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Our mission at Alto is to fulfill medicine’s true purpose — to improve quality of life — for everyone who needs it.

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

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Managing your health during the pandemic is a long game. Here are five important heart health strategies to put into play during the COVID-19 pandemic.

Your Heart Health Playbook During COVID-19

What We Know about Heart Health and COVID-19

We mostly hear about how COVID-19 affects the lungs. But any serious viral infection can put stress on the heart by forcing it to work faster and harder as the body mobilizes to defend itself. Even more troubling, COVID-19 infection can cause blood clots in the heart’s arteries or attack and weaken the heart muscle itself. 

Anyone who is already managing high blood pressure or heart disease should take the potential for damage to their cardiovascular system seriously. Just don’t let vigilance and caution spiral into fear. While the gravity of the link between COVID-19 and cardiovascular health should not be understated, there are proactive ways you can support your heart and protect yourself from infection. 

Remember—managing your health during the pandemic is a long game. It’s crucial that you continue to take your medications as prescribed and receive necessary medical care. With this in mind, here are five important heart health strategies to put into play during the COVID-19 pandemic.

Five Heart Health Strategies During COVID-19

For months now you’ve been wearing a mask, social distancing, and avoiding crowded areas whenever possible. We know it hasn’t been easy, but keep it up. According to Penn Medicine cardiologist Helene Glassberg, MD, “The number one thing is to continue what you're doing, which is staying at home when possible, practicing safe distancing, and seeking medical attention if you're having problems.” Dr. Glassberg also recommends exercising caution as states experiment with loosening restrictions, advising, “Stay the course for as long as you can to stay well.”

There have been conflicting news reports involving some blood pressure medications and COVID-19. Despite what you might have read, don’t stop taking your medications without consulting your doctor. Not only is that never a good idea, but several recent studies indicate that there is no cause for concern when it comes to these medications. 

The confusion stemmed from the fact that two common classes of blood pressure drugs, known as angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs), affect the same pathways in the body that the coronavirus takes to reach the lungs and the heart. Multiple types of both medications are available—commonly prescribed ACE inhibitors include lisinopril, captopril, and benazepril, while common ARBs include losartan, valsartan, and azilsartan. 

For a while, experts were unsure if these shared pathways meant that these medications might either help or harm people with the virus. According to Harvard Health, three different studies have found no evidence of harm for people infected with COVID-19 who continue to take ACE inhibitors and ARBs. While there is still research to be done, experts recommend that people already taking these medications should continue to do so. 

The same advice goes for any medications or lifestyle interventions that your doctor has prescribed. If anything, it is more important than ever to remain diligent with your cardiac care plan and stay in communication with your doctor. 

The prospect of sitting in the waiting room at the doctor’s office can be anxiety-provoking right now. While avoiding the doctor might feel like a safe choice in the short-term, skipping your appointments or ignoring symptoms could mean putting yourself at risk of serious health issues like heart attack and stroke, and increasing the danger of complications should you be exposed to COVID-19. 

Talk with your doctor about what safety measures have been put in place to protect you from COVID-19 exposure during your visits. Together you can assess the risks and create a plan to continue monitoring your blood pressure and heart health. Telehealth, which allows you to meet with your doctor via phone or video, may be an option and is often covered by insurance. 

If you pair virtual doctor visits with free hand-delivery of your prescription medications through Alto, you can avoid both the waiting room and long lines at the pharmacy. Transferring your prescriptions to Alto is easy and free—we’ll take care of the work for you. We’ll ask you to choose a convenient delivery window, and one of our couriers will bring your medications straight to your door at no additional cost. We can even provide completely contactless delivery if you prefer. 

Don’t Drop the Ball on Your Healthy Habits

Even though we’ve been at it for months, staying motivated to keep up healthy habits from home can still be a struggle. The stress and anxiety so many of us are feeling right now may affect our energy levels or cause us to lose interest in our usual activities. When facing distressing news reports or personal hardship, it’s tempting to self-soothe in various unhealthy ways. It’s okay to indulge sometimes, but try not to slide too far into less healthy coping mechanisms for the sake of your heart and your emotional well-being.

Cooking heart-healthy meals at home can boost your overall wellness and serve as a creative outlet. The American Heart Association created this resource for making smart shopping choices on a budget and offers a library of recipes to suit any skill level or craving. Staying active is equally important. If you find it difficult to work out from home, try thinking outside the box of what you’d normally consider fitness. For example, giving your kitchen a good scrub will get your heart rate up, and seeing your countertops sparkle will most likely relieve some stress. If you prefer to keep it simple, a brisk walk around your neighborhood is an effective choice that can help you feel connected to your community from a safe distance. 

Unfortunately, heart attacks and strokes don’t take a break when a global pandemic strikes. Do not delay getting emergency medical care because you fear going to the emergency room due to COVID-19. Heart disease is the number one cause of death in the United States, even now, and the hospital is the safest place you can be if you think you are experiencing a heart attack or stroke. Call 911 immediately at the first sign of trouble—the American Heart Association offers this resource for identifying a heart attack or stroke. We also recommend reading our article, “Heart Health Warning Signs to Watch Out For.” 

We are fully prepared to deliver your heart medications safely and on time throughout the COVID-19 pandemic. Our pharmacy locations are stocked, our couriers are standing by, and our pharmacists are on-call to answer questions and assist with coordinating refills or requesting longer fills. We offer free, contactless delivery with every single prescription so you can rest easy at home knowing that everything you need is on its way. 

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.

For an inside perspective on sales at Alto, we sat down with Craig Thompson, our Vice President of Sales, to learn about his experience at Alto and his advice for qualified sales professionals looking to join the team.

An Inside Look at a Sales Career with Alto

Why Our Sales Team is Central to Our Mission at Alto

Like so many big ideas, Alto began with a question: what if we reimagined the pharmacy experience to make people happier and healthier? Improvements were begging to be made: not only were most people and providers frustrated and dissatisfied with the status quo,  but medication non-adherence—when people don’t take the medication they’re prescribed—has hovered at 50%. In addition to $300 billion in avoidable medical costs, non-adherence is estimated to cause approximately 125,000 preventable deaths per year in the United States. 

With these problematic statistics in mind, Alto set out to do more than just dispense and deliver medications. Our mission is to fulfill medicine’s true purpose: to improve the quality of life for everyone who needs it. We aim to make our better pharmacy experience available to 100 million people by 2025 and we’ve raised over $350 million—including more than $250 million at the beginning of the year—in pursuit of this goal. 

To reach more people and expand into new markets, we are building a strong, mission-driven sales team to help forge the way. For an inside perspective on sales at Alto, we sat down with Craig Thompson, our Vice President of Sales, to learn about his experience at Alto and his advice for qualified sales professionals looking to join the team.

Can you tell us about your own career path and why you joined Alto?

Prior to joining Alto, I spent about 20 years in the medical device space. Early on, I worked for a few different companies before landing at Abbott Vascular where I started as a sales representative, led trainings across the U.S. as the Director of Medical Education, then pivoted back to become VP of Sales. I always envisioned that my next role would be a bigger version of that position; one where I could swing big and settle in for the long haul. 

What intrigued me about Alto was the size of the market. We spend more than $330 billion on prescription drugs a year in the U.S., but it didn’t seem like anyone was nailing the pharmacy experience, especially from the patient’s perspective. When I met Matt, Alto’s CEO, I was impressed by his patient-centered mission and his humble approach. The opportunity to build something from the ground up really appealed to me. I also loved the idea of working alongside a team of high caliber people with diverse professional backgrounds.

Alto represents a true convergence of healthcare and technology. Moving from medical devices or pharmaceuticals and coming here, you learn new ways to communicate and have access to new technology and resources.  We have our eyes on the future and a vision for how we want to scale. By keeping a strong focus, we’ve more than doubled our revenue each year for the past few years. As we continue to expand into major markets across the U.S., we’re looking to bring in highly talented people with existing relationships to build out our sales team. 

While we've delivered fantastic growth over the last few years, we're still in a phase of evolution where a new member of the team can have a meaningful impact on our organization. This is an ideal opportunity to take part in building something new and to know that as you help build a better business, you’re also helping to improve people’s and healthcare professionals’ lives. Not only have we leveled up the patient experience with our app, but we’re also making the pharmacy experience easier for healthcare professionals. Alto is uniquely suited for those who care about benefiting the stakeholders we work with. It’s genuinely all about the mission.

What makes a successful partnership manager at Alto? 

We’re looking for builders—creative people who can operate in ambiguity and thrive in a startup environment. Working at Alto is an opportunity to build new territories and make a real difference for people. It’s for those who want to create novel solutions rather than work with rails around them. We need innovative people with existing relationships who are motivated by Alto’s mission to improve lives. 

What exciting challenges await a potential team member? 

We're really at the tip of the iceberg as far as the products that we are bringing forward. There's a ton of work to be done as we consider how we can continue to meet the needs of both people and health care professionals. We’re always working to develop services and technology that can help impact adherence rates, improve the overall quality of life for people, and make physicians' lives easier by reducing the burden that exists on their teams from insurance companies. 

There will be a ton of opportunities for people to come in, demonstrate success, and find fulfilling professional paths. One of my visions for the coming year is to develop additional resources dedicated to professional and personal growth and implement programs with specific learning tracks. 

We work cross-functionally and are always open to learning new ways of operating and finding success. If you’re excited by the opportunity to create something new rather than inherit an existing territory, we’d love to hear from you. 

This is an exciting time to join the team at Alto. As we continue to forge new territory, expand into new markets, and develop our specialty areas, we’re already on track to achieve $1 billion in annual recurring revenue by 2021. To maintain this trajectory, we’re looking to grow our team with highly skilled individuals who align with our values and are motivated to create change. There is abundant opportunity to not only achieve success but find fulfillment by working toward a mission that positively impacts people’s lives.  

If you've found yourself considering embarking on a new adventure, we’d be thrilled to have you consider Alto as your next career milestone. Visit our careers page to see if we're actively hiring in your city. If you're not quite ready to make a move, join our talent community and follow us on LinkedIn to stay apprised of upcoming opportunities. 

In honor of National Diabetes Month, here are seven ways we can take action together to spread the word about diabetes prevention.

88 Million Reasons to Support National Diabetes Month

November is National Diabetes Month—a time to raise awareness about the diabetes epidemic that is quietly underway in our country. It’s a chance to come together and take action, not just for the one in ten Americans who have diabetes, but for the 88 million of us who are at high risk of developing it due to high blood sugar levels (a condition known as prediabetes). 

As you walk through your city or town today, consider that, statistically, one in three people you see has prediabetes and more than 80% don’t know they have it. These numbers may come as a shock, but there is hope that we can change them. By making certain lifestyle changes, those of us with prediabetes can significantly lower our risk of a type 2 diabetes diagnosis. 

Could you be one of the 88 million people in America with prediabetes? Don’t be afraid to learn about your risk—knowing where you stand will allow you to take control of your health. The CDC-led National Diabetes Prevention Program offers a free risk test and other helpful resources at doihaveprediabetes.org. If you determine that you’re at risk, talk to your doctor so you can assess your risk level and develop a prevention strategy together. 

Remember the “one in three” statistic and consider sharing this tool with your loved ones or even via your social media channels. Raising awareness is the best way to turn the tide on diabetes. 

The COVID-19 pandemic has placed a spotlight on the widespread inequities in our healthcare system, which contribute to higher risk levels and worse outcomes in underserved communities. Just like COVID-19, diabetes disproportionately affects minority and low-income Americans. According to the ADA, Americans of color are nearly twice as likely to have diabetes and related chronic diseases.

Equal access to health care is a human right—no matter your race, gender, income, sexual orientation, age, or education. We urge you to read the ADA’s Bill of Rights to know your rights and better understand the injustices that many communities are currently facing. Please also consider sharing this resource to help shine more light on a dire issue. 

If you feel inspired to make waves for change, contact your government representatives to advocate for affordable and accessible healthcare for everyone. The ADA has created this online resource to help you reach out to lawmakers in your area and ask them to support legislation designed to end health disparities during the COVID-19 pandemic—from expanding health insurance coverage to making insulin more affordable. You can also sign up as an ADA Advocate to stay informed about issues affecting people with diabetes and keep using your voice to create change. 

If you or someone you know has type 1 diabetes, you might also consider signing up to become an advocate for JDRF—a nonprofit funding research and advocating for policies to help people with type 1 diabetes (T1D). According to JDRF, “Advocates use the most powerful tools they have — their own personal stories — to communicate the financial, medical, and emotional costs of T1D to our nation's leaders.” 

From enlightening talks to a live cooking class, the American Diabetes Association (ADA) is hosting some amazing virtual events throughout the month. Ask questions, listen to inspiring stories, and learn tips that can help you live a healthier life. 

You’ll also find a slew of virtual events hosted by JDRF on their monthly calendar, including a holiday auction, various meet and greets, and a Q&A session with an endocrinologist. 

Healthy choices matter for all of us, regardless of our risk level. This is a great opportunity to work on a new habit throughout the month. Whether you decide to take a daily walk or experiment with healthy kitchen swaps like chickpea pasta or nut-based milk, pick an activity that you might actually enjoy and try your best to keep it going. 

The jury is still out on how long it takes to solidify a new habit, but one recent study found that it took an average of 66 days before participants felt that new habits like eating fruit at lunch or running for 15 minutes became automatic. Of course, the actual time will vary by person and the perceived effort of the new activity. But the study found that daily repetition during the first few weeks was the key to making the new habits stick. 

If you’re currently living with diabetes, use this month as an annual reminder to recommit to your treatment plan. Taking medications as prescribed and keeping up a healthy lifestyle, including proper nutrition and exercise, is an essential part of reducing the impact of diabetes on your long-term health and well-being. 

And if you’re among the 1.5 million people who were newly diagnosed with diabetes this year, we share some helpful tips for settling into your routine in “Managing Your New Diabetes Diagnosis.” 

Find the Best Pharmacy for Your Diabetes Care

Managing your monthly medications should never be a struggle. Our pharmacists are on-call to field medication queries and walk you through doses or injections. We can deliver whatever you need—including insulin, glucose monitors, test strips, and more—directly to your door for free. For more on how we can help, read “The Best Pharmacy for Diabetes Care.” 

Want to learn more about Alto? Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; reach out via phone/text at 1-800-874-5881, or the app. 

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

We offer the latest advice on how you can access the medications and services you need while protecting yourself from infection with COVID-19.

Navigating HIV Treatment and Prevention During COVID-19

Living with HIV during the COVID-19 pandemic

It’s been over six months since the first stay-at-home orders swept across the country, and we’re just beginning to replace widespread uncertainty about the coronavirus with real-world data. There’s still much we don’t know about how COVID-19 affects those living with HIV, but researchers are working quickly to glean insights from cases over the past months. 

Though our understanding is continually evolving and the data is limited, experts believe that people with HIV who are receiving treatment have the same risk for COVID-19 as the general population. We do know, however, that people with weakened immune systems are more likely to get severely sick from COVID-19, which underscores the already vital importance of preventing new HIV infections and ensuring access to treatment. 

If you are at risk of HIV infection or living with HIV, we encourage you to not put prevention or treatment on hold. It’s also crucial that you stick to the plan outlined by your doctor as closely as possible, especially by taking your medications correctly and on time. As your pharmacy, we’re here to help you overcome any challenges in maintaining your regimen that may arise. Let’s walk through the latest advice on how you can access the medications and services you need while protecting yourself from infection with COVID-19.

Is COVID-19 illness more severe in people living with HIV?

As we mentioned, when HIV is being treated, it does not seem to increase the risk of infection or severe illness. Those who are living with HIV and not on treatment or virally suppressed, however, may be at greater risk of COVID-19 complications. Additionally, older people living with HIV and those with other underlying health conditions may also be at greater risk of serious illness from COVID-19. It’s important to take precautions to protect yourself from COVID-19 infection by following CDC guidelines, such as wearing a mask, social distancing, and washing hands and high-touch surfaces often. 

We know that people living with HIV are more vulnerable to respiratory infections when their HIV is not well managed. That’s because their weakened immune systems may be unprepared to deal with an invading virus. For this reason, it’s incredibly important to continue your antiretroviral treatment (ART) as prescribed. If you are having difficulty continuing your treatment for any reason, talk with your healthcare provider right away.

What additional precautions should people living with HIV take?

The most important actions you can take for your health are to continue your HIV treatment and avoid potential exposure to the coronavirus. Follow the preventative guidelines outlined by the CDC to protect yourself and others from getting sick. Additionally, you should take the following precautions:

Keep your regular medical appointments and discuss ways you can reduce your risk of exposure to COVID-19 during your visits. Use telehealth services whenever possible; your doctor can advise you on the remote options available to you.

Keep at least a 30-day supply of your HIV medications on hand as well as any other medications or supplies you need to manage your health. If possible, ask for a three-month supply and choose a pharmacy that offers home delivery to avoid spending time in close contact with others while standing in lines. (Alto’s couriers will hand-deliver your medications to your doorstep, so you never have to worry about mail delays either!)

People living with HIV are at a higher risk of serious flu-related complications, make sure all your vaccinations are up-to-date, especially your flu shot.

The CDC recommends maintaining a healthy diet, aiming for 8 hours of sleep every night, and taking steps to reduce stress. 

If you start to feel sick, especially if you have a dry cough, fever, fatigue, and/or a loss of smell or taste, stay at home and contact your doctor immediately so you can determine your next steps. You will need to self-isolate to avoid spreading the coronavirus to others as you await instructions from your doctor. For this reason, we strongly recommend having a plan in place for if you get sick, including keeping 30 days’ worth of medications, food, and other supplies on hand.

How can I get tested for HIV during the COVID-19 pandemic?

It’s as important as ever to know your HIV status. If you’re at risk for HIV, talk to your healthcare provider about your options for getting tested. The CDC has stressed the importance of continued access to HIV testing and encourages people who are at risk for HIV infection to get tested in ways that support social distancing and stay-at-home orders (when they are in place), such as self-testing when possible. They have created this resource that lists self-testing services by state. You can also find in-person testing locations here. 

I’ve lost my insurance. How can I continue to get my HIV medication?

As we face this public health crisis, record numbers of people are also losing their jobs and employer-based coverage. If you’re currently uninsured or cannot afford your out-of-pocket costs, there are resources that can help. HIV.gov puts out this list of toll-free helplines that can help you find programs and services in your state to lower your treatment costs. They also list a variety of federal resources here. 

The AIDS Drug Assistance Program (ADAP), which is part of the Ryan White HIV/AIDS Program was created to help cover the cost of HIV-related prescription medications for people who have limited or no prescription drug coverage. Eligibility may vary by state, so find out more by using the ADAP Directory to identify your local program. 

How can I continue to access PrEP during the COVID-19 pandemic?

If you are at risk of HIV exposure, protecting yourself needs to remain a top priority. PrEP, or pre-exposure prophylaxis, is an HIV prevention method that's available by prescription. We explain more in our article, “All About PrEP for HIV Prevention.”

If you are already taking PrEP, talk to your provider about the possibility of telehealth options for the time being and see if you can get a prescription for a 90-day supply of PrEP. To find an in-person or online provider, visit one of the following websites:
PleasePrEPme.org
Greaterthan.org

If you need help paying for PrEP, there are assistance programs available that can cover the costs. PleasePrEPme.org maintains a comprehensive list of available resources here. 

What are some ways to cope with stress and anxiety right now?

It’s normal to experience heightened emotions during times of stress. And, unfortunately, some of the actions we are taking to protect ourselves, such as social distancing, can negatively impact our emotional well-being. Here are some ways you can protect your mental health and cope with the stress and uncertainty of the COVID-19 pandemic.

Unplug when you need to. It’s important to stay informed, however, the constant cycle of news reports and social media updates can become all-consuming and overwhelming. Take breaks from your devices when necessary and try to focus on reliable news sources and avoid social media accounts and websites that may be spreading rumors or false information.

Find soothing activities and practice them daily. Maybe you turn to a calming classic like meditation when you need to recharge or perhaps nothing makes you happier than whipping up a batch of chocolate chip cookies from scratch. Whatever helps you unwind is good for your emotional well-being and overall health. 

Stay on top of your health and wellness. Stress can disrupt your usual healthy habits. Try to move your body frequently, incorporate healthy foods, and get a full night’s sleep. You may not succeed every day and that’s okay. Just do your best to keep up your healthy habits most of the time. 

Seek help if you need it. If feelings of fear, anger, sadness, worry, or numbness interfere with your responsibilities for several days in a row or if you find yourself turning to unhealthy coping strategies like drugs or alcohol, please reach out for help. The CDC offers this list of free and confidential resources.

We are committed to ensuring you receive your HIV medications safely and on time throughout the COVID-19 pandemic. Our pharmacy locations are fully stocked, our couriers are ready, and our pharmacists can assist with coordinating early refills and longer fills. We offer free, contactless delivery, plus ongoing access to support and advice.  

Reach out to our HIV speciality team at 1 (800) 874-5881 (call/text) or send us a message through our mobile app. We’re available from 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends.

If you or someone you love is navigating a new insulin prescription, know that there is a learning curve involved. This article can serve as a framework by giving you a good grasp of the basics.

Understanding Insulin: The Basics

It’s estimated that someone is newly diagnosed with diabetes every 21 seconds in America. Of this growing population of over 34 million, approximately 8.3 million people rely on taking one or more forms of insulin to manage their condition.

If you or someone you love is navigating a new insulin prescription, know that there is a learning curve involved. From wrapping your head around the different types of insulin to figuring out your very first injection, It’s normal to have plenty of questions as you settle into a routine. While your medical provider and pharmacist are your best sources of support, this article can serve as a framework for your conversations with them by giving you a good grasp of the basics.

Insulin is a hormone that most of us produce naturally in order to regulate our blood glucose levels. People with diabetes either do not produce insulin on their own, produce too little, or their bodies don’t react to it correctly. Insulin medications enable people with type 1 and type 2 diabetes to keep their blood sugar levels within a target range. For more on this, see our article, “What’s the Difference Between Type 1 and Type 2 Diabetes.” 

When blood sugar levels get too high or too low,  long-term or life-threatening complications can occur. The goal of insulin therapy is to mimic natural insulin levels and prevent spikes and dips. Insulin can’t be taken orally because it would be broken down during digestion. It must be injected into the fatty tissue under your skin so it can reach the bloodstream. While it is most commonly administered with a syringe, there are other methods of delivery such as pens and pumps . 

Getting started with insulin can be tricky because finding the right dosage is key. Taking too much or too little can cause rapid changes in your blood sugar levels. That’s why it is important to work with your healthcare provider to find an insulin regimen that works for you. Your pharmacist can also talk through any symptoms and side effects you experience to determine if an adjustment may be necessary. Alto’s pharmacists are just a phone call, text, or in-app message away if you need advice. 

Bear with us—this can seem a bit complicated at first glance. There are different types of insulin that are defined by three factors: how quickly they start working (onset), when they reach maximum effectiveness (peak), and how long they last (duration).

Rapid-acting insulin: Begins to work about 15 minutes after injection, peaks about 1 or 2 hours after injection and lasts between 2 to 4 hours. 

Regular or short-acting insulin: Takes effect within 30 minutes after injection, peaks between 2 to 3 hours after injection, and works for approximately 3 to 6 hours. 

Intermediate-acting insulin: Starts working about 2 to 4 hours after injection, peaks 4 to 12 hours later and remains effective for 12 to 18 hours.

Long-acting insulin: Takes several hours to reach the bloodstream after injection and usually lasts for up to 24 hours.

Ultra long-acting insulin: Makes its way into the bloodstream in 6 hours and lasts 36 hours or longer without any peak. 

Depending on the type of diabetes, progression of the disease, and other individual factors, a person might need one injection per day or several and may use one form of insulin or a combination. Most people who are prescribed insulin will eventually need a combination of rapid- or short-acting and long-acting insulins. A  normally functioning pancreas releases a continual supply of insulin (basal insulin) with additional bursts when you eat (bolus insulin). Combining several types of insulin reproduces these natural actions as closely as possible. 

Your healthcare provider can help you determine the combination of diabetes medications that’s right for you and this regimen will likely change over time. We cover some of the factors that can affect your individual medication needs in our article, “Managing Your New Diabetes Diagnosis.”

There are several methods of administering the insulin you need. Your regimen will likely involve a needle but try not to worry about that—needles today are surprisingly small.  

Syringe: The classic and most common option. You’ll receive your insulin in a vial and use a syringe to inject it into the fatty tissue under the skin. 

Insulin Pen: These devices hold a cartridge of insulin and the dose can be controlled through a dial on the pen, making it easier to be precise. The insulin is delivered through a very small, replaceable needle. 

Insulin Pump: This option most closely mimics how the body releases insulin. A computerized pump delivers a continuous dose of medication around the clock via a catheter placed under the skin. 

Infusion: Typically only used in hospital settings, an infusion is when insulin is delivered directly into a vein through an IV. 

Inhaled Insulin: Inhaled insulin is a rapid-acting insulin that can be used by those with type 1 and type 2 diabetes at the beginning of a meal. It is not a substitute for long-acting insulin and is usually used in combination with insulin injections.

We know starting an insulin regimen can feel like a big change. But it’s important to think of your insulin regimen as a life skill, not a life sentence. Like any skill, mastering the intricacies will take time. What might seem frightening or confusing at first will eventually become a normal part of your daily routine. 

We’re here to take the stress out of managing your insulin prescriptions, from navigating insurance to coordinating multiple medications into one easy delivery. We’ll set up automatic refills so you never have to worry about running out of the supplies you need, plus our pharmacists will be on standby, should you have questions or need someone to walk you through your dosage instructions. 

We explain exactly how we can support you better than a traditional pharmacy in, “The Best Pharmacy for Your Diabetes Care.” Let’s make this next step in managing your diabetes as easy as possible together. 

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

It’s important to be vigilant for symptoms of cardiovascular disease. But if your heart was on the decline would you know the warning signs? From the subtle to the serious, let’s take a look at some of the ways your body could be sounding the heart health alarm.

Heart Health Warning Signs to Watch Out For

Unfortunately, not everybody has a tell-tale heart. Sometimes, when trouble is brewing within your chest, the signs can be surprisingly subtle. The heart might send an SOS with barely a whisper or offer clues that it’s pumping less effectively in areas of the body where you don’t expect them. 

Chest pain is a classic sign of heart trouble. If the pain comes on suddenly, especially if it’s accompanied by dizziness, sweating, nausea, or shortness of breath, it’s time to call 911. You could be having a heart attack and you don’t want to hesitate.

While this sensation may be felt as a sharp or stabbing pain, it can also present as a tightness or pressure. Many people have described the feeling of a heavy weight on their chest. However it presents, any sudden and overwhelming feeling in your chest is cause for alarm. Be sure to seek medical attention right away.

It’s important to note that chest pain doesn’t always center on the heart. It’s common for pain to radiate to the jaw and neck or even into your back or arms. While pain in the center of the chest is the most common sign of heart trouble for both men and women, women are more likely to experience radiating pain signals than men (although men experience them too). 

Before a full-blown heart attack occurs, the heart might send warning signs in the form of more subtle pain for months or even years. If you have pain in your upper body that comes on with exertion and subsides with rest, it could be an indication there’s an issue with your heart. On the other hand, some heart attacks happen without any of these warnings, so don’t assume your pain is innocuous just because it’s happening for the first time. 

Your heart is a pump. When it isn’t functioning properly, less blood reaches your lungs and muscles, causing you to become tired and out of breath more easily. We all get breathless after a set of jump squats or a sprint, but if you find that your threshold is noticeably diminished—for example, becoming very tired or out of breath after walking up a flight of stairs or carrying groceries—it’s time to talk to your doctor. Additionally, if you experience breathlessness while lying down or otherwise at rest, it’s definitely a sign to get checked out.

Strange Sensations or Swelling in Your Limbs

If your blood vessels have become narrowed due to a buildup of fatty deposits, it can reduce the circulation of blood to your arms and legs. When this happens, you might experience pain, numbness, weakness, or coldness in your limbs. Much like chest pain, if the sensation worsens with exertion and subsides upon rest, it may be of particular concern. But tell your doctor about your symptoms no matter what.

On the flip side, when blood flow slows down, the blood returning to the heart can get backed up, causing a build-up of fluid in the tissues. If you have unexplained swelling in your feet, ankles, or legs it could be a warning sign of heart failure, so let your doctor know. 

If your heartbeat feels irregular or rapid, it’s not necessarily a reason to be concerned. That fluttery feeling could be caused by anxiety, dehydration, or even too much caffeine. However, it could also be a sign that your heart is attempting to play “catch up” after falling behind. Take note of what else is going on when you feel this sensation. If your heartbeat suddenly becomes rapid while you’re at rest or has frequent bouts at an oddly irregular pace, it could indicate that your heart is struggling. Tell your doctor about your symptoms. 

We all sweat, but usually we can attribute it to the blazing sun or a tough workout. Sweating is a normal, healthy function that helps the body cool itself down. However, if you break out into a cold sweat for no apparent reason, it could be a sign of a heart attack, especially if it is accompanied by any of the other symptoms mentioned here. If unexplained sweating starts suddenly and you don’t feel right, call 911 right away.

A little snoring here and there is totally normal. However, if you’re regularly waking up your whole household or making choking or gasping noises in your sleep, it could be a sign of sleep apnea—a condition where you stop breathing for brief moments throughout the night. According to John Hopkins Medicine, sleep apnea is associated with high blood pressure and an increased risk of heart attack. If you frequently wake up short of breath or your loved ones have resorted to sleeping with pillows over their heads, it’s a good idea to schedule a checkup. 

Most of the time, trouble achieving or maintaining an erection is a problem with circulation or blood pressure. According to the Mayo Clinic, erectile dysfunction could be an early warning sign of heart disease. While there may be other factors at play, your doctor should investigate the possibility of heart issues before recommending treatment. 

Your heart sometimes has a roundabout way of speaking up, so it’s important to know what you’re listening for. The earlier you detect the warning signs of heart disease, the easier it will be to treat. If any symptom or sensation is causing you concern, talk to your doctor, especially if you have a family history of heart disease, smoke, or have other underlying risk factors such as high cholesterol, high blood pressure, or diabetes. Heart disease is the number one cause of death in the United States year after year, but experts believe it is about 80% preventable. There are lifestyle changes, treatments, and medications that can help. 

If you and your doctor decide to explore treatment options for heart disease, know that our team will be standing by. Our pharmacies are stocked with the full assortment of heart health medications your doctor might prescribe and our cardiology specialists are available to answer your questions with a simple text, call, or in-app message. We offer same-day delivery on all your medications so you don’t have to miss a beat while you ensure that your heart stays steady and strong. 

Dr. Lisa Sterman, M.D., MPH, is an expert in the field of HIV medicine who has been in private practice in San Francisco for over 20 years. She kindly agreed to sit down and talk with us about pre-exposure prophylaxis (PrEP), an HIV prevention method that's available by prescription.

HIV Health Spotlight: A conversation about PrEP with Dr. Lisa Sterman

This interview has been edited for length and clarity.

Dr. Lisa Sterman, M.D., MPH, is an expert in the field of HIV medicine who has been in private practice in San Francisco for over 20 years. After obtaining her Master’s in Public Health, she completed her training in medicine and HIV at UCSF. She’s been involved in clinical research for HIV medications and has worked in the community as an educator and advocate, including serving on the Board of Directors for the San Francisco AIDS Foundation, for many years. 

Dr. Sterman kindly agreed to sit down and talk with us about pre-exposure prophylaxis (PrEP), an HIV prevention method that's available by prescription. The most important thing she wanted us to know? This conversation is for everyone.

Can you tell us a little about how you got started in your field?

It’s been a long road. I started working with HIV in the ’80s. I was at college in Berkeley, and I do a lot of rock climbing. My friend and rock climbing partner was a nurse at SF General, at their famous HIV ward. I knew I wanted to go into medicine and she said, “You should come volunteer on our ward.” It was the ‘80s, so it sounded totally controversial and dangerous and I was like, “I’m in.” That’s my personality, so that's how I got started. Really, it was the doctors and nurses there that inspired me to go into HIV. They were just incredible. 

What’s something everyone should know about PrEP?

Everyone needs to know that there is a pill that prevents HIV. So many people haven’t even heard of the concept. Nearly everyone is eligible with a short screening set of labs, so talk to your provider and find out if you might want to consider PrEP.

A lot of people may think, “I’m not at risk” or, “that’s not my group of people.” The way I teach it is: if you’ve ever had sex, you’re at risk for HIV. If you’ve ever shared drug needles, you’re at risk for HIV. Everyone should know their status. 

Editor’s Note: To learn more about PrEP and how it works, see our article, “All About PrEP for HIV Prevention.”

If you’re using condoms every time you have sex, would you still recommend PrEP? 

Yes, condoms break or fall off, and then you can have exposure. They are not 100%. I would say we’ve come as far as we can with condoms, that piece of HIV prevention efforts is great, and this is the next step. Condoms may prevent or reduce the risk of other STIs, but they are not the only or appropriate way to protect yourself from HIV if you are at higher risk for HIV.

Some groups of people at risk for HIV can’t always ask their partner to use condoms. They may not have the power in the relationship or they may be under pressure because they’re exchanging sex for commodities like housing, money, food, shelter, or drugs. PrEP helps empower many people who are at risk and can be taken without a partner’s knowledge or consent. In this way, some groups of people have a better chance of protecting themselves against HIV.

How can you go about talking to a doctor about PrEP? 

It would be nice if doctors asked every patient the right questions. I ask anybody who walks through my door, “Do you have risks for x, y, and z?” Part of that is taking a sexual history, but not every provider is going to do that. For a motivated patient who wants to go out and find a PrEP provider, there are great websites like pleaseprepme.org where you can find providers that do video calls, or for other folks, a trusted relationship with an in-person provider. There are more conservative areas in the US where you might perceive yourself to be at risk for HIV, but you can’t talk about who you are having sex with, who your partners are having sex with, or how you exchange all those things. If you worry about feeling stigmatized by your provider, there are other resources out there. It’s just that a lot of people don’t know about them.

Need help finding a PrEP provider? Try: 

If you decide to use PrEP, what does the process look like? 

We need to verify that you’re HIV-negative, but we’ll probably send you off with a prescription for PrEP at the initial appointment. If you’re at high risk, we want to get the medication into you before we even necessarily know the results of your HIV test. We’ve come to find that a rapid start to HIV prevention is important. We don’t want to miss the opportunity to protect someone during the week when their labs are being done. There is very little risk in taking a week’s worth of PrEP even if you are HIV positive.

So, you would start PrEP and then we’d follow up in a week to go over your labs. We’d treat any STIs, make sure your renal function is normal, and then we’d continue these tests on a regular basis while you’re on PrEP. The standard protocol is every three months. Some patients with

very high risk of STI exposures may need more frequent testing for other STIs.

I think the key is to make sure everyone knows it’s out there and for everyone to be able to have that conversation with a healthcare provider they feel comfortable with. People need to understand where they are at risk and where they are not. PrEP for HIV is not for everyone. We think about PrEP as having “seasons of risk.” A person’s need to use it may come and go depending on what their lifestyle is like. You need to be having an ongoing conversation about how your risk changes over time. 

How do you think Alto can be helpful to people on PrEP? 

Alto is a wonderful way for people to access their meds, especially during COVID. It’s convenient. It shows up when you need it. For PrEP and HIV meds I can have them provide all sorts of support for the patients. Everyone is knowledgeable—I’ve worked with some of Alto’s pharmacists in other capacities. I’ve had great experiences with Alto and I think my patients would say the same. 

Is there anything else you’d like to tell our community?

Your relationship with your healthcare provider is so important. If you don’t feel like you can tell them everything that is going on, you need a new provider. If you’re feeling stigmatized and someone is not supportive of your lifestyle, then switch, if possible, to an online pharmacy or a community health center that works with the LGBTQ community and get your PrEP that way. Any online pharmacy that handles PrEP will have someone sensitive to these communities, lifestyles, and risk factors.

Even though I do everything I can to encourage an open dialogue, I don’t always get all the information out of people either. Sometimes people feel embarrassed, but we can’t support someone if we don’t know what they’re doing. The first step is to have a healthcare provider that you really trust. The second step is to be really honest with that person. Help them help you prevent HIV.

For more information about Dr. Lisa Sterman and her practice, you can view her profile here. 

HIV Health Spotlight: A conversation about PrEP with Dr. Lisa Sterman 

Our pharmacists share a few tricks that can save money, time, and avoid confusion later on. Let’s walk through the ideal prescription experience one step at a time. 

How to be a prescription overachiever!

You’ve just been handed a new prescription by your doctor. While you could have it sent to the nearest pharmacy, pay what they tell you is owed, and take the medication without question, a prescription overachiever knows a few tricks that can save money, time, and avoid confusion later on. 

If straying from business as usual sounds like a hassle, we’ll let you in on a little secret. We consider ourselves the ultimate prescription overachievers—nothing brings us more joy than taking care of the details for you. From savings investigations to free drop-offs, there are some serious perks on the table. Let’s walk through the ideal prescription experience one step at a time. 

Don’t let the concept of “doctor knows best” deter you from asking questions. Every time you get a new prescription you should be sure you understand what, how, and why. 

You’ll always have access to a team of experts at Alto, but it’s still important to have this initial conversation with your doctor. If you’re unsure what you should be asking, here’s a solid start: 

Why is this medication the best choice for me?

What would happen if I don’t take my medication correctly?

Don’t be afraid to seek as much clarity as you need. This information will help you stick to your plan and there are no wrong questions when it comes to your health. 

2. Decide where and how to get your prescription filled 

While you could take your prescription to the nearest pharmacy and wait in line, a busy retail atmosphere may prevent you from getting much one-on-one time with your pharmacist. Mail-order options offer convenience but can be problematic if you need your prescription right away. Thankfully, at Alto, we’ve built a better pharmacy experience.

Ask your doctor to send your prescription directly to us and we’ll reach out to set up your account. As soon as your medication is ready, we’ll send you a text or give you a call to schedule your free delivery. As a full-service pharmacy, we can fill all medications, including specialty, over-the-counter, brand, and generic. And you’ll have access to a team of experts who’d be happy to answer questions and discuss your concerns. 

According to a recent report from the Organization for Economic Cooperation and Development, on average, Americans spend about $1,200 on prescription drugs a year. However, if you know where to look, there are opportunities to get a better deal. Every time you send a new prescription to Alto, our team works tirelessly behind-the-scenes to find you the best price. We’ll automatically look for any savings, including prescription discounts, coupons, and assistance programs, then show you which option provides the lowest possible cost. If it turns out that paying out of pocket is cheaper than going through insurance, we’re going to let you know. So far, we’ve saved our patients more than $23 million on their medications. 

Now that you have your prescription in hand, it’s a good idea to review the details. Should you take it on an empty stomach or with a meal? Are there special instructions to keep in mind or side effects to expect? Understanding the facts can go a long way in reducing your risk of adverse effects. If any questions still linger, our patient care pharmacists are a simple text or phone call away. 

Whether you thrive on responsibility or you’re more of the “wing it” type, it never hurts to enlist a little help in sticking to your plan. Setting a recurring alarm will ensure you never miss a dose, so we went ahead and included one within the Alto app. If your prescription is ongoing, you can use calendar alerts to help you remember your refills or simply leave it to us! We’ll automatically reorder your medication before you run out and get in touch to schedule delivery. 

Questions may come up in the days and weeks to come, so be sure to have your healthcare provider’s contact information handy. If you experience any unusual symptoms or are unsure if a certain supplement will interact with your medication, don’t hesitate to check in with your doctor or the team at Alto.

Remember—being a prescription overachiever might sound like more work, but you don’t have to put in the extra effort when you have Alto on your side. We thrive on handling the details so you can stay focused on your health. 

Curious if your prescription could cost you less? Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; call or text 1-800-874-588 or download the mobile app for secure messaging.

In this article we’ll share what a typical IVF schedule might look like, beginning with medications used to grow follicles, the egg retrieval process, and finally, transfer options.

IVF Medications: Schedule and Side Effects Explained

IVF, or in vitro fertilization, is one form of treatment that may help those experiencing infertility to conceive. In fact, at least 8 million babies born today are a result of this procedure. That’s remarkable when you consider the first successful IVF procedure was only conducted in 1978.  

In this article we’ll share what a typical IVF schedule might look like, beginning with medications used to grow follicles, the egg retrieval process, and finally, transfer options. Let’s take a closer look at how one might arrive at each step. 

What Medications Should I Expect with IVF? 

The IVF process itself requires considerable IVF medication use on a precisely timed schedule. For these reasons, it’s important to understand what you might be prescribed as well as any potential IVF medication side effects. 

On the first day of a patient’s menstrual cycle they will typically call to schedule a “baseline” visit for Day 3 of their cycle. This appointment includes an ultrasound and bloodwork. After this visit, if approved, patients will start hormone injections (commonly referred to as “stimulation meds” or “stims”). 

These injections stimulate egg production so a woman’s body produces many follicles in a cycle, not just one (follicles house eggs that contain all the hormones and fluids needed to make an egg mature). Patients with one or more follicles already grown may need to wait until their next period cycle or use a different protocol. 

Stims are typically injected between 6-9PM daily at a consistent time. 

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HIV Health Spotlight: A conversation about PrEP with Dr. Lisa Sterman

How to Be a Prescription Overachiever!

IVF Medications: Schedule and Side Effects Explained

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