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There are more than 25 million individuals in the U.S. living with asthma, including more than 5 million children. While most asthma cases involve the same common symptoms — shortness of breath, chest tightness, and wheezing — day-to-day life with the condition can vary significantly from one person to another. Not only is there a wide spectrum of the severity and frequency of symptoms, but there are also different types of asthma with distinct causes and triggers. (They are not mutually exclusive, so it’s possible to fulfill the diagnostic criteria for more than one type of asthma.) Here’s what to know about the main types of asthma, including important treatment considerations.

Understanding the Different Types of Asthma

Asthma is a chronic respiratory condition in which the airways in your lungs become narrow and inflamed, often leading to difficulty breathing. There are several different types of asthma: allergic asthma, non-allergic asthma, nocturnal asthma, occupational asthma, cough-variant asthma, and a related condition called exercise-induced bronchoconstriction. While there is variation among these asthma types with respect to causes, triggers, and treatment options, there are also some similarities, including the core symptoms of asthma such as coughing, wheezing, chest tightness or pain, and shortness of breath.

Some people with asthma experience intermittent flare-ups while others have symptoms the majority of the time, or persistent asthma. Persistent asthma can be categorized further as mild persistent, moderate persistent, or severe persistent depending on the severity of symptoms.

Allergic asthma is the most common form of asthma, accounting for about 60% of all asthma cases in the U.S. It occurs when an individual’s immune system interprets substances such as household dust mites, pet dander, or pollen as harmful and releases antibodies that ultimately lead to inflammation in the airways. Allergic asthma frequently involves allergy symptoms like nasal congestion, a runny nose, and itching in the eyes, nose, or ears in addition to core asthma symptoms. There is often a genetic component.

Read When to See a Healthcare Specialist for Allergy Treatment

10-33% of all individuals with asthma experience symptoms caused by triggers other than allergies including a history of smoking or exposure to secondhand smoke, respiratory infections, pollution, cold weather, humidity, and exercise. This is referred to as non-allergic asthma. It often develops later in life in comparison to allergic asthma. As part of the diagnosis process, your healthcare provider will rule out allergies as the cause of your asthma symptoms.

60% of all individuals with persistent asthma also experience nocturnal asthma, a type of asthma in which symptoms worsen at night. Those with nocturnal asthma frequently have their sleep interrupted as a result of coughing, wheezing, or chest tightness. There are many factors involved in the development of nocturnal asthma including smoking; dust or other allergens; and other illnesses or health conditions such as the cold, flu, sinusitis, gastroesophageal reflux disease (GERD), and sleep apnea. Your circadian rhythm and nightly fluctuations in the hormones epinephrine and histamine are also believed to play a role.

Since your daytime breathing can’t be used to diagnose nocturnal asthma, your doctor may ask you to test your breathing at home or participate in a sleep study to confirm a diagnosis.

Occupational asthma occurs when you are exposed to chemicals in your work environment that affect your respiratory function and breathing such as paint, cleaning products, mold, fungi, or dust. 11 million individuals in the U.S. are exposed to an occupational asthma-linked substance at their workplace. Workers who may have a higher risk for occupational asthma include bakers, farmers, metal and plastics workers, woodworkers, and those who work in manufacturing.

As many as 90% of individuals with asthma experience respiratory symptoms during physical activity — a subcategory of asthma known as exercise-induced bronchoconstriction (EIB). Exposure to airborne irritants including smoke, pollution, and pollen and/or to cold, dry air may contribute to symptoms.

There is much variation in individual experiences of EIB symptoms. Some individuals begin to have difficulty breathing right when they start exercising while others have more noticeable symptoms shortly after they return to a state of rest. Symptoms quickly disappear in some cases but last up to 24 hours in others.

If you have symptoms of exercise-induced bronchoconstriction, it’s important to stay active. Rather than avoiding exercise to prevent an asthma flare-up, speak with your healthcare provider about your asthma treatment plan and look for forms of exercise with an appropriate level of intensity.

In some cases, a dry cough is a symptom of cough-variant asthma. This type of asthma is more common in children than adults. It can be difficult to diagnose since a dry cough is also linked to other health conditions. If your cough wakes you up at night, worsens in cold, dry weather or after exposure to allergens, or occurs after exercise, you may have cough-variant asthma.

30% of all individuals with cough-variant asthma eventually develop classic symptoms of asthma. The goal of treatment for cough-variant asthma is to prevent the condition from progressing into a more severe form. Inhaled corticosteroids, which reduce inflammation and swelling in the airways, are the frontline treatment for cough-variant asthma.

All types of asthma can be managed with a combination of asthma medications, healthy lifestyle habits, and additional preventive measures to avoid triggers. However, given the spectrum of severity of symptoms — and the variety of asthma triggers — there isn’t a one-size-fits-all approach to treatment. Your doctor will advise you on the most effective treatment plan for your individual needs. 

If you have mild asthma, you may only need quick-relief rescue medications to manage acute symptoms. Albuterol (branded options include ProAir® HFA, Proventil® HFA, Ventolin® HFA) and Levalbuterol (Xopenex HFA®) are common quick-relief asthma medications. They may be taken via inhaler or nebulizer.

If you have moderate to severe asthma, you may need long-term maintenance medication in addition to a rescue medication for flare-ups. There are two main types of long-term asthma control medications:

Inhaled corticosteroids including Flovent® HFA and Qvar Redihaler® 

Combination inhalers that contain both corticosteroids and long-acting beta agonists (LABAs) including fluticasone and salmeterol (Advair Diskus®); budesonide and formoterol (Symbicort®); mometasone and formoterol (Dulera®); and fluticasone and vilanterol (Breo Ellipta®)

If you have allergic asthma, your doctor may also recommend over-the-counter or prescription allergy medications such as oral antihistamines (Claritin®, Allegra®, Zyrtec®), decongestants  (Afrin® and Sudafed®), and corticosteroid and cromolyn nasal sprays. While these medications can help you avoid allergy-induced asthma attacks, they are not a substitute for classic asthma medication. If you have nocturnal asthma, your doctor may recommend adjustments to the timing of your dosages to help you experience a better quality of sleep.

To learn more about asthma medication and management, read A Guide to Common Asthma Medications.

Alto Pharmacy is here every step of the way to make it easy to manage your asthma symptoms. Our team of pharmacists is available to answer questions about your asthma medications, and we offer free, same-day delivery and medication management tools like reminders and auto refills in our app.

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881 to learn how Alto can support your asthma treatment plan.

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.

A healthy immune system offers protection against the bacteria and viruses that cause illness, deploying antibodies that attack these invaders. An autoimmune disease occurs when the immune system cannot differentiate between outside germs and healthy cells and mistakenly attacks various tissues and organs throughout the body.

What is an autoimmune disease?

A healthy immune system offers protection against the bacteria and viruses that cause illness, deploying antibodies that attack these invaders. An autoimmune disease occurs when the immune system cannot differentiate between germs and the body’s own cells and mistakenly attacks various tissues and organs.

There are more than 80 of these conditions, with variation in the affected area of the body; some of the most common autoimmune disorders involve the joints and muscles, digestive tract, nervous system, and skin. There is also significant variation in day-to-day life with autoimmune disorders. Some, like type 1 diabetes, require daily management, while others may have periods of intensified symptoms known as flare-ups. In all cases, there are treatment options that can reduce discomfort and help you experience a better quality of life. Here’s what to know about the most common types of autoimmune disorders.

Causes and symptoms of autoimmune disorders

Many autoimmune disorders do not have a specific known trigger, but the following factors may play a role in the development of certain conditions.

Genetics — some autoimmune disorders such as lupus and multiple sclerosis run in families and likely have a genetic component.

Sex — of the 23.5 million Americans living with an autoimmune disease, 78% are women. Specific autoimmune disorders that are more common in women than men include rheumatoid arthritis, psoriasis, celiac disease, inflammatory bowel disease, lupus and multiple sclerosis, among others.

Obesity — being overweight or obese may increase an individual’s risk of developing rheumatoid arthritis or psoriatic arthritis.

Smoking — research suggests a connection between cigarette smoking and lupus, rheumatoid arthritis, hyperthyroidism, and multiple sclerosis.

Medications — some medications including blood pressure medications, statins (which are commonly used to treat high cholesterol), and antibiotics may increase a person’s risk for certain autoimmune disorders. Consult with your doctor about medication side effects if you have concerns.

While exact symptoms and treatment options vary by condition, as explained in more detail below, there is also some overlap. Fatigue, joint pain and swelling, rashes and other skin issues, digestive issues, and swollen glands are common signs of a variety of autoimmune disorders.

Most autoimmune disorders do not have one single test to confirm or rule out a diagnosis. With the majority of these conditions, the diagnosis process involves several steps including a physical exam and multiple tests.

If you have potential symptoms of an autoimmune disease, a common first step is an antinuclear antibody (ANA) test. This is a blood test that checks for antinuclear antibodies, the type of antibodies that attack healthy cells. If you have a positive ANA result, your doctor will likely recommend additional tests to identify the specific autoimmune disease.

A negative ANA test does not necessarily mean that you do not have an autoimmune disease. If you have negative ANA results, your doctor may recommend additional tests for other antibodies or inflammation markers depending on your symptoms. Tests used to diagnose autoimmune disorders include:

An erythrocyte sedimentation rate (ESR) test — which examines how quickly your red blood cells sink to the bottom of a test tube — may be used to diagnose rheumatoid arthritis and lupus. 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 — may be used to diagnose rheumatoid arthritis, lupus, and inflammatory bowel disease.

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

Depending on your symptoms, your healthcare provider may refer you to one of the following specialists:

A rheumatologist who treats autoimmune disorders of the joints and muscles including rheumatoid arthritis and lupus.

A gastroenterologist who treats autoimmune disorders of the digestive system including Crohn’s disease, celiac disease, and ulcerative colitis.

An endocrinologist who treats autoimmune disorders of the endocrine system including Graves’ disease and Hashimoto’s thyroiditis.

A dermatologist who treats skin-related autoimmune disorders including psoriasis.

Common autoimmune disorders and treatment

These are some of the most common types of autoimmune disorders affecting individuals in the U.S. Symptoms, treatment, and diagnostic tests vary by condition.

Rheumatoid arthritis occurs when your immune system attacks the lining of your joints, causing pain and inflammation throughout your body. It is a progressive condition, and getting an early diagnosis and staying proactive about treatment can help prevent more severe damage to your joints.

Several medications may be used to reduce the pain and inflammation caused by rheumatoid arthritis, including over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil®), aspirin (Bayer®) or naproxen (Aleve®); acetaminophen (Tylenol®); and Janus kinase (JAK) inhibitors such as baricitinib (Olumiant®), tofacitinib (Xeljanz®), and upadacitinib (Rinvoq®). In addition, avoiding or reducing your intake of sugars and refined carbohydrates and gluten can also help reduce inflammation.

Disease-modifying anti-rheumatic drugs (DMARDs) like methotrexate (Rheumatrex®), sulfasalazine (Azulfidine®), and leflunomide (Arava®) and injectable biologic DMARDs like etanercept (Enbrel®), infliximab (Remicade®), adalimumab (Humira®), and certolizumab pegol (Cimzia®) are often prescribed to slow tissue damage.

Type 1 diabetes is an autoimmune condition that occurs when the body mistakenly attacks the pancreas with antibodies. This destroys the pancreas’s insulin-producing cells, so individuals with type 1 diabetes cannot produce any insulin and rely on daily insulin therapy to manage their blood sugar.

For more information on managing type 1 diabetes, read our previous blogs:

What’s the Difference between Type 1 and Type 2 Diabetes?

How to Live with Type 1 Diabetes at Any Age

Psoriasis is a skin disorder that occurs when inflammation caused by an immune response causes new skin cells to grow too quickly. It is characterized by thick patches of skin covered with white or silver scales, also referred to as plaques. There is a genetic component, and psoriasis often runs in families. 

Many individuals with psoriasis experience periodic flare-ups. While not all psoriasis flare-ups can be attributed to a specific cause, skin injury, stress, and cold weather are common triggers.

There are a variety of treatments for psoriasis, including steroid creams; anthralin (Drithocreme HP® and Zithranol®), an anti-inflammatory medication; moisturizers; UV light therapy; vitamin D3 ointment; and vitamin A creams.

Systemic lupus erythematosus (SLE), the most common type of lupus, affects many different parts of the body including the skin, joints, kidneys, brain, and heart. Common symptoms include joint pain and swelling, severe fatigue, and rashes. Without effective treatment, lupus can lead to other health complications over time, including blood clots and inflammation of the heart or kidneys, and increase your risk for a heart attack or stroke. Getting diagnosed early and starting treatment as soon as possible is critical to managing lupus.

Lupus treatment varies depending on the severity of symptoms and which part of the body is affected. Other-the-counter NSAIDs and oral corticosteroids including prednisone (Deltasone®, Prednicot®) may be used to treat joint pain and stiffness. Antimalarial medications including hydroxychloroquine (Plaquenil®) are often prescribed to reduce pain and inflammation, prevent flare-ups, and treat rashes.

Inflammatory bowel disease refers to several autoimmune diseases that affect the digestive tract including Crohn’s disease, which involves any part of the small or large intestine, and ulcerative colitis, which involves the colon, rectum, or both organs.

Common symptoms of both Crohn’s disease and ulcerative colitis include diarrhea, abdominal cramps, bloody stools, fever, fatigue, loss of appetite, and weight loss. Many individuals with these conditions experience periods of time without symptoms, also known as remission. Treatment options include the following:

Antidiarrheal and anti-inflammatory medications such as oral 5-aminosalicylates and corticosteroids

Immunomodulators, a group of medications that act on the immune system to reduce the inflammation that causes Crohn’s

Biologics, a group of medications that are derived from antibodies and used to prevent inflammation in more severe cases, such as adalimumab (Humira®), golimumab (Simponi®), infliximab (Remicade®), tofacitinib (Xeljanz®), ustekinumab (Stelara®), and vedolizumab (Entyvio®)

Other common autoimmune diseases include:

Multiple sclerosis, which affects the nervous system

Addison’s disease, which affects the adrenal glands

Graves’ disease, which affects the thyroid gland in the neck

Celiac disease, which affects the digestive tract

Living with any chronic condition is easier with a reliable pharmacy partner by your side. Our pharmacists have specialized training in the treatment of autoimmune diseases 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.

While many heart conditions develop gradually over time, there are others that start before birth. Congenital heart disease refers to a variety of structural problems with the heart that happen while a fetus is still developing. (An individual type of congenital heart disease may also be referred to as a congenital heart defect.) It is the most common birth disorder in the U.S., affecting about 40,000 babies each year, with 800,000 adults living with the condition.

Congenital Heart Disease, Explained

There is a spectrum of severity of congenital heart defects. While about 25% of all babies born with congenital heart disease have a critical heart defect (CHD) that requires surgery or other medical treatment, other types are mild. Take a look at some of the most common congenital heart defects.

In some types of congenital heart disease, the specific causes are unknown. Others have a genetic component and are passed through families. A mother’s health history and lifestyle habits can also affect how a baby’s heart develops in the womb. The following risk factors in a mother have been linked to a baby’s development of congenital heart disease.

Having type 1 or type 2 diabetes, hypertension, obesity, thyroid disorders, or epilepsy

Taking certain medications such as phenytoin and retinoic acid

If you are considering starting a family and have concerns about your baby’s risk of a genetic heart defect, ask your doctor about testing options that may detect a congenital heart disorder during pregnancy. In addition, consult with your doctor if you are unsure if a medication is safe to take during pregnancy.

Congenital heart disease may affect any of the following heart structures:

The right atrium, one of the heart’s two upper chambers which receives blood without oxygen from other parts of the body

The left atrium, the heart’s other upper chamber which receives oxygen-rich blood from the lungs

The right ventricle, one of the heart’s two lower chambers which pumps blood without oxygen from the right atrium to the lungs

The left ventricle, the heart’s other lower chamber which pumps oxygen-rich blood to the rest of the body

Coronary arteries, which supply your heart with oxygen-rich blood

The heart’s four valves, which keep blood flowing properly through the heart

The septum, the wall of tissue separating the left and right sides of the heart

These are the most common types of congenital heart disease affecting U.S. adults. Symptoms, treatment, and diagnostic tests vary by heart defect.

Comprising about 20% of all congenital heart disease cases, ventricular septal defect is the most common congenital heart defect in babies. It is a small or large hole between the ventricles. Treatment depends on the size of the hole. If a hole is larger, surgery may be required within a baby’s first four to six months of life. There is often no additional treatment needed after surgery.

Most infants with ventricular septal defect also have a heart murmur, a swishing sound that is audible with a stethoscope. Other symptoms include fast breathing, high heart rates, frequent sweating, even while at rest, and poor weight gain.

Another common type of congenital heart disease, atrial septal defect is a hole between the atria. Many infants with this defect do not have any symptoms.

In about 80% of cases, the hole closes naturally. If the hole does not close, a child may need surgery or a non-surgical procedure known as an interventional cardiac catheterization. As with ventricular septal defect, this condition typically does not require additional treatment after the first procedure.

Tetralogy of fallot (TOF) is a congenital heart defect in which the wall that separates the ventricles — the ventricular septum — is abnormally positioned, with a hole. It can obstruct the flow of blood through the heart, in some cases causing heart muscle to thicken. All TOF cases require surgery, typically within a baby’s first year of life.

Patent ductus arteriosus involves the connection between the aorta and the heart’s pulmonary artery. While in the womb, a baby’s aorta and pulmonary artery are linked by a blood vessel called the ductus arteriosus, which allows blood to flow directly to the aorta. In healthy babies, the ductus arteriosus naturally closes not long after birth. In babies with this heart defect, the blood vessel remains open, potentially causing heavy blood flow to the lungs. 

There are a variety of treatment options for patent ductus arteriosus, including medications, non-invasive procedures, and surgery. Nonsteroidal anti-inflammatory drugs (NSAIDs) may help close a premature baby’s patent ductus arteriosus but typically aren’t effective for full-term babies, children, or adults. If a baby has minimal symptoms, surgery is often delayed until they are between 6 to 12 months old. However, if a baby is experiencing poor weight gain or rapid breathing, surgery may be recommended during their first six months.

Transposition of the great arteries (TGA)

About 10% of all babies with congenital heart disease have transposition of the great arteries (TGA), a problem with the positioning of the two main arteries that carry blood away from the heart to other organs. Babies born with this condition have low oxygen levels, which may cause a bluish tint to the skin. The condition requires a surgical procedure called an arterial switch operation shortly after birth. In most cases, heart function is restored to normal after surgery.

Aortic valve stenosis is an issue with the aortic valve, from which oxygen-rich blood travels to other parts of the body. In healthy babies, the aortic valve has three flaps that open and shut to accommodate the flow of blood. Babies with this defect may have a small aortic valve or the flaps may not function properly. This structural problem can block the flow of blood from the heart, which can put additional pressure on the left ventricle. Treatment depends on the specific issue with the aortic valve and may include a non-invasive procedure or surgery.

Living with congenital heart disease as an adult

Living with congenital heart disease as an adult varies significantly by individual and by condition, given the wide spectrum of these defects. Most adults with a congenital heart defect are regularly monitored by a cardiologist who specializes in congenital heart disease throughout their lives. In some cases, you may have to take additional precautions to prevent complications related to certain types of congenital heart disease such as the following:

Infective endocarditis, an infection caused by bacteria in the heart lining, or in a heart valve or blood vessel. If untreated, it can lead to a blood clot, heart valve damage, or heart failure

Arrhythmia, an irregular heartbeat which can affect the heart’s ability to pump blood and increase your risk of developing a blood clot

Pulmonary hypertension, high blood pressure in the arteries that run from the heart to the lungs

Care for your heart with support from Alto

At Alto, we make it as simple as possible to manage heart health issues and follow the treatment plan your doctor recommends. We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

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

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.

Heart failure, which affects approximately 6.2 million U.S. adults, can be a confusing term. Contrary to what many people assume, it does not mean that your heart no longer works, or has stopped beating, but rather that this vital organ cannot pump blood and oxygen as well as a healthy heart.

What to Know About Heart Failure

Heart failure, which affects approximately 6.2 million U.S. adults, can be a confusing term. Contrary to what many people assume, it does not mean that your heart no longer works, or has stopped beating, but rather that this vital organ cannot pump blood and oxygen as well as a healthy heart. While heart failure is a progressive condition with the potential for serious health complications, it can be managed through lifestyle changes and medication. Read on to learn about heart failure symptoms, causes, and treatment options.

In all cases of heart failure, the heart cannot deliver enough blood and oxygen to the rest of your body. Sometimes this is because weakened heart muscle leaves the heart’s main pumping chambers — the ventricles — unable to carry out their pumping function. This type of heart failure is called heart failure with reduced left ventricular function (HF-rEF). In other cases, the ventricles are too stiff to fill with enough blood between beats. This type of heart failure is called heart failure with preserved left ventricular function (HF-pEF).

Ejection fraction (EF) is an important measurement of heart function for those who have heart failure with reduced left ventricular function. Expressed as a percentage, EF measures the amount of blood pumped from the left ventricle when it contracts. An EF of 55 to 70% is considered a healthy range.

Since heart failure is a progressive condition, your EF gives your doctor insight into any changes in your heart function. An echocardiogram is the most common way to measure your EF, but a magnetic resonance imaging (MRI) scan or nuclear stress test may also be used.

Despite the importance of EF, it is not the sole determinant of heart function. Those who have heart failure with preserved left ventricular function may have a normal EF. These cases of heart failure are often caused by high blood pressure, which gradually thickens the ventricles. Stiff ventricles cannot relax enough to fill to their full capacity, which is why they do not pump out enough blood.

Heart failure can affect many other organs, including the lungs, liver, and kidneys. The potential for additional health complications increases as heart disease progresses, which is why it’s important to stay proactive about your health and follow your doctor’s recommendations for treatment.

Heart failure primarily occurs as the result of other health conditions that weaken or stiffen the heart. Coronary artery disease, the most common type of heart disease, is the leading cause of heart failure. The condition gradually narrows and thickens the arteries that supply your heart with blood and oxygen. Severe blockages in the arteries can prevent the heart from pumping enough blood, leading to the development of heart failure.

High blood pressure is another common cause of heart failure, particularly cases of heart failure with preserved left ventricular function (HF-pEF). If you have high blood pressure, your heart has to work harder to deliver blood to the rest of your body. Over time, this can make your left ventricle too stiff to properly pump out blood.

Both type 1 and type 2 diabetes are linked to heart failure, as high blood sugar can affect your blood vessels and cardiac nerves. Heart failure may also be caused by a variety of heart health conditions including cardiomyopathy, congenital heart disease, heart valve disease, and arrhythmias.

Lifestyle factors such as smoking, eating a high-cholesterol or high-sodium diet, heavy alcohol consumption, and a lack of physical activity may increase your risk for heart failure, especially if you have one of the conditions above.

These are some of the most common symptoms of heart failure:

Shortness of breath when exercising or lying down

Fatigue and a feeling of weakness in your legs

Swelling in your ankles, legs, and abdomen

A persistent dry, hacking cough or wheezing

There is a spectrum of severity of heart failure cases, and treatment varies by individual depending upon symptoms and heart function, as well as the underlying cause. If you have early-stage heart failure, your doctor may recommend lifestyle changes and prescribe medications that can alleviate symptoms and prevent the condition from progressing.

The following medication classes, many of which lower blood pressure, are commonly used to treat early stages of heart failure.

Angiotensin converting enzyme (ACE) inhibitors

Often used to treat high blood pressure, ACE inhibitors block production of a hormone that causes blood vessels to narrow, helping constricted blood vessels expand so that more blood can flow through.

Like ACE inhibitors, ARBs protect blood vessels from a hormone that causes them to narrow, lowering blood pressure.

Another medication class commonly used in the treatment of high blood pressure, beta blockers cause the heart to beat more slowly, which lowers your blood pressure and opens up your veins and arteries.

Calcium channel blockers prevent calcium from entering the smooth muscle cells of the heart and blood vessels so that the heart can beat with less force. This opens up narrowed blood vessels and lowers blood pressure.

If you have atrial fibrillation — an irregular heart rate condition — or another heart health condition, your treatment plan for heart failure may include anticoagulants, medications that reduce the blood’s ability to form new clots and prevent existing clots from growing.

Cholesterol-lowering medications such as statins may be used to treat those who have early-stage heart failure and high cholesterol.

Many people with heart disease retain fluid. Diuretics, also referred to as water pills, can help eliminate excess water and sodium, which reduces the heart’s workload.

Small lifestyle changes are an important part of managing mild to moderate cases of heart failure. They can help alleviate symptoms and slow the progression of the condition. Here are some of the lifestyle changes your doctor may recommend.

Avoiding or limiting your caffeine intake

Anyone can benefit from these lifestyle changes, even those who do not have heart failure. Heart-healthy living is a lifelong practice, and the best way to prevent health issues like heart failure in the future is to prioritize your heart health today.

Some individuals with more advanced heart failure may need a procedure such as coronary bypass surgery or an angioplasty, both of which target a blocked coronary artery. Pacemakers may also be used to help control the rhythm of their heart, often in tandem with a bypass surgery and medications. 

Protect your heart with support from Alto

At Alto, we make it as simple as possible to manage your risk for heart health issues and follow the treatment plan your doctor recommends. We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

Alto’s mission is to improve the quality of life for all who need medicine, building a pharmacy experience that serves people of all backgrounds. As we work toward a more inclusive and accessible healthcare system, we recognize the importance of diversity among physicians, pharmacists, nurses, and other public health figures. In honor of Black History Month, take a moment to learn about five influential Black healthcare leaders past and present — those who paved the way and those who continue to break barriers today

Five Black Healthcare Leaders to Celebrate

Alto’s mission is to improve the quality of life for all who need medicine, building a pharmacy experience that serves people of all backgrounds. As we work toward a more inclusive and accessible healthcare system, we recognize the importance of diversity among physicians, pharmacists, nurses, and other public health figures. In honor of Black History Month, take a moment to learn about five influential Black healthcare leaders past and present — those who paved the way and those who continue to break barriers today. (For additional inspiration, revisit the first post in this series.)

Dr. M. Jocelyn Elders: the first Black U.S. surgeon general

As a Black woman born to farmers in a rural, poverty-stricken area of Arkansas, M. Jocelyn Elders encountered numerous obstacles on her path to becoming the first Black U.S. Surgeon General in 1993. At 16, she met a doctor for the first time, but she didn't consider a profession in healthcare until she connected with Edith Irby Jones, the first Black person to attend the University of Arkansas Medical School, during college.

Throughout her career, Dr. Elders balanced clinical practice and research, increasing the public’s awareness of adolescent health issues. In 1987, Bill Clinton, then the governor of Arkansas, appointed Dr. Elders as head of the state’s Department of Health. The Arkansas state legislature mandated sexual education and substance misuse prevention programs in the K-12 curriculum in 1989 in large part because of Dr. Elders’ advocacy. During her tenure as Surgeon General, Dr. Elders continued to champion progressive policies, advocating for better sexual education programs, distribution of condoms in schools, and abortion rights. She remains active in the field of public health as a professor emeritus at the University of Arkansas School of Medicine.

Bernard J. Tyson: former CEO of Kaiser Permanente

As chairman and CEO of Kaiser Permanente, Bernard Tyson transformed the company’s services to account for social determinants of health like food access and affordable housing as well as the importance of mental health and wellness. He was also instrumental in the development of the Kaiser Permanente School of Medicine, which trains physicians to be not only clinicians, but patient advocates and innovators, too. By shining a spotlight on how social determinants of health contribute to disparities in health outcomes, Tyson leaves behind a legacy that reaches far beyond Kaiser’s services.

Nadine Burke Harris: first surgeon general of California

A physician, researcher, advocate, and California’s first surgeon general, Dr. Nadine Burke Harris has transformed how our society responds to childhood trauma. While running a health clinic in an underserved San Francisco neighborhood, she observed that preventative health practices and quality treatment didn’t resolve her patients’ risk for poor health outcomes. Drawing upon research from the CDC and Kaiser Permanente on adverse childhood experiences (ACEs), which linked early adversity to higher rates of chronic illness later in life, Dr. Burke Harris studied her own patients and found that more than 67% had experienced at least one ACE. She has helped increase public awareness of ACEs and toxic stress, advocating for universal screening of children and adolescents for signs of trauma. Her 2014 TED Talk, “How Childhood Trauma Affects Health Across the Lifetime,” has been viewed more than 7.5 million times, and she published The Deepest Well: Healing the Long-Term Effects of Childhood Adversity in 2018.

Dr. Patrice Harris: first Black female president of the American Medical Association

Despite not knowing any doctors while growing up in West Virginia, Dr. Patrice Harris’ passion for medicine started early. The board-certified psychiatrist initially planned to pursue pediatrics but shifted her focus after discovering an interest in psychiatry during medical school. Her focus on child psychiatry allows her to merge her passion for children with her expertise in mental health. Throughout her career, Dr. Harris has focused on the role of implicit bias within the medical profession and how unconscious biases among healthcare workers influence health disparities.

Dr. Harris’ involvement in the professional healthcare community spans many leadership positions at state and national organizations. She became the first Black woman elected as president of the American Medical Association in 2020. During her tenure, she focused on a variety of health issues, from opioid addiction to COVID-19. She previously chaired the AMA’s Opioid Task Force, providing evidence-based recommendations to clinicians with the goal of ending the opioid epidemic.

Betty Smith Williams: first Black graduate of the Frances Payne Bolton School of Nursing

Betty Smith Williams was the first Black student to earn a nursing degree from Cleveland’s Frances Payne Bolton School of Nursing, in 1954, and the first Black individual to teach at a higher education institution in the state of California, but her individual accomplishments are only a part of her legacy. Williams has helped ensure that today’s aspiring Black healthcare professionals have the opportunities and support to break down barriers of their own. She was instrumental in developing the National Black Nurses Association and the National Coalition of Ethnic Minority Nurse Associations, Inc. — initiatives that have elevated the voices of Black nurses within the profession. In uniting Black nurses, Williams hoped to create better health outcomes among the Black community. In her own words: "We had no voice, but we understood our culture and our unique needs better than anyone else.”

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Cystic fibrosis is a progressive genetic condition that primarily affects your respiratory and digestive function. More than 30,000 children and adults in the U.S. are living with cystic fibrosis. Currently, there is no cure for this condition, but it is manageable. With advances in treatment, people with cystic fibrosis are able to experience a better quality of life and live to a longer age. Here’s what to know about managing cystic fibrosis.

Understanding Cystic Fibrosis

Our bodies all produce mucus, digestive enzymes, and other fluids that lubricate our organs and tissues. People with cystic fibrosis have a genetic mutation that increases the thickness of these fluids. This can affect many organs in your body, particularly your lungs and digestive tract. Cystic fibrosis makes it more difficult for air to pass through your lungs and for the intestine to absorb vital nutrients. In more advanced stages, cystic fibrosis may result in severely impaired respiratory function. The thicker fluids can also trap bacteria, making individuals with cystic fibrosis more susceptible to a variety of infections.

Cystic fibrosis is caused by a mutation to a gene — the cystic fibrosis transmembrane conductance regulator (CFTR) gene — that affects how water and salt move through your body’s cells. Both parents must carry a mutated copy of this gene in order for a child to develop cystic fibrosis. However, having two carrier parents does not guarantee that a child will have cystic fibrosis; there is a 25% chance.

A child with just one carrier parent will not have cystic fibrosis, but they may become a carrier themselves, increasing their own children’s risk for the condition. Genetic testing can identify a child’s risk of developing cystic fibrosis or becoming a carrier. Tests may also be performed during pregnancy if you have concerns about your baby’s potential risk for cystic fibrosis.

Blog

Understanding the Different Types of Asthma

What is an autoimmune disease?

Congenital Heart Disease, Explained

Understanding Rheumatoid Arthritis

What to Know About Heart Failure

Five Black Healthcare Leaders to Celebrate

Understanding Cystic Fibrosis

How We Established Better Boundaries and Clearer Code Ownership at Alto

An Introduction to Skin Health

Next Steps After an HIV Diagnosis

Diabetes Resource Round-Up

The Science Behind Vaccines

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