provider can help you develop individualized targets for healthy blood sugar levels, which may be different from the numbers above. Try not to worry about what “normal” looks like for other people, and focus instead on taking simple actions to control your diabetes and live your healthiest life, like staying active and quitting unhealthy habits.

You should have an annual check-up once per calendar year. This appointment is the foundation of preventative care: since each individual’s risk for specific preventable health conditions may vary, discussing your personal health history and vital signs with your doctor will help you determine which preventative measures to prioritize.

In addition to checking with your physician about which vaccines, screenings, and medical tests you need, ask if your family history indicates an increased risk for any health conditions.

Prevention and screening become more important as you age. Regular colorectal cancer screening is recommended for everyone 50 and over. If you have risk factors like an immediate family member with colorectal cancer, your doctor may suggest earlier screening.

The American Cancer Society recommends annual mammograms for all women between 45 and 54. Some women begin screening for breast cancer as early as age 40 depending on their risk and family history. Women 55 and older can continue with yearly mammograms or switch to every two years. Your doctor can help you determine the right screening frequency for your individual needs. 

Preventative health doesn’t just happen in your doctor’s office. Everyday choices like what you eat and how often you exercise can protect your health for years to come.

Staying active is one of the most important things you can do to prevent cardiovascular disease and maintain a healthy weight. If you’re just starting to figure out your ideal exercise routine, know that you don’t have to exert yourself too hard to reap the benefits of physical activity. Even just 30 minutes of moderate exercise most days of the week can help strengthen your heart.

Everyone should do their best to limit their intake of the following foods, but it’s especially important if you face a greater risk for heart disease or diabetes:

Saturated and trans fats, which can raise your cholesterol

Sodium, which may increase your blood pressure

Sweets and sugar-sweetened beverages, which have been linked to both type 2 diabetes and an increased risk for heart disease

Other things you can do to stay healthy? Chronic stress can elevate your blood pressure, putting you at a greater risk for heart attack and stroke, so try to manage stress in heart-healthy ways like getting enough sleep, maintaining a fulfilling social life, and practicing mindfulness and gratitude. And it’s never a bad time to cut back on your alcohol consumption and quit smoking, if you currently smoke.

Prioritizing your physical and mental well-being today can help you prevent health issues in the future. We’re here to help make that as simple as possible.

At Alto, a pharmacist is your partner in health. If you take medication, we will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to make your medications as affordable as possible. And our team of patient care pharmacists is available to chat whenever questions come up. Reach out through our in-app messaging or by phone at 1-800-874-5881.

While there is no cure for pulmonary fibrosis, a combination of medications, oxygen therapy, and active lifestyle choices can slow the progression of the disease and reduce discomfort.

Pulmonary Fibrosis: What to Know About Symptoms and Treatment

Pulmonary fibrosis is a progressive, long-term lung disease in which the lungs become scarred, making it difficult to breathe. Though less common than other lung diseases, pulmonary fibrosis can lead to serious complications like pulmonary hypertension, respiratory failure, and lung cancer, so early detection and proactive monitoring of symptoms is critical.

While there is no cure for pulmonary fibrosis, a combination of medications, oxygen therapy, and active lifestyle choices can slow the progression of the disease and reduce discomfort. Read on to learn more about pulmonary fibrosis, including how to recognize and treat pulmonary fibrosis symptoms.

Pulmonary fibrosis scars and thickens the connecting tissue in the lungs and alveoli, which are delicate air sacs that transport oxygen into your bloodstream. Over time, the lung tissues grow thicker and it becomes more difficult for the alveoli to deliver oxygen into the body, making it increasingly challenging to breathe. As the disease progresses, you may experience shortness of breath more frequently during everyday activities.

The development of pulmonary fibrosis varies significantly in individuals. For some people, symptoms arise very quickly. For others, they may take years to develop.

While the severity of pulmonary fibrosis symptoms vary from one person to another, there are some common symptoms:

Widening and rounding of the tips of the fingers or toes

Some people with pulmonary fibrosis experience acute flare-ups in which symptoms such as shortness of breath intensify for several days up to several weeks. Medications including antibiotics and corticosteroids, which ease swelling and inflammation, may be used to treat these sudden spikes. Some people may also be placed on a ventilator during these flare-ups to assist with breathing.

As with COPD, smoking increases your risk of developing pulmonary fibrosis, but so do other factors like long-term exposure to pollutants and toxins, certain medical conditions and medications, and radiation therapy. Below are the most common risk factors for pulmonary fibrosis.

The aging of the lungs has been linked to higher susceptibility for respiratory diseases. While pulmonary fibrosis can affect infants and children, it primarily occurs in middle-aged and older adults. Most people with the condition develop it between ages 50 and 70.

While it’s possible for a non-smoker to develop the condition, pulmonary fibrosis is far more common in smokers. It may occur in people who also have emphysema, a lung disease that falls under the umbrella of COPD.

Jobs in mining, farming, and construction often involve long-term exposure to toxins such as silica dust, asbestos fibers, hard metal dusts, coal dust, and bird and animal droppings that damage the lungs. If you work in these fields, you may have a greater risk of developing pulmonary fibrosis.

While pulmonary fibrosis cases in women have increased in recent years, it continues to affect more men than women overall. This may be due in part to the fact that men are more likely than women to smoke and to work in the professional fields linked to pulmonary fibrosis.

Radiation treatments for lung cancer and breast cancer and certain chemotherapy drugs, including methotrexate and cyclophosphamide, may increase your risk of developing pulmonary fibrosis.

The extent of the damage to the lungs during radiation treatments depends on the following factors:

How much of the lung was exposed to radiation

In rare cases, other medications have been linked to pulmonary fibrosis, including heart medications like amiodarone, antibiotics like nitrofurantoin and ethambutol, and anti-inflammatory medications like rituximab and sulfasalazine. If you take any of these medications and have concerns, consult with your healthcare provider about potential risks. Be sure to follow your doctor’s recommendations, as abruptly stopping the use of a medication can be dangerous.

Researchers believe that there may be a genetic component to certain types of pulmonary fibrosis, as a small percentage of people living with the condition have at least one other affected relative. Research into possible genetic influences is ongoing. If someone in your family has had pulmonary fibrosis, speak with your doctor about your risk. They may refer you to a genetic counselor.

To determine if you have pulmonary fibrosis, your healthcare provider will ask about your medical history and conduct a physical exam to evaluate symptoms. They may use a stethoscope to listen for abnormal sounds such as crackling when you breathe.

It can be challenging to diagnose pulmonary fibrosis since symptoms overlap with those of other lung diseases. Your doctor may order additional tests, such as blood and imaging tests, pulmonary function tests, and, in some cases, a biopsy to rule out other illnesses and confirm a pulmonary fibrosis diagnosis.

There are a variety of treatment options to alleviate your pulmonary fibrosis symptoms and help you maintain a healthy and active life. Your doctor may recommend one or more of the following common treatments.

There are two primary medications that slow the progression of lung scarring and preserve lung function: pirfenidone (Esbriet®) and nintedanib (OFEV®). Both medications are similarly effective at treating symptoms and improving lung capacity.

Common side effects of pirfenidone include:

Difficulty falling asleep or staying asleep

Common side effects of nintedanib include:

Consult with your healthcare provider about the potential risks and benefits of treating pulmonary fibrosis with pirfenidone or nintedanib, and make sure they are aware of any other medications you take.

Oxygen therapy transports more oxygen into your lungs, increasing your tolerance for physical activity and helping you stay active. It can be administered in a hospital during flare-ups or at home. If you have a home oxygen delivery system, your doctor will likely also prescribe a portable device to use when you are on the go. There are different devices for oxygen therapy. Your doctor will recommend one based on several factors including lung function and lifestyle.

Pulmonary rehabilitation is a program of education and exercise classes, typically in a group setting, aimed at improving lung function and reducing symptoms. In these programs, nurses and respiratory therapists share important information about managing pulmonary fibrosis and teach you how to conserve your energy and increase your level of fitness.

A lung transplant, in which a damaged lung is replaced with a healthy lung from a donor, is a treatment option for some individuals with pulmonary fibrosis. While it can improve your breathing capacity and tolerance for physical activity, a lung transplant is a major procedure with risks of complications. 

In determining if you are eligible for a lung transplant, your healthcare provider will consider multiple factors such as whether you are in overall good physical health aside from your pulmonary fibrosis and if you have any other life-threatening conditions.

Pulmonary fibrosis can make it difficult to recover from other infections, so it’s important to take steps to boost your immunity and avoid getting sick. In addition to practicing good hygiene and maintaining a healthy distance from anyone who’s sick, stay current on your annual pneumonia and flu vaccinations, and practice healthy habits like staying active, eating well, and avoiding cigarette smoke.

How Alto can support your pulmonary fibrosis treatment

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

Reach out via phone at 1-800-874-5881 or in-app messaging to learn how Alto can support your pulmonary fibrosis treatment plan.

Chronic obstructive pulmonary disease (COPD) is a progressive and long-term inflammatory lung condition characterized by a persistent cough and shortness of breath. Read on to learn more about the stages of COPD, including the symptoms and treatment options for each stage.

What to Know About the Four Stages of COPD

Chronic obstructive pulmonary disease (COPD) is a progressive and long-term inflammatory lung condition characterized by a persistent cough and shortness of breath. While COPD is caused by smoking 85-90% of the time, exposure to secondhand smoke, air pollution, and industrial dust and fumes also contributes to cases. It’s the third leading cause of death in the U.S. and affects more than 15 million Americans.

Detecting COPD early on is critical to slowing the progression of the disease and avoiding serious complications. Doctors use a system called the GOLD Criteria to determine how severe each person’s COPD is. There are four distinct stages of COPD: mild, moderate, severe, and very severe. Your physician will determine your stage based on results from a breathing test called a spirometry, which assesses lung function by measuring how much air you can breathe in and out and how quickly and easily you can exhale. They will also consider the severity of your symptoms and the frequency of flare-ups.

As a progressive lung disease, COPD symptoms gradually become more severe over time, and people with COPD also grow increasingly susceptible to complications such as heart problems, pulmonary hypertension, and lung cancer. But while there is no cure for the condition, it is treatable: you can slow the progression by working with your doctor to establish a treatment plan and maintaining healthy lifestyle habits like avoiding cigarette smoke, exercising regularly, eating a healthy diet, and getting your yearly flu shot.

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