Expires 06/01/2021

Specialty Pharmacy

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Alto Pharmacy Technician

Alto Pharmacist

At Alto, we’re obsessed withour missionto improve quality of life for everyone who needs the help of medicine. Our mission guides us in all we do and every decision we make. 

Services that reduce travel and encourage social distancing are now more essential than ever, not only for vulnerable populations but all of us as members of our communities. Alto’s free same-day doorstep delivery ensures you have safe and reliable access to medications in this time of uncertainty. 

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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. 

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 what you need to know about potential changes to your coverage when your plan updates on January 1st. 

What You Need to Know About Your Insurance in the New Year

With a new year comes new insurance benefits, copay costs, and deductible resets. Here’s what you need to know about potential changes to your coverage when your plan updates on January 1st. 

It is common for insurance companies to adjust their rates and offerings each year and then allow people to select new plans or renew their current coverage. The process enables insurers to update their plans based on inflation, the introduction of new medications, and other market changes. It also provides each of us an opportunity to assess and adapt our health insurance needs every year. 

If you had health insurance this past year, you likely went through an “open enrollment” period in the fall. During that time, you learned how your plan was changing and which key benefits would continue. You then had the opportunity to renew your current plan for another year or switch to a new option altogether. 

Why are insurance renewals important right now?

Most health insurance plans operate on a calendar year, meaning any changes take effect on January 1st. We recommend reviewing any recent changes to your plan to avoid unwelcome surprises later in the year. 

Which insurance updates might impact me the most?

As you review your yearly changes, you’ll want to make special note of the following, as these updates could affect your budget: 

Your premium is the cost of your health insurance plan each month. It’s common for your premium to change slightly from year to year, so be sure to double-check if yours is going up.

Your deductible is the amount you have to pay for healthcare services before your insurance starts to help cover the costs. For example, if your deductible is $2,500, you will need to pay that amount for covered services on your own before your copay kicks in. Your deductible resets at the beginning of the year, which could mean a significant uptick in your healthcare expenses until you spend enough to cover your deductible. Make sure to budget accordingly. 

Your copays and coinsurance—the amount you’ll owe for healthcare services after you’ve exceeded your deductible—may also change. Different types of health services can have different copays, so look closely at the ones you think you’ll use most often. 

A formulary is a list of generic and brand-name medications that are covered by your insurance company. The list includes tiers that indicate which medication versions are preferred by your insurer and therefore offered at a lower out-of-pocket cost for you. 

If you have current prescriptions, you’ll want to make sure that your plan still covers your specific medications. You may also want to find out if there is a cheaper version of your medication available that you can discuss with your healthcare provider. If you fill your prescription with Alto, we’d be happy to investigate the options for you and let you know if there are alternatives that could lower your costs. 

For more on decoding common insurance terms, we recommend this helpful glossary from JDRF. 

What can I do if I find out my medications are more expensive?

Combing through insurance updates can be confusing, especially if you discover that you have to pay more for your medications this year. If copay changes and deductible resets affect your out-of-pocket expenses, we’ll search for any available savings, so you’ll know you’re getting the lowest price. 

If your insurance company requires a written request from your doctor to keep you on the same medication because of formulary tier changes, we’ll work with your doctor to proactively file the paperwork. Plus, we’ll keep you informed the whole way. 

Read more about prior authorizations and how we can help here. 

Yes! Your updated health insurance plan may come with new benefits that can save you money and enhance your health. Look for bonus perks like free annual exams and preventative care; discounts on fitness and nutrition programs, gym memberships, chiropractic care, and massage; savings on health products; and reduced vision care rates. Often, people forget to use these benefits, which can mean money left on the table.

As you make your health plan for the coming year, don’t forget the benefits of choosing a better pharmacy. With a simple switch to Alto, you’ll get insurance support, price investigations, and your medications hand-delivered for free. Plus, you can call or text our pharmacists any time for quick advice. If 2020 saw you waiting in line or on hold to access pharmacy support, let this be the year that the care you need comes directly to you.

Ready to switch to a better pharmacy? Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; reach out via phone, text, or the app.

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

Managing the Costs of Fertility Treatment

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

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

If You Have Health Insurance, Start There

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

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

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

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

There are also companies that provide personal loans specifically for fertility treatments, with flexible monthly payment options. At Alto, we’ve worked with companies like Lending Club and CapExMD to help our customers get the fertility medications they need. Most companies allow you to apply online and some even provide budgeting tools on their websites so you can get an idea of what your monthly payments might be. 

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

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

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

If you’re uninsured, we can help you apply for income-based assistance programs like the Compassionate Care Program, which could help you save up to 75% off your fertility medications if you qualify. Even if you are still in the planning stages of your fertility journey, the earlier you can apply to the program, the better. Ideally, you will want to have approval before your fertility prescriptions are sent to your pharmacy. 

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

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

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

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

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

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

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

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

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

Would you like to learn more about how Alto can help you manage your fertility treatment costs? Visit alto.com/fertility or give us a call at 1-800-874-5881. Our team is available 9 am - 9 pm PT Monday - Friday, and 10 am - 6 pm PT on weekends. We’re ready to be your partner through it all, from your first cycle to your last. 

At Alto, we believe that staying on top of your health should be as simple as possible. Here’s how we’re applying this philosophy to feeling our best this winter and creating healthy habits that we can cultivate all year long. 

Alto’s Guide to Wellness in the New Year

It’s easy to feel jaded about setting health goals for the new year. We often enter January with optimism and big intentions, only to find our new habits slipping within days or weeks. But let’s not give up on our health goals altogether. The sense of renewal at the start of the year can be a powerful motivator—provided we don’t saddle ourselves with unreasonable expectations and an “all-or-nothing” attitude. 

At Alto, we believe that staying on top of your health should be as simple as possible. That’s why we built a pharmacy that delivers medications and expert advice directly to you. Here’s how we’re applying this philosophy to feeling our best this winter and creating healthy habits that we can cultivate all year long. 

According to U.S. News & World Report, 80% of New Year's resolutions fail by mid-February. It’s not that we’re incapable of making meaningful changes. It’s that the way we’re accustomed to making resolutions doesn’t set us up for success. 

If you haven’t been exercising at all during quarantine, setting a goal to work out for an hour every day may not be practical. Instead, behavioral scientist, Susan Weinschenk Ph.D., outlines three critical steps for building new habits that stick: start with a small and specific action, tie it to an existing habit, and make it easy to accomplish during the first week. 

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

During the darker winter months, you may find your mood dropping along with the temperature. According to the Mayo Clinic, these seasonal bouts of melancholy are likely related to reduced exposure to sunlight, which can upset your circadian rhythm and cause serotonin (the “happy hormone”) levels to dip. 

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

Though it is tempting to go into full hibernation mode, excess sleep can make the issue worse. Try to stick to your usual sleep schedule and get some form of physical activity every day. If you find that your appetite and sleep patterns are adversely affected, or your symptoms interfere with your daily responsibilities, reach out to your doctor or a mental health professional. There are treatments available that can help make the seasonal shift much more manageable. 

Despite your best intentions, your health goals can become sidelined by the season’s viral villains: the common cold and flu. Neither is curable, so a solid prevention strategy is your best bet for staying well. Getting your annual flu shot and following COVID-19 precautions such as wearing a mask and social distancing will undoubtedly help, but your last line of defense is your immune system. 

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

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

Unfortunately, no matter how many antioxidant-rich foods you eat, it’s not always possible to avoid coming down with a cold or flu. If you can’t stomach one more raw garlic clove and you’re simply feeling miserable, over-the-counter (OTC) medications can help ease your symptoms and reduce the amount of time you feel knocked off your feet. 

Here are the medications our pharmacists recommend to help you feel better fast.

Not sure why you’re feeling so sick? Read “Cold, Flu, or COVID-19? Your Seasonal Symptom Guide” for clues. If you think you may have symptoms of COVID-19, it’s important to avoid contact with others and call your medical provider right away. 

When you’re sick, your nose can alternately feel like a leaky faucet and a blocked pipe. If you have nasal or sinus congestion, a decongestant, such as pseudoephedrine, can help. For a runny nose or postnasal drip, an antihistamine may do the trick. 

Just keep in mind that antihistamines may make you drowsy, while decongestants may keep you awake. Decongestants come in both oral and spray or drop form. If you’re considering a nasal spray or drops, don’t use them for more than three days in a row, or you may end up even stuffier than you were before (due to a condition called rebound congestion). 

If you’re taking other medications, talk to your doctor or pharmacist before starting a decongestant or antihistamine. Adverse interactions are possible with some medications, such as those that treat heart disease. If you’re an Alto customer, simply reach out by phone, text, or in-app chat, and one of our pharmacists can help determine which medicine may be right for you.

A raw, scratchy throat is often the first painful signal that a cold or flu is coming on. However, it could also be a sign of something more serious, such as a streptococcus bacterial infection (strep throat). Talk with your doctor if the pain in your throat is persistent, severe, or if you have trouble swallowing. For milder soreness, over-the-counter pain medications such as ibuprofen or acetaminophen may help.

Medicated lozenges and gargles that contain oral anesthetics/analgesics such as phenol and benzocaine are also available. These products can provide temporary pain relief for your throat. Just don’t use them for more than a few days in a row. You want to remain aware of whether the pain is progressing and may need a doctor’s attention.  

Coughing from time to time is your body’s way of clearing out your lungs. But constant coughing can be a nuisance at best and pretty painful at worst. 

If your cough is wet, you’ll need an expectorant, which will help to loosen mucus in your chest and throat. Guaifenesin is the active ingredient in OTC cough syrups designed to clear congestion from your airways. 

For a dry cough that just won’t quit, look for a cough suppressant, also known as an antitussive. Cough suppressants help to relieve your cough by blocking the cough reflex. A common antitussive ingredient you’ll see on the shelf is dextromethorphan. 

Though fevers aren’t fun, they’re actually an encouraging sign that your immune system is mobilizing to fight off an infection. According to the Mayo Clinic, except for very young or old individuals, generally healthy people don’t need to take medication to lower their temperature if it’s under 102 degrees Fahrenheit. However, if you’re feeling uncomfortable, a pain-and-fever reducer like acetaminophen or ibuprofen can help with your fever and also soothe muscle aches. 

For When It All Hits You Like a Ton of Bricks

Of course, coming down with a cold or flu is often so unbearable because it brings on a slew of uncomfortable symptoms all at once. Rather than keeping a pile of medications on hand, you can seek out one of the many multi-ingredient “cold and flu” medicines.  

These all-in-one options seem to have endless variations. In reality, they all contain different combinations of the four ingredients we’ve covered: decongestants, pain and fever reducers, cough suppressants, and expectorants. Once you know which basic components to look for, you will notice that there is really no difference between brand name and generic versions of these medicines—except that the generic version is often much cheaper. 

Just keep in mind that combination cold and flu medications often have more ingredients than you need to treat your symptoms, putting you at greater risk of side effects and overdosing. Make a note of the active ingredients in every OTC medication you take and never double up on medications containing the same ones. If only one symptom is truly bothering you, it’s best to stick to medicine that only relieves that specific discomfort. 

When in doubt, talk to your pharmacist. The team at Alto is on call to discuss which medications will be most effective and safe. We’re available from 9 am - 9 pm PT Monday - Friday, and 10 am - 6 pm PT on weekends; download the mobile app for secure messaging, or call or text 1-800-874-5881.

Remember—keep wearing your mask and social distancing to prevent the spread of COVID-19. It will also help keep you safe from catching a cold and flu. Get plenty of sunshine, prioritize sleep, and spice up your meals with immune-boosting foods. With these precautions in place, we hope you’ll be enjoying a healthy winter season ahead. 

Whether you’re pregnant, trying to conceive, or thinking about adding to your family, experts recommend starting to take a prenatal vitamin right away. Here’s what you should know if you’re ready to take a prenatal vitamin for the first time.

What to Look for in a Prenatal Vitamin

Whether you have recently found out that you are pregnant or are just starting to consider the possibility, prenatal self-care can feel a lot more complicated. Everything you do now has implications for two (or more!). 

The good news? A simple prenatal vitamin can help put your mind at ease. It’s one of the easiest and most effective ways to ensure you get the key vitamins and minerals needed to nourish your baby through a healthy pregnancy. 

Whether you’re pregnant, trying to conceive, or thinking about adding to your family, experts recommend starting to take a prenatal vitamin right away. By beginning early, you’ll help seed your body with the nutrients it needs for the earliest stages of fetal development. Here’s what you should know if you’re ready to take a prenatal vitamin for the first time.

With a wide range of over-the-counter prenatal supplements to choose from, we recommend consulting with your healthcare provider about the ideal choice for you. In some cases, your doctor might even prescribe a prenatal vitamin based on your unique nutritional needs. If you’re starting to do your research, here are the key nutrients your doctor will likely recommend supplementing. 

As you tour the ingredient label on any prenatal supplement, folic acid should be your first stop. This B vitamin helps the body make new cells and prevents congenital disabilities that affect a baby’s brain and spinal cord. 

Folic acid’s role in fetal development is crucial, so the CDC recommends all women of reproductive age take at least 400 micrograms per day. Birth defects of the brain and spine, known as neural tube defects, usually occur during the earliest weeks of pregnancy, often before many women know that they are pregnant.  

You will find that most over-the-counter prenatal supplements contain between 400 and 800 micrograms of folic acid. Sometimes, your provider may want you to take a little more, however any product with 1,000 micrograms of folic acid or more requires a prescription. 

You may also see this vitamin listed as “folate,” a general term for vitamin B9. Folic acid is a synthetic version of folate that is more stable when exposed to heat and easily absorbed by the body. 

Iron is a mineral that helps your body make blood cells that supply oxygen to your growing baby. It also helps prevent anemia, which occurs when your blood has too few healthy red blood cells. Your body needs more iron than usual during pregnancy because your total blood volume increases. The Mayo Clinic recommends supplementing with 27 milligrams of iron a day. 

Developing babies need calcium for bone growth. If you’re not getting enough, your own bone density could suffer. The general guideline is to take 1,000 milligrams per day while pregnant or nursing, which is the equivalent of three to four servings of dairy. Calcium can also be found in greens like spinach and broccoli. If you’re concerned that you’re not getting enough calcium in your diet, be sure to look for this mineral in your prenatal supplement. 

Vitamin D helps with calcium absorption and bone growth. The Mayo Clinic recommends that you get 600IUs of Vitamin D per day. 

Omega-3 fatty acids include docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). These essential fats support heart and neurological health. DHA, in particular, is known to support fetal brain development. 

While dietary sources like fatty fish are the best source of omega-3’s, this can present an issue if you want to limit fish consumption while pregnant. Some fish contain high levels of mercury, which can impair brain development in babies. For that reason, researchers at the Women's and Children's Health Research Institute advise that you take the recommended 200 milligrams of DHA a day in supplement form. 

The Mayo Clinic also suggests looking for a prenatal vitamin that includes vitamins C, A, and E; B vitamins; zinc; and iodine. Penn Medicine created this helpful chart to find the recommended daily allowance while you’re pregnant or lactating, but it’s important to consult with your doctor about your needs. 

The Mayo Clinic cautions against taking extra doses of your prenatal vitamin or doubling up on multivitamins as this could be harmful to your baby. You should always take your prenatal vitamins as directed by your doctor. If you forget to take a dose, don't worry, there is no need to double up. Just take your next dose at your regularly scheduled time.

A quality prenatal vitamin combined with a healthy, balanced diet is the best way to ensure your body and growing baby get all the nutrients they need. Talk with your healthcare provider to develop a plan to eat well and supplement your nutrition before and during pregnancy. 

Prenatal vitamins pack a powerful punch, which can make them tough to stomach for some people. The iron in prenatal vitamins can cause constipation, so it helps to drink plenty of fluids, get physical activity daily (if your healthcare provider gives you the okay), and eat more fiber. If constipation becomes a problem, talk with your doctor. Trying another form of iron or a stool softener can help with constipation. 

Some people become nauseous when taking vitamins. If you’re already feeling queasy during your pregnancy, this can present a significant hurdle. Try taking your prenatal vitamin with a meal and experiment with different times of the day. Some people cut their pill in half and take one piece in the morning and the other at night. You might also consider trying a different vitamin brand as each will vary in size, shape, and smell. A gummy, chewable, or liquid option might provide a more palatable option as well. 

If you just can’t seem to stomach your daily pill, don’t give up on your prenatal completely. Your healthcare provider can help you find a solution that won’t sacrifice your nutritional needs. 

The Mayo Clinic recommends that you do not use additional nutritional or herbal supplements during pregnancy. The FDA does not review dietary supplements for safety and effectiveness, and some ingredients could be harmful during pregnancy. 

The Mayo Clinic notes that one possible exception is ginger, which has been shown to help with nausea and is safe for pregnancy. 

If you are considering taking any supplements, always talk with your healthcare provider first. And remember that supplementation—your prenatal vitamin included—should not replace a well-balanced diet full of healthy vegetables and fruits. 

Think of your prenatal vitamin like any medication—more isn’t necessarily better. Stick with the recommended daily dose unless your doctor advises a more significant boost or suggests additional supplements. 

If your doctor recommends a prescription prenatal, you can have the prescription sent straight to Alto, and we’ll hand-deliver it to your home for free. Plus, our pharmacists will only be a phone call, text message, or in-app chat away if questions come up. You’ve likely got plenty on your mind right now, so allow us to handle all the details of your medication needs. 

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 on call 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. 

We were honored to sit down with Dr. Hildreth to discuss the challenges and opportunities we are facing at this pivotal moment in history. In addition to recounting his inspiring personal story, he shared many profound insights about the COVID-19 pandemic and the state of American healthcare. 

The COVID-19 Vaccine & Racial Disparities in Healthcare: A Q&A with Dr. James Hildreth

In August, we announced that Dr. James Hildreth had joined our newly formed Advisory Board as one of its first two anchor members. Dr. Hildreth’s extensive healthcare expertise has been invaluable as we’ve sought to guide Alto into the future and continue reimagining the pharmacy experience. 

A Fascinating Chat with Dr. James Hildreth

Dr. Hildreth is the President and Chief Executive Officer of Meharry Medical College—one of the nation’s oldest and largest historically Black academic health sciences centers. He is internationally renowned for his decades of influential HIV research and is deeply entrenched in our current global health challenge as a member of the FDA’s COVID-19 Vaccine Review Committee.

Can you tell us about your background and professional journey?

I grew up in a small town in Arkansas. It was one of those towns where if the two traffic signals were synchronized, you could drive right through and not even notice it. My father passed away when I was eleven years old. Quite honestly, because we were poor and Black, my father received very little medical attention. That was what prompted me to become interested in medicine.

I had no role models to look to, so I went to the library and read books about medicine. At age thirteen, I read a series of books that ranked your chances of getting into various medical schools. One of the universities was head and shoulders above all the rest, so my life’s work became getting into Harvard University.

To make a long story short, I got scholarships to Harvard, Princeton, Brown, Yale, Stanford, and many other places. But because my research had shown that Harvard was the place to go, that’s where I went. I got a job at the medical school, and the professor who ran the lab was also from Arkansas. He took me under his wing, and suddenly I wanted to be an immunologist. 

It was too late to change my major, but I was hooked. I applied for and was awarded a Rhodes scholarship in 1978, becoming the first Rhodes scholar from Arkansas who was Black. I got my Ph.D. in Immunology then went to Johns Hopkins School of Medicine. 

I planned to become a transplant surgeon until I met my very first patient. She was an African American woman with HIV who had just given birth to a baby who also tested positive. At the time, all we could do was watch them die, and that impacted me deeply enough to change my trajectory. I became an HIV researcher, and I have been studying HIV for the last thirty-eight years. 

I have been President of Meharry Medical College for five years. I feel that my life has come full circle because Meharry’s mission is to give opportunities to individuals who otherwise wouldn’t have them. 

Can you tell us more about Meharry’s mission?

Meharry was founded in 1876, but the story is that in 1826, a young, white teenage boy named Samuel Meharry was driving his salt wagon in the backwoods of Tennessee. His wagon got stuck in the mud, so he knocked on the door of a nearby cabin. An African American family greeted him, gave him a place to stay for the night, and helped him on his way. He promised them that if he ever had any resources, he would do something for Black people. 

Sure enough, fifty years later, he and his four brothers made a gift to a central Tennessee college to start a medical department for African Americans. That department evolved into Meharry Medical College.

To be leading an organization whose purpose is to give opportunities to people who look like me makes me feel that my life has come full circle. Meharry is one of four Black medical schools in the country, and without us, the face of medicine in this country would look very different. We are very proud of our mission and I’m so happy to be leading the organization at this time. 

Given that you’re on the FDA’s Vaccine Review Committee for COVID-19, what is your perspective on how we’ve handled the pandemic to date?

It’s hard to avoid acknowledging how politics have devastated our response to this pandemic. Viruses don’t respect borders, especially when you’re dealing with a pandemic virus. We should have had a nationwide response from the very beginning. Ideally, the whole country should have shut down for several weeks. That would have saved tens of thousands of lives.

What are your thoughts on how the pandemic might unfold going forward?

In my opinion, we’re entering a frightening period because we’re at the base of an exponential rise in cases. It’s essential to understand that for every case we diagnose, there are probably four, if not eight, cases that go undiagnosed. Many people don’t know they have the virus and are spreading it. 

Our country represents four percent of the global population but twenty percent of the people who are dying. That’s unimaginable to me. When you’re dealing with an airborne pathogen that can be transmitted so easily, it is unacceptable and unethical not to have stronger leadership and mandates in place. 

Can you share any insights on potential vaccines and vaccine distribution?

I’m on the FDA committee that will review the data from the drug companies and make recommendations about approval. In a couple of weeks, we will review the Pfizer vaccine. I can tell you that the data from both Moderna and Pfizer are very compelling. Both vaccines appear to be highly effective.

Neither of these vaccines is what we’d call a “sterilizing vaccine,” They will not prevent a person from getting infected, but they will limit the amount of disease that occurs after infection. The other exciting aspect of these vaccines is that they represent a new type: messenger RNA vaccines. Rather than using a protein for the vaccine, we’re using a message that encodes for the protein. There was some doubt if this new type of vaccine would work in humans, but it does. This development will facilitate future vaccines quite nicely. 

By the spring of next year, there will likely be two vaccines approved for use. The question is: who will get those first forty million doses that become available? Healthcare workers will probably get them first, then people in nursing homes and assisted living facilities. Many experts, myself included, are trying to make the case that those most vulnerable to disease and death should be next in line. The CDC has already worked with the states to develop distribution plans, but they are not in line with that thinking. There are going to be a lot of intense discussions in the coming weeks. 

What are the healthcare topics that get you most excited—or keep you up at night—right now?

The pandemic has revealed something that minority healthcare professionals have known for a long time: there is a wide gap in the health status of Americans. If you are African American or Latinx and live in certain communities, you are much more likely to have certain chronic conditions. This increased risk is related to your zip code, educational attainment, where you work, and what your job might be, but running through all of this is an underlying current of racism. 

We can’t solve the problem until this country has a necessary conversation about the role of racism in every domain of American life. I like the way that Martin Luther King put it. He said that when you have centuries of neglect, suppression, oppression, or denial, there is an interest that accumulates. The answers to these problems are going to be much more expensive and time-consuming than if we had been dealing with them all along. 

No matter what industry we’re in, all of us need to have tough conversations about what race really means. Take, for example, the sequencing of human genomes. African genomes are the ancestral genomes—all of us can link our humanism back to Africa. But of all the hundreds and thousands of genomes that have been sequenced, very few of them come from folks who look like me. 

It’s the same as my experience in medical school in the 1980s. We learned to treat the average, middle-aged white male because that’s who the studies were centered on. The exclusion of certain groups from clinical trials, programs, and conversations has created a wide gap that we now have to close. We need to have every healthcare institution at the table trying to work on it.

On a positive note, as the pandemic reveals these disparities, many organizations are awakening to the fact that there is work to be done. I’m encouraged by what happened after we witnessed the senseless murder of George Floyd. It was a really painful time for me because that could have been me, my son, or my brother. It could have been any one of us. But the response that we witnessed wasn’t just from African Americans and liberals. It seemed to me that people of all different backgrounds and races came together to say that this is unacceptable. It gave me some hope that we can change this and become a better nation.

What opportunities do you see for Alto in the world of healthcare?

I think Alto has a great opportunity to improve people’s quality of life who need to take medications to improve their health status. Before she passed, my mother would complain about how difficult it was to get her prescription medications. The ability to simplify and improve the process for everyone will positively impact a significant population of people. 

I was humbled that you asked me to be in your advisory group. I’m excited about what you’re doing, and I think it’s going to make a big difference for many people. 

As we approach the holidays, I’d like to share something I’ve told my students. The last thing you want to do is create a situation where this is the last holiday you’ll spend with some of your older relatives. Please be mindful that there is a lot of the virus out there, wherever you are in the United States. Please take steps to protect yourselves and your families. Have a wonderful holiday, but if you can, make it virtual.

Note: This interview was conducted in early December 2020. 

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.

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The COVID-19 Vaccine & Racial Disparities in Healthcare: A Q&A with Dr. James Hildreth

An HIV Prevention Milestone: Truvada Goes Generic

The Lowdown on Healthy Blood Pressure

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The Unexpected Benefit of Being Stuck Home for the Holidays

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