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After an initial stroke, 1 in 4 individuals will have another within five years. Medications play an important role in preventing another stroke and treating stroke-related complications, often in tandem with lifestyle changes.

There’s no one-size-fits-all treatment plan. Your doctor may prescribe one or more medications based on the underlying cause of your stroke as well as its impact on your physical and mental health.

Medications Used After a Stroke

After an initial stroke, 1 in 4 individuals will have another within five years. Medications play an important role in preventing another stroke and treating stroke-related complications, often in tandem with lifestyle changes.

There’s no one-size-fits-all treatment plan. Your doctor may prescribe one or more medications based on the underlying cause of your stroke as well as its impact on your physical and mental health.

Here’s what to know about stroke causes and medications commonly prescribed during recovery.

A stroke disrupts the flow of blood and oxygen to the brain, potentially damaging brain tissue. This can lead to impaired speech, impaired cognitive function, memory loss, numbness, and paralysis.

Strokes can be life-threatening, so it’s important to seek immediate medical care if you exhibit signs of a stroke such as the following:

Sudden numbness or weakness in the face, arm, or leg

Sudden confusion or difficulty speaking or understanding speech

Sudden severe headache without another cause

There are two types of strokes, with different underlying causes:

An ischemic stroke occurs when blood flow to the brain is blocked, often due to a blood clot or the accumulation of plaque in blood vessels. It is the more common type of stroke. Associated health risk factors include high cholesterol, atrial fibrillation, and diabetes.

A hemorrhagic stroke occurs when a blood vessel in the brain leaks or ruptures, damaging brain cells as a result. Associated health risk factors include high blood pressure and aneurysms.

Additionally, a transient ischemic attack (TIA) — sometimes referred to as a ministroke — occurs when there is temporarily reduced or blocked blood supply to the brain, often as the result of a blood clot. Unlike ischemic and hemorrhagic strokes, a TIA does not result in permanent damage.

Many of the leading risk factors for a stroke are modifiable, including:

Aftercare may include management of these risk factors.

There are a variety of medication classes used during stroke recovery, including the following.

Since high blood pressure is a leading cause of hemorrhagic strokes, stroke recovery may involve the use of several types of blood pressure medications.

Beta blockers cause the heart to beat more slowly and less forcefully, lowering blood pressure. Commonly prescribed beta blockers include atenolol (Tenormin®), bisoprolol (Zebeta®), metoprolol tartrate (Lopressor®), metoprolol succinate (Toprol-XL®), acebutolol (Sectral®), and propranolol (Inderal®).

ACE inhibitors lower blood pressure by blocking production of a hormone called angiotensin II, which causes blood vessels to narrow. Commonly prescribed ACE inhibitors include benazepril (Lotensin®), enalapril (Vasotec®), fosinopril (Monopril®), lisinopril (Prinivil®, Zestril®), and ramipril (Altace®).

Calcium channel blockers prevent calcium from entering the smooth muscle cells of the heart and blood vessels so that the heart beats with less force. Commonly prescribed calcium channel blockers include amlodipine (Norvasc®), diltiazem (Cardizem CD®, Tiazac®), nifedipine (Procardia XL®), and verapamil (Calan SR®, Verelan®).

Diuretics lower blood pressure by helping the body get rid of excess sodium and water, reducing the volume of fluid in blood vessels. Commonly prescribed diuretics include chlorthalidone (Thalitone®, Tenoretic®, and Clorpres®), hydrochlorothiazide (HydroDiuril®, Microzide®, and Esidrix®), and indapamide (Lozol®).

Read Common Types of Blood Pressure Medications to learn more about these medications and potential side effects.

Anticoagulants interrupt the body’s natural blood clotting process to prevent new clots from forming and existing ones from growing. The following types of anticoagulants may be prescribed after an initial ischemic stroke.

Warfarin (Coumadin® and Jantoven®) prevents your liver from producing proteins that help form blood clots. It is taken orally as tablets. It has been associated with excessive bleeding in some individuals. Inform your doctor if you have a bleeding disorder so that they can prescribe an alternative.

Direct-acting oral anticoagulants (DOACs) directly block the blood’s ability to form new clots. Commonly prescribed DOACs include apixaban (Eliquis®), dabigatran (Pradaxa®), edoxaban (Savaysa®), and rivaroxaban (Xarelto®).

Read How Anticoagulants Prevent Blood Clots From Forming to learn more about these medications and potential side effects.

Like anticoagulants, antiplatelets prevent blood clotting and may be used during recovery from an ischemic stroke. They prevent platelets from coalescing, targeting a particular step in the formation of blood clots. Clopidogrel (Plavix®) is a commonly prescribed antiplatelet during stroke recovery.

Aspirin may also be used for antiplatelet therapy. If you are taking aspirin, avoid taking other nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen and naproxen, as they may interfere with aspirin’s antiplatelet effect.

Atrial fibrillation, or Afib, is a rapid heart rate caused by irregularities in the heart’s upper chambers. It can lead to the accumulation of blood and the formation of blood clots, increasing an individual’s risk for stroke. (Having other conditions such as high blood pressure, diabetes, or heart failure in addition to Afib may further increase your risk for a stroke.)

There are several medications that may be used to control heart rate and prevent a secondary stroke, including beta blockers, calcium channel blockers, and an antiarrhythmic called digoxin (Digox®, Lanoxin®, Digitek®).

Since high cholesterol may be associated with an increased risk for an ischemic stroke or ministroke, statins — a type of cholesterol-lowering medication — may be prescribed during stroke recovery. Statins act on the liver to reduce the amount of cholesterol produced by your body, in turn preventing plaque accumulation.

Commonly prescribed statins include atorvastatin (Lipitor®), fluvastatin (Lescol®), lovastatin (Mevacor®, Altoprev®), pravastatin (Pravachol®), rosuvastatin calcium (Crestor®), and simvastatin (Zocor®).

Read How to Manage High Cholesterol: Diet, Medications, and More to learn more about these medications and potential side effects.

If you have diabetes, your doctor may revisit your diabetes treatment plan after an ischemic stroke. Individuals with type 1 diabetes require insulin every day to maintain healthy blood sugar levels. Treatment for type 2 diabetes is more varied and may involve insulin, oral medications such as metform, or a combination of both.

A stroke may lead to the loss of bone density. This can increase an individual’s risk for osteoporosis, a condition that weakens bones. After a stroke, your doctor may recommend increasing your intake of calcium and vitamin D — the most important nutrients for bone strength and health — depending on your symptoms.

Treatment for osteoporosis may also include medications such as bisphosphonates, which prevent the loss of bone mass. Commonly prescribed bisphosphonates include alendronate (Fosamax®, Binosto®), ibandronate (Boniva®), risedronate (Actonel®, Atelvia®), and zoledronic acid (Reclast®).

Many individuals experience depression after a stroke, both as a response to the emotional challenges of stroke recovery and due to stroke-induced biochemical changes in the brain.

Medication may be necessary to manage symptoms of depression. There are many types of antidepressants, including:

Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac®), sertraline (Zoloft®), citalopram (Celexa®), and escitalopram (Lexapro®)

Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta®), venlafaxine (Effexor®), and desvenlafaxine (Pristiq®)

Atypical antidepressants such as trazodone, mirtazapine (Remeron®), and bupropion (Wellbutrin®)

A psychiatrist can recommend the best option based on your particular symptoms of depression, your overall health history, and other medications you’re taking.

Recovery from a stroke is often a gradual process. In addition to taking medication and practicing a healthy lifestyle, your doctor may also recommend speech therapy, physical therapy, and/or occupational therapy.

It’s important to take care of your emotional and mental health. Speak with your healthcare provider about resources that can support your recovery and help you adjust to the changes a stroke may bring. Individual psychotherapy or support groups can be helpful tools.

At Alto, we make it as simple as possible to 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 messaging or by phone at 1-800-874-5881.

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

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

A healthy pregnancy begins well in advance of trying to conceive. Preconception health planning sets you up to feel your best while growing a baby, allowing you to work towards health goals and manage preexisting conditions that could potentially result in complications.

How to Have the Healthiest Pregnancy Possible

It can also help you make any necessary changes to your treatment plan — for example, if you take a medication that is considered unsafe during pregnancy, your doctor can help you safely transition to an alternative.

Below, we break down some of the most important steps to take as you focus on your health and wellness while building or growing your family.

1. Consult your doctor about your health history

As you begin to plan for a baby, schedule a doctor’s appointment to identify any health issues that can impact pregnancy — whether it’s your first, second, third, or fourth.

While chronic health conditions like diabetes, hypertension, thyroid disease, and asthma are sometimes linked to pregnancy complications, you can prevent health challenges during pregnancy by staying proactive about treatment. For those with diabetes, this means working with your provider to maintain healthy blood sugar levels before trying to conceive. The same goes for hypertension and blood pressure levels.

Read Navigating Pregnancy With Type 1 or Type 2 Diabetes

Be sure to discuss any past pregnancy complications, if relevant. Experiencing certain complications in a first pregnancy can increase your risk of having them again in a later pregnancy. These complications include:

This does not mean that a recurrence is inevitable. Proactively managing your risk before and during pregnancy is the most important thing you can do to prevent these complications.

You should also share any health issues that you experienced during postpartum, including mental health challenges.

Changing a medication regimen or treatment plan

A pre-pregnancy care checkup is also an opportunity to discuss potential changes to your treatment plan. Bring all medications you are currently taking with you to this appointment, including vitamins and herbal remedies.

Never stop taking a prescribed medication without first consulting your doctor. Many medications cannot be abruptly discontinued and require you to slowly titrate, or taper off, over a period of time

It is recommended to focus on preconception health at least three months prior to pregnancy. However, everyone has unique health needs, and you may need more time to prepare for a healthy pregnancy. Try, as much as possible, to be patient and give your body the time and space it needs.

2. Get all recommended vaccines and screenings

At the beginning of your family building journey, ask your doctor which vaccines are recommended for your age. Certain infections or illnesses can cause birth defects or pregnancy complications. Many of these can be prevented with vaccines. And since illness-fighting antibodies can pass through the placenta, vaccinated individuals can pass along immunity to their growing baby in the womb.

It’s important to stay up to date since the recommended timing of vaccines varies. Not all can be given during pregnancy while others can. Your doctor can clarify which vaccines are recommended before pregnancy, during pregnancy, and after delivery. (Two of the most important vaccines for pregnant women, the flu vaccine and the Tdap vaccine (tetanus, diphtheria, pertussis), can be safely administered during pregnancy.)

Additionally, sexually transmitted infections (STIs) including HIV, HPV, and viral hepatitis can cause pregnancy complications and harm a developing fetus. Fortunately, treatment can prevent transmission to a baby. Screening for these infections is a critical step in planning for a healthy pregnancy.

3. Take steps to live your healthiest life

In the months before trying to conceive, revisit your health habits and make any changes to your routine or lifestyle that can support the healthiest pregnancy possible. There are several key areas to focus on.

Several nutrients are especially important to consume in the months before pregnancy. 

The American College of Obstetricians and Gynecologists recommends taking a prenatal vitamin with at least 400 micrograms of folic acid every day for at least a month before pregnancy through the first trimester. This important nutrient supports a baby’s growth and development and can prevent certain birth defects.

Depending on your health history and previous pregnancies, your provider may advise you to increase your intake of folic acid with an additional supplement.

(You can add prenatal vitamins to your next Alto delivery!)

Calcium helps build a developing fetus’s bones and teeth. Dairy products including milk, cheese, and yogurt are the primary sources of calcium, but you can also get this nutrient from other sources including:

If you are concerned about your calcium intake, ask your doctor about calcium supplements.

Iron also helps support a healthy pregnancy. Some prenatal vitamins include iron. It can also be found in the following iron-rich foods:

In addition, be sure to eat foods that support your body’s absorption of iron, including the following fruits and veggies, which are rich in vitamin A and beta-carotene:

If you have anemia, your doctor may recommend additional iron supplements.

An omega-3 fatty acid called DHA, or docosahexaenoic acid, is important for fetal growth and development. It can be found in some foods such as fatty fish. Depending on your diet, your doctor may recommend taking supplemental DHA before and during pregnancy and in the postpartum period. Some prenatal vitamins contain DHA, but not all, so be sure to check the ingredient list.

Since heavy caffeine consumption can affect fertility, it is recommended to reduce your intake to 200-300 mg per day.

Aim for about 150 minutes of moderate physical activity per week, incorporating some muscle-strengthening exercises.

Being underweight or overweight can cause health issues during pregnancy. Try to reach and maintain a healthy weight in the months before trying to conceive. Your provider is an important resource and can advise you on whether your weight may impact your pregnancy.

Smoking, drinking alcohol, and using certain drugs — including misusing prescription medication — can cause serious health issues during pregnancy like preterm birth and birth defects. When planning for a future pregnancy, do not be afraid to ask for any support needed to give up harmful behaviors. Your provider can offer resources. 

It’s also important to avoid secondhand smoke during pregnancy.

Genetics are a factor in your baby’s health and the progression of your pregnancy. Prior to pregnancy, discuss your family’s health history as well as your partner’s with your provider. This allows them to identify any genetic risk factors.

Some couples and individuals may be referred to a genetic specialist for reasons such as the following:

A family history of a genetic condition, birth defect, chromosomal disorder, or cancer

Two or more pregnancy losses or a stillbirth

Having given birth to a child with a genetic condition, birth defect, or intellectual disability

These risk factors do not guarantee that your baby will develop a health condition or that you will have a complicated pregnancy. Genetic testing can determine the likelihood of passing on a genetic issue to a child. A genetic specialist can help you understand your options for testing.

5. Prioritize your partner’s health as well

Preconception health concerns both parents. Male partners should also take steps to become as healthy as possible, which will improve their own reproductive health and fertility. This includes limiting their alcohol intake, quitting smoking or using harmful substances, and eating a healthy diet. (These lifestyle factors have been linked to issues with sperm production.)

Other important steps for male partners to take before trying to conceive include getting screened for STIs and consulting with a provider about family health history and medication use.

Alto Pharmacy can support you in preparing for a healthy pregnancy, however that looks for you. From delivering prenatal vitamins straight to your doorstep, supporting you in managing a chronic condition, or helping you navigate fertility treatment, we make it as simple as possible to focus on your health.

We offer free, same-day delivery and in-app medication management tools like reminders and auto refills. Additionally, our pharmacists are available to answer any questions you may have about medications or side effects.

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

For many Americans living with a chronic health condition, prescription medications are necessary to manage symptoms and prevent complications. But following a treatment plan can be easier said than done. There are many considerations involved, from managing medication interactions and side effects to staying on track with related testing and follow-up appointments. And of the 66% of U.S. adults who are prescribed medication, only half take their medication as prescribed.

National Pharmacists Month Spotlight: Wei-Lin Chang

At Alto, medication therapy management pharmacists like Wei-Lin Chang help patients navigate all the complexities of managing a chronic disease. As part of our coverage of American Pharmacist Month 2022, we spoke to Wei-Lin about her professional path, the challenges of retail pharmacy, and the importance of medication education.

What motivated you to pursue a career in pharmacy?

I honestly didn’t know what I wanted to do when I first entered college. My parents encouraged me to pursue a career in healthcare, but I knew I was a bit too squeamish around needles to become a doctor or nurse.

I took a chemistry class that I really enjoyed and decided to do all the pharmacy prereqs. I then did an internship with the head of pharmacy at Cook County Hospital in Chicago. Through that experience, I saw firsthand that pharmacists were a critical liaison between patients and doctors, with so much valuable information about medication strength, directions, dosing, and administration.

After that, I pretty much knew that pharmacy was for me. I’ve been practicing since 2002.

What challenges have you encountered as a pharmacist?

Before Alto, I worked in traditional retail pharmacy. In that setting, you’re so busy as a pharmacist — it’s one customer after another after another.

I worked both daytime and night shifts, and it was during the night shift, when the store was much more quiet, that I could really counsel patients without feeling so pressed for time. During the day, I simply didn’t have the free minutes to always answer patient questions or give recommendations.

Another challenge I faced was the perception of our profession. At the beginning of my career, in the early 2000s, many people I encountered didn’t know a pharmacist did much beyond putting pills in bottles and handing them off to customers. Not only did this lead to frustration from my customers, who would wonder what we were doing and why it was taking so long, it led to missed opportunities to more actively participate in a patient’s health journey. 

More medication education for patients is an urgent need within American healthcare. People taking multiple medications have to be mindful of potential side effects and medication interactions.

The growing field of medication therapy management is an opportunity for pharmacists to play an even bigger role in patient health, and I’m very proud to work for a company that prioritizes this particular area of pharmacy.

As a medication therapy management (MTM) pharmacist, I contact patients who take multiple medications — often multiple heart medications — and review their entire regimen over the phone. I make sure that they understand the purpose of each medication they’re taking and are on track with related testing.

For example, it’s important to get your liver function checked every 6-12 months if you’re taking cholesterol-lowering medications that are processed by the liver, or to get your A1C levels checked every 3-6 months if you’re taking diabetes medication.

We also discuss side effects, interactions, when to take medication, and what food to take it with. Too often, there isn’t the space for these conversations between pharmacists and patients, but they are so essential to a patient’s overall health. 

I love our pharmacy specializations. It’s unique to have a team that focuses solely on patients and another team that focuses on fulfillment. Not all pharmacies have a medication therapy management program, and it’s possible at Alto in part because of our smart allocation of resources.

Being able to use all of my time to focus on my core job functions is such a contrast to retail pharmacy, where you’re constantly bombarded from all sides at once.

As a pharmacist, what does “care” mean to you?

Care to me means going above and beyond for your patients and making sure all loose ends are tied. As an example, I recently initiated a transfer for one of the heart medications a patient takes. At Alto, we always complete every single step of the prescription transfer process on the patient’s behalf. He was so appreciative, and when I got off the phone, I could tell from his voice that he was smiling ear to ear. That’s the experience I want all of my patients to have.

This is part of a series of pharmacist profiles to recognize American Pharmacist Month 2022. To keep the Pharmacist Month celebrations going, meet patient care pharmacist Travis Allison and specialty patient care pharmacist Gabrielle Kaplan.

Despite the misconception of HIV as an illness that primarily affects young people, nearly half of all those with HIV in the U.S. are age 50 and older. This is both a testament to the effectiveness of treatment, as many of these individuals were diagnosed at an earlier age, and a reminder that people of all ages can receive an HIV diagnosis.

HIV and Aging: What to Know

As the HIV population ages, management of the condition continues to evolve, with different health challenges to navigate. Below, we highlight several important health considerations to be mindful of.

Antiretroviral therapy (ART) has been the frontline treatment for HIV since 1995. It is a combination of medications that keep HIV from replicating, stopping the progression of the virus and preventing transmission.

When all medications are taken every day as prescribed, ART can help those with HIV maintain an undetectable viral load. As a result, more than half of all individuals living with HIV in the U.S. are not at risk of transmitting the virus to others.

Regular attendance at doctor’s appointments is an important part of proactively managing HIV. Your provider needs to monitor your body’s response to your individual ART protocol, testing bone, kidney, metabolic, cardiovascular, cognitive, and liver function. (Thanks to the variety of medication options, it is easy to make adjustments as needed if you experience side effects or don’t achieve the desired results.)

For older adults with HIV, ongoing monitoring and testing is especially important, as there is a greater possibility of side effects such as impaired cognitive function and bone health issues.

It is also important to closely monitor how ART interacts with other medications. As you age, you are more likely to be prescribed multiple medications to manage several conditions.

People of all ages should be regularly tested for HIV, since a diagnosis is possible at any age. Older individuals are less likely to be tested — and more likely to receive a late diagnosis — due to the following factors:

The misconception of HIV as exclusively a young person’s illness

The overlap between HIV symptoms and typical signs of aging

Remember that getting tested is the only way to know your HIV status. Continue to stay proactive about regular testing every year. Search for an HIV testing site near you.

Older adults with HIV are more likely to also have health conditions associated with aging, including:

Here’s a quick look at how HIV intersects with several of these health issues.

The ongoing immune system activity and inflammation caused by HIV can contribute to plaque accumulation in blood vessels, a leading factor in the development of cardiovascular disease. Statins, a type of cholesterol-lowering medication, have been shown to lower the risk of heart disease in individuals with HIV.

To protect your heart health while living with HIV, stay on track with preventative care. Your provider should regularly check your cholesterol, blood pressure, and blood sugar. Additionally, maintain a heart-healthy lifestyle, with healthy habits like exercising regularly, eating a balanced diet, and refraining from smoking.

HIV has been linked to a greater risk of cancers including liver cancer, lung cancer, cervical cancer, and Hodgkin’s lymphoma. Ask your doctor about the recommended frequency of screenings for these types of cancer as well as others that are not related to HIV and AIDS.

The gradual loss of bone mass is a normal part of aging. For those with osteoporosis, a condition that weakens bones, the changes are more pronounced. HIV can increase a person's risk of developing osteoporosis. (While osteoporosis disproportionately affects women, both men and women with HIV face an increased risk.)

A simple bone mineral density test, sometimes referred to as a DEXA scan, can identify bone health issues. This screening is recommended for all women over the age of 65 and all men over the age of 70. If you have HIV, you may need earlier and/or more frequent screening. Consult with your doctor about recommended frequency.

Aging brings a risk of cognitive decline for anyone, regardless of health history. HIV has been linked to a faster decline in cognitive function. Though older individuals with HIV were once thought to have an elevated risk of dementia, the evolution of ART has helped lessen this possibility. However, a milder form of cognitive impairment called HIV-associated neurocognitive disorder (HAND) remains a health concern for older those with HIV.

Regular health exams should include screening for signs of cognitive issues including changes related to thinking or memory.

Loneliness and social isolation — factors in the development of physical health issues like dementia as well as mental health disorders — are more common among older adults. Older individuals with HIV should be even more proactive about monitoring mental health, as living with HIV at any age is linked to depression.

Make sure your doctor screens you regularly for depression and other mental health issues. If you have symptoms, ask about potential treatment options or a referral to a psychiatrist or psychologist. You may also want to explore additional resources such as virtual or in-person support groups for older adults with HIV.

Navigate HIV treatment with Alto by your side

Our pharmacists have deep expertise in HIV treatment and prevention and can help you get started with antiretroviral therapy. We will coordinate with your doctor and your insurance provider, if applicable, to ensure that you’re receiving the best option for your needs at the best price. To learn more, reach out any time via text or phone at 1-800-874-5881, or in-app messaging.

A child’s diabetes care needs don’t stop during the school day, and starting a new school year or returning to the classroom after a diagnosis can be overwhelming for students and parents alike. Advanced planning and coordination with school staff can ease the transition and ensure that your child has everything they need to stay safe and healthy while at school. Below, we highlight the most important steps to take.

Managing Your Child’s Diabetes at School

To ensure effective management of your child’s diabetes during the school day, school staff should be informed of your child’s treatment plan as well as what to do in the event of a hypoglycemia or hyperglycemia emergency. There are two important plans to finalize and share with the school.

A diabetes medical management plan (DMMP) is the foundation of your child’s care regimen at school. It translates your endocrinologist’s recommendations into actionable items for your child’s school nurse, teacher, and other school staff members who are responsible for students.

A DMMP should cover every aspect of your child’s diabetes management, including the following. The American Diabetes Association has a detailed DMMP template that you can use as a starting point.

Insulin therapy needs, including the delivery device and timing of dosages and whether to contact you to adjust a dose

Important considerations for physical activities

Diabetes care needs — and the amount of support a child needs with them — evolve with time. Include information about your child’s self-care skills in your plan, clarifying specifically what support will be required from staff. Each school year, revisit your child’s DMMP with your endocrinologist and make updates if needed.

As you finalize your child’s treatment plan and your DMMP, consult with your endocrinologist about your insulin delivery device options. Many children find it convenient to use an insulin pump while at school, given the ease of use and automated timing of injections.

Insulin pens, which combine insulin and a syringe into a single device, also allow for faster and easier administration than syringes. (Some types of insulin pens are covered under pharmacy benefits — Alto may be able to help your child get started with these devices.)

You may also want to explore a continuous glucose monitoring (CGM) device for your child’s blood glucose monitoring needs. In contrast to traditional blood glucose meters (BGMs), which provide a single blood glucose reading by pricking a finger, CGMs automatically collect glucose readings regularly throughout the day. They can identify patterns that aren’t as easily captured by a traditional BGM and eliminate the need to step away for blood sugar readings. (Some CGMs give you the option of adding “followers,” so that you can alert your child’s provider and the school nurse to a potential emergency.)

504 Plan or Individualized Education Program (IEP)

After your DMMP has been finalized, the next step is to draft a 504 plan or individualized education program (IEP). This plan takes all of the information about your child’s care needs from the DMMP and documents the school’s specific responsibilities.

If the school nurse will typically oversee your child’s care, a 504 plan should address who will step in if the nurse is unavailable. Account for after-school activities and events and field trips as well.

Share any relevant information with your child. For example, make sure they know who to go to for help with blood sugar testing or if they experience symptoms of low blood sugar.

This plan should be revisited each year and shared with anyone who will be responsible for your child during the school day or at school events. View the ADA’s template for a 504 plan.

Many staff members are integral to a child’s diabetes management during the school day: the school nurse, your child’s teacher, and administration, as well as the sponsors of extracurricular activities and nutrition service staff. Their knowledge of diabetes and level of comfort overseeing care may vary. In addition to distributing the DMMP and 504, consider asking your healthcare professional to lead a special training for key staff members.

Have one-on-one conversations as needed to get any information about school policies that impact your child’s diabetes. Here are some topics to cover with specific staff members.

Make sure that you, your child, and your child’s teacher are on the same page about each other’s needs. Ask about classroom rules and guidelines, such as what a student needs to do in order to leave the room — is it necessary to ask permission each time? Let the teacher know more about your child’s specific signs of hypoglycemia, as these vary by individual.

Many children with diabetes find it helpful to bring lunch to school, for carbohydrate counting purposes. If your child will eat meals in the cafeteria, request information about the menu and dietary guidelines from a member of the nutrition services team.

Participating in physical activities is both beneficial to your child’s diabetes management and important for their social life. Share any relevant information with the physical education instructor or another staff member to ensure that your child can safely participate.

Make sure your child’s school has all diabetes essentials on hand, including the following:

Blood glucose meter and extra batteries (include these as a backup even if your child uses a CGM)

Insulin and syringes or pens (include these as a backup even if your child uses a pump)

In addition, be sure that the school has the supplies needed to treat hypoglycemia in an emergency. Ideally, there will be one emergency kit in the nurse’s office and another in the classroom. Label it with your child’s name and include the following:

During your conversations with school staff, discuss a system for keeping track of supplies and notifying you when low.

Lastly, your child should wear a medical ID necklace or bracelet to school every day. This will ensure that they receive prompt and correct treatment in the event of an emergency.

A partner in your child’s diabetes care

Navigating your child’s diabetes diagnosis is easier with a reliable pharmacy partner. At Alto, we’re committed to making it as simple as possible to manage diabetes, with free same-day delivery and medication management tools like reminders and auto refills in our app. And our dedicated diabetes support team is here to ensure that you have all the information you need to follow the treatment plan your child’s doctor recommends.

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

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

How to Manage an Overactive Thyroid

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

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

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

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

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

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

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

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

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

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

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

Unintentional weight loss even with increased food intake

Enlarged thyroid gland at the base of your neck

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

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

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

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