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Whether traveling domestically or abroad, arriving at your destination with the medication you need is rarely as simple as packing it in your suitcase. From TSA compliance to temperature control, there are many factors to consider when traveling with medication — not to mention getting enough of a supply for the whole trip (plus extra, just in case).

Managing Your Medications While Traveling

Planning is key to managing your prescriptions and staying on top of your health needs while you’re away from home. Follow these tips to prepare for your next trip.

Research your destination’s medication laws

Many medications that are legal in the U.S. aren’t allowed in other countries. And it’s not only prescription medications: even over-the-counter treatment options may not be permitted in some destinations.

To avoid any unwelcome surprises while going through customs — or any missed doses — confirm that your medications are legal in the country you’re visiting. As a starting point, check with that country’s U.S. embassy. Consider that some countries may only allow a 30-day supply for certain medications and/or require you to carry an official prescription or additional information from your doctor with you. If you learn that your medication is not allowed at your destination, contact your healthcare provider to discuss your options.

There are legal considerations to be aware of even if you are traveling within the U.S. For example, you may be able to fill certain prescriptions out of state if you lose your medication or forget to order a refill before your trip, but the laws vary by state and there are often restrictions on controlled substances. Do your research in advance and make sure to prepare for any scenario.

Make sure you have enough of your medication

Unforeseen changes can happen when traveling, so it’s important to have more than enough medication on hand. Aim for an additional week or two’s supply. Allow yourself plenty of time to fill your prescription(s) before your trip. Depending on when you are due for a refill, you may need to request an early refill authorization from your insurance company — sometimes referred to as a vacation override — in order to get your medication in advance. (Alto can help with this!) 

In addition, make sure you’re prepared in the event that you misplace your medication during your trip. Write down the generic names of your medications, which may be more commonly available at pharmacies in other countries.

Lost luggage can be more than an inconvenience if your medication is in your checked bag, so always pack any important medications in your carry-on. This does mean you’ll have to be mindful of security requirements, particularly if carrying liquid medication. The U.S. Transportation Security Administration (TSA)’s current limit on liquids, gels, and creams in a carry-on bag is 3.4 ounces (100 milliliters), but there are exceptions for liquid medications. For the easiest travel experience, inform the TSA officer that you are carrying more than 3.4 ounces of liquid medication before your screening process begins, and be aware that additional screening of your medication may be required.

Keep your medications in their original packaging to avoid any issues when passing through security or customs. You may want to bring an official prescription or other documentation of your medical condition as an additional precaution, especially if you take a controlled substance or are traveling abroad.

Many medications lose their effectiveness if held at extreme temperatures, which is another reason to put your medication in your carry-on, as a plane’s luggage compartment can be very cold. If you take a medication that requires refrigeration like insulin, make sure you have what you need to hold your medication at an appropriate temperature.

Many people with diabetes use insulated medication bags to refrigerate insulin when traveling. Read ‘How to Prepare a Diabetes Emergency Kit’ for more information on the diabetes essentials to bring on a trip.

If you’re traveling far from home, anticipate how time zone changes may impact your medication schedule. Before your trip, ask your doctor how to handle the time zone shift and what to do if you accidentally miss a dose — some medications have more flexible timing of doses than others. 

Getting a last-minute refill before a trip is low stress with a flexible pharmacy partner like Alto. We offer free same-day delivery seven days a week, with the convenience of choosing the best delivery window for your schedule. And we’ll 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

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

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

Overall heart health involves all the components of this complex network. Coronary artery disease — the most common type of heart disease — affects your blood vessels and the flow of blood to your heart. It typically develops over the course of many years, and many of the key risk factors can be managed. Here’s what to know about preventing and treating this type of heart disease.

Coronary Artery Disease, Explained

Your heart is at work every minute of the day, pumping blood to deliver oxygen to vital organs. Each part of the heart plays a role in this important task, along with the rest of your cardiovascular system, including your arteries and blood vessels.

Like any organ in your body, your heart needs oxygen to function. Coronary arteries are the blood vessels that supply your heart with oxygen-rich blood. Coronary artery disease occurs when these blood vessels are hardened or blocked, affecting the flow of blood to the heart itself.

This condition is often caused by atherosclerosis — the accumulation of substances like cholesterol and blood-clotting material in your arteries. (These substances are collectively referred to as plaque). A variety of factors can increase your risk for atherosclerosis — and therefore your risk for heart disease — including high LDL cholesterol, high blood pressure, diabetes, obesity, physical inactivity, and smoking. Additional key risk factors for heart disease include age and family history. 

There are several known symptoms of coronary artery disease, including chest pain or tightness (also called angina) and shortness of breath. Depending on where your blood vessels have narrowed, you may also experience pain, numbness, or weakness in your arms or legs. Women are more likely than men to experience additional symptoms such as nausea, back and jaw pain, and shortness of breath without accompanying chest pain.

Symptoms of coronary artery disease present differently from one person to another. It is best to discuss your risk of heart disease with your doctor if you have concerns rather than waiting for symptoms to appear. It’s especially important to be proactive if you have a family history of heart disease.

In the long term, coronary artery disease can increase your risk for other heart health issues, including heart attack and heart failure, which occurs when your heart cannot pump all of the blood that your body needs. These serious health risks are preventable — by identifying coronary artery disease at an early stage and following the treatment plan your doctor recommends, you can manage the condition and lower your risk for related complications.

Too often, people learn that they have coronary artery disease only after experiencing a more serious complication like a heart attack, stroke, or heart failure. Consulting with your doctor about your risk for heart disease and staying up to date with blood pressure, cholesterol, and blood glucose screenings is key to detecting heart health problems early on. Here are some of the numbers your doctor will track to identify your risk for heart disease, along with your individual and family health history.

The National Institutes of Health defines normal blood pressure for most adults as below 120 mm Hg systolic and 80 mm Hg diastolic. (Systolic pressure, the first number in your blood pressure reading, is typically the reading that’s most important when monitoring blood pressure.) If your blood pressure falls in this range, typical screening frequency is at least once per year. If your blood pressure is in a higher range, ask your doctor about recommended screening frequency.

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

In the long term, high blood sugar can damage your blood vessels, and diabetes is a risk factor for coronary artery disease. It’s important to monitor your blood glucose levels as part of your broader heart disease prevention efforts, especially once you enter your 50s and 60s. Your doctor can advise you on recommended screening frequency.

Remember that it’s never too early or too late to prioritize heart-healthy living. Read our previous blog, ‘How to Prevent Heart Disease at Any Age’ to learn about important heart disease prevention actions for your age group.

If you have coronary artery disease, your doctor may recommend lifestyle changes and/or medications to manage your heart disease risk factors. Quitting smoking, planning a heart-healthy diet, and exercising more frequently are often a first step in managing coronary artery disease.

The specific medications used to treat coronary artery disease vary by individual. Your doctor may prescribe one or more of the following types of medications depending on your health history:

Cholesterol-lowering medications like statins, fibrates, and niacin

Blood pressure medications like beta blockers, calcium channel blockers, and ACE inhibitors

Anticoagulants and antiplatelets to reduce your risk of blood clots

Heart-healthy living is a lifelong practice, and heart disease prevention or treatment is an ongoing commitment to your health. At Alto, we make it as simple as possible to manage your risk for heart health issues like coronary artery disease and stay on top of cholesterol-lowering or blood pressure management medications. 

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.

When inflammation persists, it no longer serves a helpful purpose. This type of inflammation, also referred to as chronic inflammation, occurs when your body consistently acts like it’s under attack, releasing white blood cells indefinitely. In the long term, an elevated white blood cell count can affect other organs such as your heart, lungs, and kidneys. Research has also found a connection between chronic inflammation and other chronic diseases including heart disease, diabetes, cancer, Alzheimer’s disease and Crohn’s disease.

Inflammation, Explained

Acute inflammation is the body’s natural way of fighting infections and injuries as part of the healing process. When you have an injury, blood flow increases as your body instinctively releases white blood cells, proteins, and other inflammatory chemicals to protect the wounded area. This leads to redness, swelling, and pain at the site of injury. The body reacts similarly when you have a virus or cold, but in these instances, the blood cells and inflammatory chemicals are released throughout the whole body rather than to one spot. This type of inflammation is good for you, as it allows your body to heal.

But when inflammation persists, it no longer serves a helpful purpose. This type of inflammation, also referred to as chronic inflammation, occurs when your body consistently acts like it’s under attack, releasing white blood cells indefinitely. In the long term, an elevated white blood cell count can affect other organs such as your heart, lungs, and kidneys. Research has also found a connection between chronic inflammation and other chronic diseases including heart disease, diabetes, cancer, Alzheimer’s disease and Crohn’s disease.

Read on for more information about the causes and symptoms of chronic inflammation and how to prevent or treat it.

Causes and symptoms of chronic inflammation

Several known factors can trigger chronic inflammation:

Lifestyle factors including obesity, diet, smoking, alcohol use, stress, and sleep disorders

Autoimmune diseases like type 1 diabetes or lupus, in which the body mistakenly attacks itself

Long-term exposure to pollution, industrial chemicals, or other toxins

Some individuals with this type of inflammation experience fatigue, fever, and joint and muscle pain. However, while there are clear physical signs of acute inflammation, chronic inflammation does not always have visible symptoms.

Your doctor can help determine if you have chronic inflammation. They will likely ask about your symptoms and perform a physical exam as a first step. They may then order additional tests to detect inflammation. These tests look for various indications of inflammation in your body, but they cannot formally diagnose inflammation or any other health condition. Rather, they provide a more comprehensive picture of your health so that your doctor can recommend the best next steps.

Potential tests your doctor may recommend during this process include a C-reactive protein (CRP) test and/or an erythrocyte sedimentation rate (ESR) test. A CRP test identifies your blood levels of CRP, a protein produced in your liver. Chronic and acute inflammation have both been linked to high levels of CRP.

An ESR test examines how quickly your red blood cells sink to the bottom of a test tube, with higher rates of settlement pointing toward more inflammation. Doctors often recommend this test when there is a possibility of high inflammation.

Sometimes these tests may help your doctor diagnose an inflammation-linked condition, such as rheumatoid arthritis or type 2 diabetes.

Chronic inflammation and other health conditions

There is a connection between chronic inflammation and many other health conditions. Inflammation can occur directly as the result of rheumatoid arthritis, which is both an autoimmune condition and an inflammatory disease. If you have rheumatoid arthritis, your immune system attacks your joints — often in your hands, writs, and knees — which leads to inflammation. There is also a direct link between inflammation and other inflammatory diseases, like ulcerative colitis and Crohn’s disease.

Inflammation has also been linked to heart disease and diabetes, but research into this connection is ongoing. While inflammation is more common in individuals with these health conditions, there is not yet definitive evidence that inflammation by itself directly increases your risk for these conditions.

Inflammation in the walls of your blood vessels has been linked to atherosclerosis, the accumulation of fats, cholesterol, and other substances in your arteries. In the long term, atherosclerosis increases your risk for a heart attack or stroke.

Since obesity, smoking, and physical activity are all risk factors for inflammation, heart disease, and diabetes, the overlap of these risk factors likely plays a role in the connection between the conditions. The good news is that a single healthy choice can lower your risk for all three diseases at once.

Your healthcare provider will recommend treatment based on the type of inflammation you have, however not all cases of chronic inflammation require medication.

Two types of medications are commonly used to lower both acute and chronic inflammation: nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil®), aspirin (Bayer®) or naproxen (Aleve®) and oral steroids including prednisone (Deltasone®, Prednicot®), methylprednisolone (Medrol®), and dexamethasone (Decadron®, Dexasone®). Steroid injections can reduce inflammation in a specific joint or muscle and are often used to treat rheumatoid arthritis.

If you have an inflammatory disease, your doctor may recommend medications specifically used to treat that disease. Medication classes commonly used to treat inflammatory diseases include:

Disease-modifying anti-rheumatic drugs (DMARDs) like methotrexate (Rheumatrex®), sulfasalazine (Azulfidine®), and leflunomide (Arava®). These medications can slow the progression of rheumatoid arthritis.

Statins, a type of medication commonly used to treat high cholesterol. They have anti-inflammatory effects and can lower CRP levels.

You can also fight inflammation simply by what you eat. An anti-inflammatory diet includes antioxidant-rich foods like the following: 

Cherries, blueberries, oranges, and other fruits

There are also some foods that have been linked to higher levels of inflammation. If you have chronic inflammation, your doctor may suggest limiting your intake of the foods below as part of your treatment plan:

White bread, pasta, pastries, and other refined carbohydrates

Soda, fruit juices with added sugar, energy drinks, and other beverages high in sugar

Red meat and processed meat like hot dogs and sausage

At Alto, we’re committed to making it as simple as possible to prioritize your health and well-being and stay on top of your medications.  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.

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.

If you take insulin daily to manage type 1 or type 2 diabetes, it’s important to choose a method of insulin delivery that fits your lifestyle and diabetes management needs. Many individuals who are often on-the-go find insulin pens to be most convenient given their portable size, discrete nature, and quick administration time. 

What to Know About Insulin Pens

Read on for more information about these devices, including the different types of insulin pens and what to consider when choosing one.

An insulin pen combines insulin and a syringe into a single device, allowing for a faster and easier administration than syringes. When it is time to administer an insulin injection, all you have to do is attach a new needle and dial the correct dosage on the pen. If you take multiple types of insulin every day, many insulin pen manufacturers offer color-coded pens or different designs to help you quickly identify each pen’s type of insulin.

While insulin pens simplify insulin delivery and how you measure your doses, you will still need to self-administer injections throughout the day. This is in contrast to an insulin pump, which automatically delivers doses of insulin at specific times. If you require many insulin injections each day, you may want to ask your healthcare provider if an insulin pump would be a good fit for your diabetes management needs.

There are two main types of insulin pens: disposable and reusable.

A disposable insulin pen contains a prefilled cartridge used for multidosing. You will discard the pen once the cartridge is empty or when the insulin expires, depending on the type of insulin you are using. These devices are sometimes referred to as “flex pens” or “quick pens.” Common brands include Lantus®, Tresiba®, Humalog®, Novolog®, and Basaglar®.

A reusable pen contains cartridges of insulin that are discarded once empty or when the insulin expires. You will replace the empty or expired cartridge with a new one and reuse the pen. These are sometimes referred to as “smart pens.” Common brands include InPen® and NovoPen®.

Follow the steps below to safely administer your insulin injections with a disposable or reusable insulin pen. A diabetes educator or healthcare provider can answer any questions and help you become more comfortable using the device.

1. Verify the expiration date of your insulin and do a visual check to make sure it has no clumps — most pens have a visible insulin reservoir. If the insulin is cloudy, roll the pen for a minute. (If the insulin is clear, you do not have to roll the pen.) If you take multiple types of insulin, make sure you are using the correct type.

2. Remove the pen cover or cap and sterilize the pen tip with alcohol using a cotton swab or gauze pad.

3. Attach a new needle to the pen, and have a sharps container ready for the used equipment. (You will need to use a new needle for each injection.)

4. Prime the pen if using it for the first time. Dial the dosage knob to two units, hold the pen with the needle pointing up, and tap the pen gently to let any air bubbles rise to the top. Press and hold the knob and look for a drop of insulin. If you do not see any insulin, repeat these steps as needed until at least one drop appears. This removes air bubbles from the needle and ensures that the needle is properly functioning. 

5. Choose an injection site, typically your abdomen, thigh, or arm, and wipe it with an alcohol swab. Hold the needle at the angle instructed by your doctor, most often a 90-degree angle.

6. Insert the needle into the skin and push the button on your insulin pen to deliver the injection. Wait ten seconds to make sure all of the insulin has been absorbed into your skin.

Unused pens must be refrigerated. However, do not place them in the freezer. Once in use, you may keep your insulin pen at room temperature. It’s important to avoid extreme temperatures as much as possible, so do not leave them anywhere where they will get too hot, like a car, or too cold. In addition, check the product’s package insert for an expiration date or consult your doctor about when to discard a pen or cartridge with unused insulin.

What to consider when choosing an insulin pen

You should consult with your doctor before choosing an insulin pen. In addition, consider the following factors:

The type of insulin you take — some insulin pens are only compatible with specific types of insulin.

Your insulin dosing needs — each pen has a maximum dosage. In addition, different pens can deliver insulin in increments of a half unit, one unit, or two units.

Your insurance coverage — ask your insurance provider what coverage they offer of insulin pens, if any, and explore the costs of other insulin delivery methods to determine the best fit for your needs.

Most insurance plans have separate medical and pharmacy benefits. In most cases, professional services provided by your doctor will fall under medical benefits while prescription diabetes medications — including insulin — will fall under pharmacy benefits. 

Some diabetes supplies, including many reusable insulin pens, are covered under a third type of benefits: the Durable Medical Equipment (DME) section of your policy. There may be restrictions on the brands or suppliers that are available, and it’s important to check with your specific policy to understand what will be covered and under which sections.

Many disposable insulin pens are often covered with your pharmacy benefits, in which case Alto may be able to help you get started with using an insulin pen. We will work with your insurance (if applicable) and any third party savings programs so that you can get your insulin pen at the lowest possible price.

A diabetes pharmacy partner you can rely on

At Alto, we believe a pharmacy should be a partner in your diabetes care. We have a dedicated diabetes support team to ensure that you have everything you need to follow through on your individualized treatment plan. Reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

At Alto, we strive to reduce the stress that comes with managing your diabetes however we can. As a pharmacy for all of your diabetes needs, we’re able to sync all of your medications and supplies into a single delivery every month. In fact, you might even be a little surprised by just how much is included in a diabetes delivery, so we put together a short overview of what’s inside the box.

What’s in Your Alto Pharmacy Diabetes Delivery

We recommend unpacking your full package upon delivery and making sure you have everything you need. Carefully check insulated wrappers or ice packs to make sure you don’t miss any medications or supplies, and promptly place any items marked “Refrigeration Needed” in your refrigerator.

A quick note on refrigeration: we understand how important it is that your medications and supplies arrive in good condition, and we use temperature controlled packaging to ensure that insulin is held at the right temperature while it’s on the way to you.

Depending on what your care team has prescribed, you’ll probably have many or all of the following in your Alto delivery:

Diabetes medications in the form of vials, pens, pills, tablets, or inhalation devices

Insulin pumps (small electronic devices that deliver doses of insulin at specific times - common brands include Omnipod®)

Blood glucose meters, test strips, and lancets (common brands include Accu-Chek® and OneTouch®)

Smart insulin pens (a method of insulin delivery that combines insulin and syringe into a single device - common brands include InPenTM)

Continuous glucose meters (CGMs) (a small electronic device that automatically collects glucose readings at regular intervals throughout the day - common brands include Dexcom® and Freestyle Libre®)

Supplies like needles or syringes will be packaged in their own bag with a label that explains their purpose.

Note: the specific medications and supplies you have for your injections and diabetes care may look different than what is displayed in these photos. If your physician has instructed you to use a specific device, supply or medication, always follow their instructions.

It’s important to practice safe disposal methods for your needles and other injection or testing supplies. 

Use your red sharps container to safely store your needles after use. Sharps should never be thrown loosely into the trash, in the toilet, or in the recycling bin. Sharps that retract after use or are very small should follow the same disposal method as all other sharps.

Alto does not accept returns of sharps containers - you can find a safe local disposal site here.

If you need a new sharps container, send us a message in the app, and we’ll add it to your next delivery.

We’re a one stop shop for all your diabetes management needs. In addition to auto refills and med syncing, we offer free, same-day delivery and automatic savings investigations. And our team of pharmacists is always here to answer your questions by phone or the Alto app. 

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881 to learn how Alto can be a partner in your diabetes care.

A consistent lack of sleep can also affect your physical and mental health in the long term. Here's what you can do to improve your sleep hygiene.

How Sleep Affects Heart Health | Alto Pharmacy

If you’ve ever slept less than the CDC-recommended minimum of seven hours per night, you may have experienced short-term effects of sleep deprivation like forgetfulness, irritability, and an inability to focus. A consistent lack of sleep can also affect your physical and mental health in the long term. And just like diet choices and frequency of physical activity, your sleep habits are linked to your risk for heart disease.

Below, we explain more about how sleep affects heart health and what you can do to improve your sleep hygiene.

Sleep allows your body to recharge. As you enter a state of deep sleep, your heart rate slows down and your blood pressure drops. These physical changes give your heart a chance to recover from how hard it works when you’re awake.

When you don’t spend enough time in uninterrupted deep sleep, your heart doesn’t get the opportunity to rest. Research has found that chronic sleep deprivation and sleep disorders can contribute to numerous cardiovascular health issues including high blood pressure, high cholesterol, and a greater risk for a heart attack or stroke.

Cardiovascular health issues related to sleep

Over time, many sleepless nights can lead to higher baseline blood pressure levels during the day. High blood pressure, or hypertension, is among the leading risk factors for heart disease and stroke. If you experience consistent stress or if you have other risk factors for high blood pressure, you may be more likely to develop high blood pressure as a result of sleep deprivation.

Poor sleep may also contribute to these cardiovascular health issues:

Coronary artery disease occurs when cholesterol and other fatty material (collectively referred to as plaque) builds up in your arteries, making it harder for your heart to pump blood to the rest of your body. This accumulation of plaque is also called atherosclerosis.

Some research has found that a lack of sleep may contribute to atherosclerosis. This is partially due to the connection between sleep deprivation and hypertension, as high blood pressure strains your arteries. In addition, poor sleep can trigger chronic inflammation over time, which also contributes to the accumulation of plaque and the hardening of your arteries.

Chronic sleep deprivation may also increase your risk for a heart attack. One research study found that people who slept less than six hours per night had a 20% higher risk of a heart attack in comparison to those who got more sleep.

While your heart slows down when you are in a state of deep sleep, your heart rate and blood pressure can increase if you wake up suddenly. Over time, consistent sleep disruptions can put greater stress on your heart and contribute to your overall heart attack risk.

A stroke is a cardiac event in which blood flow to your brain is interrupted, causing brain cells to die. Because sleep deprivation can drive high blood pressure and plaque accumulation in your arteries — two leading risk factors for strokes — there is also a correlation between a lack of sleep and your risk of having a stroke.

Type 2 diabetes is a condition in which your body’s cells become resistant to insulin, and your pancreas cannot produce enough insulin to regulate levels of blood glucose. It develops gradually due to a mix of genetic, lifestyle, and environmental factors.

Research has linked poor sleep to prediabetes, a health condition defined primarily by blood sugar levels that are higher than normal but below the official range for a type 2 diabetes diagnosis. If left untreated, prediabetes can progress into type 2 diabetes and lead to health complications in the long term, including cardiovascular issues.

If you already have diabetes, a lack of sleep or frequently interrupted sleep may also impact blood sugar management.

There are two primary sleep problems that can impact your long-term cardiovascular health: sleep apnea and insomnia.

Sleep apnea is a disorder in which your airway is blocked during sleep, which causes you to stop breathing for short periods of time. It affects your oxygen levels while sleeping and may increase your risk for high blood pressure, heart attack, and stroke.

Insomnia is when you have trouble going to sleep or staying asleep. Many individuals have experienced insomnia in the short-term, and the CDC estimates that 1 in 10 U.S. adults may experience chronic insomnia.

More than 1 in 3 adults in the U.S. report getting less than the recommended seven hours of sleep per night. The good news is there are steps you can take to improve your sleep hygiene. Start with the following:

Maintain a consistent sleep schedule, going to bed and waking up at the same time every day, including weekends.

Avoid use of electronic devices close to your bedtime.

Get plenty of natural light and stay physically active during the day, but avoid exercising close to bedtime.

Avoid consuming food or beverages close to bedtime, particularly caffeine, alcohol, and high-sugar or high-fat foods.

Keep your bedroom dark and quiet and maintain a comfortable temperature. 

Read our previous blog for strategies that can help you avoid stress-related sleep problems..

If you think you may have a sleep disorder, you should also consult with your doctor for a diagnosis and treatment, in addition to taking the actions above.

At Alto, we’re committed to making it as simple as possible to protect your heart health and stay on top of cholesterol-lowering or blood pressure management medications.  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

How Sleep Affects Heart Health & Tips for Better Sleep

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

How to Prepare for Cold and Flu Season

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

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

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

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

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

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

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

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

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

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

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

Get a good night’s sleep and regular exercise

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

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

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

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

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

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

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

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

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

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

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

In addition, check out free mental health apps like What’s Up?, which helps you manage stress and negative thoughts through a therapy approach called cognitive behavioral therapy (CBT), and Insight Timer, which has a diverse library of free guided meditations.

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

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

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

Evidence suggests that gut health may also belong on the list of heart disease risk factors. Here’s what to know about the link between heart health and gut health, including steps you can take to maintain a balanced gut microbiome.

What to Know About the Heart and Gut Health Connection

Different factors can increase your chance of developing heart disease, like age, family history, high cholesterol, and high blood pressure, among others. And now, evidence suggests that gut health may also belong on the list of heart disease risk factors.

There are trillions of bacteria, fungi, and other small, microscopic organisms called microbes housed in your digestive system. They are collectively referred to as the gut microbiome. In recent years, researchers have found that the gut microbiome affects more than your digestive health alone. Heart disease is one of several health conditions that may be at least partially fueled by an unhealthy balance of gut bacteria.

The good news? This is a heart disease risk factor you definitely have control over. Here’s what to know about the link between heart health and gut health, including steps you can take to maintain a balanced gut microbiome.

Metabolites and your cardiovascular system

During the digestive process, microbes produce substances called metabolites. One of these substances in particular, trimethylamine (TMA), is linked to your risk for cardiovascular disease and other chronic health conditions like diabetes.

TMA forms when the bacteria and other organisms within the gut microbiome consume choline, a nutrient contained in red meat, fish, poultry, and eggs. The liver then converts TMA into a substance called trimethylamine N-oxide (TMAO). 

The medical community has identified a connection between high levels of TMAO in your blood and deposits of cholesterol, blood-clotting material, and other substances in your arteries. These substances are collectively referred to as plaque, and its accumulation in your arteries is referred to as atherosclerosis, a leading cause of cardiovascular disease, heart attacks, and strokes.

A 2017 analysis of several studies on the connection between TMAO blood levels and cardiovascular health found a correlation between elevated TMAO levels and serious cardiovascular issues. In the studies, researchers looked at people from different categories of health conditions in multiple countries, like individuals with and without diabetes, and individuals with and without chronic heart failure. 

Each group included individuals with various TMAO levels. The results showed that people with the highest levels of TMAO were 62% more likely to experience serious cardiovascular issues like heart attacks and strokes. The link appeared to be independent of other key risk factors for heart disease like diabetes and obesity.

In addition to the findings about TMAO, researchers have also identified a link between gut health and inflammation (redness, warmth, and swelling around tissues and joints). Inflammation is part of the body’s natural response to an injury, but when it persists after the healing process and becomes chronic inflammation, it can lead to an ongoing high white blood cell count.  

Over time, this elevated level of white blood cells can affect other organs including your heart, lungs, and kidneys, which may influence your risk for heart disease and other chronic conditions like diabetes.

The majority of the body’s inflammatory cells are stored in tissues in your gut, and researchers have found that an inflamed gut can trigger inflammation elsewhere in your body. Certain gut bacteria produce substances that enter your bloodstream and create inflammation in every part of the body that they travel through. This inflammation in the walls of your blood vessels can eventually lead to atherosclerosis.

Researchers are still learning about the gut microbiome’s influence on your risk for various health conditions. One thing they do know for sure is that a healthy gut microbiome is an important component of your overall health, and there are simple steps you can take to maintain a balanced digestive system.

A balanced diet is a great starting point for better gut health. Start by limiting foods that are processed or high in sugar or fat — particularly cookies, sugary drinks, salty snacks, and frozen foods — as these can lead to increased inflammation. Opt for fiber-rich foods like beans, peas, bananas, and asparagus; fermented foods like kimchi, yogurt, miso, and kefir; and collagen-rich or collagen-boosting foods like salmon, mushrooms, and egg whites.

Staying physically active and avoiding unhealthy habits like smoking and heavy alcohol consumption can also improve your gut health. Looking for a fitness routine that fits your schedule and health needs? Aim for about 150 minutes a week or 30 minutes per day. Explore different activities until you find the one that’s right for you — whether virtually or in person.

Over the long term, stress can lead to many physical and mental health problems, including digestive issues. Staying physically active reduces stress, so you’re already tackling this risk factor simply by working out regularly.

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