Shop Alto Essentials to add pharmacy products to any prescription delivery!

Your partner in navigating the ins and outs of prescriptions — at no extra cost.

Alto Pharmacy Technician

Alto Pharmacist

It’s official: Alto Pharmacy is a great place to work! We’re honored to join the community of Great Place to Work-Certified™ companies based on team member feedback and a rigorous assessment of our company’s culture and benefits.

Join us in delivering our industry-leading pharmacy care to millions of people across the country. As a member of the team, you’ll play an integral role in improving our customers’ quality of life and redefining what’s possible in pharmacy. 

Be Part of a Great Place to Work — Join Our Team

Hear first-hand from members of the Alto technology teams.

Read the latest Alto blog posts covering healthcare, family health, managing diseases, and other Alto highlights.

Blog | Alto Pharmacy

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.

Hyperthyroidism occurs when the thyroid produces too much thyroid hormone, accelerating the metabolism beyond normal. The condition can result in unintentional weight loss and/or an irregular or rapid heartbeat. Without treatment, it can lead to more serious complications such as congenital heart failure, eye health issues, and osteoporosis.

There are several effective treatment options for hyperthyroidism, including medications and surgical procedures. Here’s what to know about managing hyperthyroidism.

Causes and risk factors of hyperthyroidism

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.

There are several ways to diagnose hyperthyroidism, including a physical exam, blood tests, and imaging tests.

Your healthcare provider may check your thyroid, eyes, heart, hands, and skin during a physical exam to confirm a diagnosis of hyperthyroidism.

Your provider may recommend thyroid function testing, which consists of measuring your thyroid hormone levels via blood samples. Hyperthyroidism is characterized by elevated levels of the thyroid hormones triiodothyronine (T3) and thyroxine (T4) and lower-than-normal levels of thyroid-stimulating hormone (TSH).

Your provider may also use one or more imaging tests to more closely examine your thyroid, including a radioactive iodine uptake (RAIU) test, a thyroid scan, and a thyroid ultrasound.

There are a variety of treatment options for hyperthyroidism. Your provider will make individualized recommendations based on the cause of your hyperthyroidism and your overall health history.

The following types of medications are commonly used in the treatment of hyperthyroidism.

Anti-thyroid medications including methimazole (Tapazole®) and propylthiouracil (PTU) reduce symptoms by preventing over-production of thyroid hormones. These medications are typically taken for at least a year, though symptoms may improve within weeks or months.

Radioactive iodine is an oral medication that targets overactive thyroid cells, causing the thyroid to shrink and lowering hormone levels within a few weeks. This treatment approach permanently affects thyroid function, so symptoms of hyperthyroidism will not reappear. In most cases, the use of thyroid hormone medications is necessary after this treatment to maintain balanced hormone levels.

Beta blockers can control associated symptoms such as a rapid heartbeat, nervousness, or tremors. These medications cause the heart to beat more slowly and less forcefully. They will not change hormone levels and are typically used in tandem with anti-thyroid medications or radioactive iodine therapy. Commonly prescribed beta blockers include atenolol (Tenormin®), bisoprolol (Zebeta®), metoprolol tartrate (Lopressor®), metoprolol succinate (Toprol-XL®), acebutolol (Sectral®), and propranolol (Inderal®).

Some cases of hyperthyroidism require removal of part or all of the thyroid gland in a procedure known as a thyroidectomy. While this is effective at treating hyperthyroidism, it can result in an underactive thyroid (hypothyroidism), which requires ongoing use of thyroid supplements.

Iodine consumption can contribute to the development of hyperthyroidism or worsen symptoms. Managing hyperthyroidism often includes monitoring iodine intake.

If your provider recommends following a low-iodine diet, try to avoid or limit your intake of seafood and seaweed, which have the highest iodine content of all foods. Other high-iodine foods to consume in moderation include milk and dairy products, egg yolk, and iodized salt.

Never make significant changes to your diet without first consulting your provider or a nutritionist.

Managing hyperthyroidism is easier with a reliable pharmacy partner by your side. Our pharmacists can answer any questions you may have about treatment, and we offer free, same-day delivery and medication management tools like reminders and auto refills in our app.

To learn more, reach out any time through secure 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.

The Alto product and engineering team has long been focused on initiatives that improve our unit profitability. Now that we’ve laid a strong foundation, we've started to think about our next big bets: How do we expand our services beyond delivering prescriptions? How do we test new value-add offerings quickly and iteratively? That’s where the incubation team comes in.

Meet the Innovation Team Building Alto's Next Big Bets

The Alto product and engineering team has long been focused on initiatives that improve our unit profitability. Now that we’ve laid a strong foundation, we've started to think about our next big bets: How do we expand our services beyond delivering prescriptions? How do we test new value-add offerings quickly and iteratively? That’s where the innovation team comes in.

Newly launched in 2022, the team is small and scrappy by design. We’re a product manager, two engineers, a part-time designer, and a part-time manager with a single mission: to launch at least two significant new business experiments per year. If an experiment is successful, we’ll scale it into a full workstream before handing it off to a stand-alone product team.

We started with over-the-counter (OTC) medications. OTCs, or medications you can buy without a prescription, like Advil, are high-margin products that users are accustomed to purchasing at traditional, brick-and-mortar pharmacies. The goal of this experiment was to assess how much interest users have in adding OTCs to their order while checking out in the Alto app. We set a target conversion rate and offered OTCs only from our San Jose pharmacy, which is less busy than our San Francisco pharmacy but close enough to engineers in San Francisco for in-person troubleshooting.

Our initial hypothesis: if we present users with a small selection of OTCs targeted to their needs (based on the prescriptions in their cart), they’ll be more likely to convert. With support from our pharmacy partners, we carefully curated a recommendation algorithm that would suggest nine OTCs based on the medications already in the user’s cart.

In the interest of lean experimentation, we wanted a scrappy technical solution that could be implemented quickly while meeting our high user experience standards and minimizing operational risk. We settled on the following architecture:

We prioritized creating a clean API for Alto’s customer-facing app and using as much of our current infrastructure as possible. Although OTCs are distinct from prescriptions, we decided to reuse our existing prescription model rather than build a new one from scratch. This allowed us to leverage existing systems and operational workflows, reducing engineering time and risk of regression.

Behind the API, we opted to store our OTC formulary and associated metadata in in-memory data structures:

ADVIL = SkuId.new(sku: '...', sku_type: '...').freeze
CLARITIN = SkuId.new(sku: '...', sku_type: '...').freeze
FISH_OIL = SkuId.new(sku: '...', sku_type: '...').freeze
...
METADATA_BY_SKU_ID = {
  ADVIL.hash_code => {
    image_url: '...',
    name: 'Advil Ibuprofen 200mg Coated Tablets',
    quantity_description: '100 tablets',
    product_description: 'Easy to swallow powerful pain reliever for headaches, joint and muscle pain.',
  },
  CLARITIN.hash_code => {
    image_url: '...',
    name: 'Claritin 24 Hour Allergy Tablets',
    quantity_description: '30 tablets',
    product_description: 'Non-drowsy, 24 hour relief of symptoms due to allergies: sneezing, runny nose, itchy and watery eyes.',
  },
  FISH_OIL.hash_code => {
    image_url: '...',
    name: 'Fish Oil 500mg Softgels',
    quantity_description: '130 softgels',
    product_description: 'Dietary supplement with EPA and DHA omega-3 fatty acids to support heart health and maintain normal triglyceride levels.',
  },
  ...
}.freeze

This gave us a nice balance of speed and flexibility. We knew that we could optimize once we had established our OTC offering and gained an understanding of how it would evolve within Alto.

The results of phase 1 were a bit disappointing, but very interesting: the conversion rate of users who checked out with an OTC was just under our target. However, nearly half of all users who saw the experience would scroll down to peruse all nine OTCs that were offered.

Based on this positive sign of engagement, we hypothesized that perhaps we just weren’t showing the right OTC products to the user. For phase 2, we decided to scrap the limited recommendations and allow users to explore an entire catalog of OTCs.

Phase 2 required categorizing our list of OTCs into buckets such as “Top Sellers,” “Covid Care,” and “Allergy & Asthma.” We built a new fetch_categorized endpoint to return our OTC catalog structured by category, adding search functionality into the client so that users could quickly filter for a specific product. This search field was also heavily tracked with analytics events to help us learn which products to add to our catalog in the future.

This new experience immediately outperformed phase 1. After a few performance improvements (speeding up our catalog and product image load times), we eventually hit our target conversion rate — even managing to surpass it on some weeks!

Our eventing did show that a significant number of users with multiple prescriptions or smaller screens were not even seeing the OTCs in Cart, as they were pushed below the fold. We tried experimenting with alternate spots to show our catalog:

1. An interstitial that shows after Cart and before Checkout - this didn’t perform any better than the control and was quickly scrapped.

2. A single carousel at the top of Cart - this out-performed the control but at the cost of our guardrail metric. With a decrease in the overall checkout rate, we decided to stick with the control for now.

This phase of UI experimentation validated that our users wanted an offering of categorized OTCs. However, our initial technical solution wouldn’t scale as we rolled out to more of our pharmacies. The following questions led us to this conclusion.

How might we support changes to our OTC catalog on a per-pharmacy basis?

Given factors such as inventory, geography-related price sensitivities, and experimentation, we wanted to make sure that we could tweak the OTC experience for users getting deliveries from a specific pharmacy.

In the status quo implementation, that would have likely meant adding an additional layer to our data structures like so:

SKUS_BY_PHARMACY_AND_CATEGORY = {
  SF_PHARMACY_ID => [
    AddOnOtcCategoryType::TopSellers => [
      IHEALTH,
      FLONASE,
      ASPIRIN,
      ...
    ],
    ...
  ],
  ...
}

We weren’t worried about memory space limits given our relatively small number of pharmacies and OTC catalog. We were concerned, however, that each modification would require an engineer to go in and make code changes, get PR approval, and wait for a full deploy for the update to go live. This would be a bad use of engineering time, and our CI/CD process would become a bottleneck to otherwise quick modifications.

How might we add and remove OTCs from our catalog?

Similarly, we knew that adding and removing OTCs from our catalog would also be a somewhat regular workflow. There are some other considerations when adding a new OTC (Is it in our product database? Do we need any new procurement/inventory workflows to make sure it gets stocked in our pharmacies? Do we have a nice image to render in the app?), but we wanted to automate the technical side as much as possible — or at least be able to automate it.

The natural next step was to move our OTC catalog into the database.

Alto’s OTC Database Schema. Some columns excluded for brevity.

Now, rather than grabbing from in-memory data structures, we are efficiently querying the database for the OTC catalog of a user’s specific pharmacy, preloading all of the associated models needed for our API response.

OtcCategory
  .includes(otc_category_products: { otc_product: :otc_product_metadata })
  .where(otc_category_products: { pharmacy_id: pharmacy_id })
  .where(otc_product_metadata: { pharmacy_id: pharmacy_id })


At the time of writing, an engineer is still required to go in and make the changes at the database level. However, we plan to build an admin dashboard so that designated pharmacy partners can tweak our OTC catalog without the help of an engineer.

We’re excited about our next iteration, which will allow users to add OTCs to their upcoming deliveries at any point, not only when checking out. It will likely be live by the time you read this.

Once that’s released, we will continue to learn, iterate, and pay down technical debt — more specifically, maturing the OTC data model in our backend and eliminating the need for them masquerade as prescriptions.

Looking even further ahead, the innovation team has more exciting and impactful projects on our roadmap. We can’t wait to share what’s in store!

Endometriosis is a condition in which tissue that should only grow in the uterus implants and grows elsewhere. It can cause significant pain in some cases and is often a factor in female infertility.

Various forms of pain relief and fertility treatment can help address endometriosis symptoms and related health complications. Here’s what to know about the condition’s causes, symptoms, and treatment options.

Endometriosis: A Leading and Treatable Cause of Female Infertility

Endometriosis is a condition in which tissue that should only grow in the uterus implants and grows elsewhere. It can cause significant pain in some cases and is often a factor in female infertility.

Various forms of pain relief and fertility treatment can help address endometriosis symptoms and related health complications. Here’s what to know about the condition’s causes, symptoms, and treatment options.

The endometrium is the tissue that typically lines the lining of the uterus. Endometriosis occurs when this type of tissue grows outside of the uterus, most commonly in the ovaries, fallopian tubes, and lining of the pelvic cavity. It may also grow in the intestines, rectum, bladder, vagina, cervix, or vulva. In extremely rare cases, it may be found outside of the pelvic area.

Just like endometrial tissue that grows normally in the uterine lining, the abnormal tissue that characterizes endometriosis thickens and bleeds during each menstrual cycle. However, whereas normal endometrial tissue is shed with the cycle, the abnormal tissue cannot leave the body. This can lead to inflammation and scarring of the surrounding tissue, as well as adhesions that bind the pelvic organs to one another.

In cases of endometriosis where tissue grows in the ovaries, the condition may lead to the development of cysts in the ovaries.

There is a spectrum of severity of endometriosis cases, defined by the amount of excess tissue and resulting cysts, scar tissue, or adhesions. The level of pain, which varies by individual, does not always correlate to the stage or severity of the condition. Pain typically peaks during a menstrual period.

The specific causes of endometriosis have not been identified, but the medical community believes that the following factors may contribute to its development:

Retrograde or reverse menstruation, in which endometrial tissue flows backwards through the fallopian tubes and into the abdomen during a menstrual cycle

Transformation of the cells that line the inside of the abdomen into endometrial-like tissue as the result of hormone or immune factors

Transformation of embryonic cells into endometrial-like tissue during puberty as the result of hormone factors

Attachment of endometrial cells to an incision during surgical procedures such as a hysterectomy or c-section

Transport of endometrial cells to other parts of the body via blood vessels or lymphatic fluid

Issues with the immune system that keep the body from destroying abnormal endometrial tissue

In addition, the following risk factors are often linked to endometriosis:

Getting your first menstrual cycle at an early age

Having an abnormally short menstrual cycle (e.g., less than 21 days)

Abnormally heavy menstrual periods lasting beyond seven days

Other health conditions that prevent the flow of menstrual blood during a menstrual period

There is also evidence that endometriosis may have a genetic component. You may have a higher risk of developing it if you have a mother, sister, or aunt with the condition.

Common symptoms of endometriosis include:

Pain, especially severe menstrual cramps in the abdomen or lower back

Painful urination or bowel movements during menstrual periods

Gastrointestinal issues including diarrhea, constipation, and nausea

Endometriosis can look very different from one individual to another, with varying experiences of symptoms. In some cases, the condition may not be accompanied by any noticeable symptoms.

How endometriosis affects female fertility

Endometriosis is a leading cause of female infertility, as abnormal growth of endometrial tissue can block the fallopian tubes, preventing the fertilization of an egg. It accounts for 24-50% of all female infertility cases, and one-third to one-half of individuals with the condition experience difficulty conceiving.

In mild or moderate cases of endometriosis, surgery to remove adhesions, cysts, and scar tissue is all that is needed to restore fertility. In other cases, additional procedures or fertility treatment may be required.

Getting an accurate diagnosis is critical to effectively treating the condition. However, the diagnosis process can be lengthy, with multiple steps, as symptoms frequently overlap with those of ovarian cysts, pelvic inflammatory disease, and irritable bowel syndrome (IBS).

An evaluation for endometriosis begins with a conversation about your health history. Several tests may be used during the diagnostic process, including the following.

A transvaginal or abdominal ultrasound, which provides images of your reproductive organs to help your doctor identify cysts potentially related to endometriosis

A laparoscopy, a procedure that inserts a small camera through the abdomen with the goal of directly identifying endometrial tissue outside of the uterus. This is the only procedure that can definitively confirm a diagnosis of endometriosis.

Severe pain from endometriosis can affect daily activities, and there are a variety of pain relief options, including both medications and surgery. Your doctor will likely try non-surgical interventions as a starting point and recommend procedures if the condition does not respond to initial treatment.

The following treatments may be used to treat discomfort caused by endometriosis or related health issues:

Over-the-counter pain medication such as ibuprofen

Supplemental hormones including the male hormone androgen, which can regulate hormonal production or minimize fluctuation to prevent abnormal tissue growth

Hormonal birth control including pills, patches, and vaginal rings, which prevent abnormal tissue growth by decreasing fertility

Gonadotropin-releasing hormone (GnRH) agonists, which block the production of estrogen to prevent menstruation

If symptoms do not improve after the treatments above, your doctor may recommend surgery. In addition to its usage during the diagnosis process, a laparoscopy can remove abnormal endometrial-like tissue. 

A hysterectomy, which removes the uterus and cervix, is typically reserved for severe cases. The procedure permanently affects your fertility, and you will not be able to become pregnant after the procedure. It’s important to consult your doctor about your options as well as your reproductive goals before moving forward.

In vitro fertilization (IVF) — a process in which eggs and sperm are fertilized and then placed into the uterus with the potential outcome of a pregnancy — can help individuals experiencing endometriosis-related infertility conceive.

In cases where fallopian tubes are blocked or severe scar tissue is present, your doctor may recommend proceeding directly to IVF before trying to conceive naturally.

Since 2016, Alto has supported more than 50,000 fertility journeys. We understand that fertility treatment is a significant investment — physically, emotionally, and financially — and we see ourselves as a partner in your health.

We offer free, same-day delivery seven days a week and temperature controlled packaging to ensure that your fertility medications always arrive in the right condition. And our fertility-trained pharmacists are available until 9 pm PST (12 midnight EST) on weeknights to offer any support you need.

Everyone should prioritize their heart health and take impactful steps to lower their risk of heart disease, a widespread and serious condition. For those with diabetes, it’s especially important to be proactive, as the condition doubles your risk of heart disease and stroke.

Understanding the Diabetes-Heart Health Connection

Read on to learn how diabetes affects heart health and what you can do to lower your risk of heart disease if you have diabetes.

The term heart disease refers to several different conditions that affect the heart:

Coronary artery disease — the most common type of heart disease — occurs when the blood vessels that supply the heart with oxygen-rich blood are hardened or blocked, affecting blood flow to the heart.

Peripheral arterial disease is characterized by a similar hardening of the arteries in the legs and feet. It is often the first sign of cardiovascular disease in an individual with diabetes.

Heart failure occurs when the heart cannot pump blood and oxygen as well as a healthy heart, often due to damaged heart muscle or blocked arteries.

A stroke occurs when the flow of blood and oxygen to the brain is blocked, often due to a blood clot or the accumulation of plaque in blood vessels.

Diabetes is one of several primary drivers of heart disease, along with uncontrollable risk factors like age and family history as well as controllable ones such as:

The connection between diabetes and heart health is twofold. First, it can directly increase your risk of heart disease, as high blood sugar — the defining feature of diabetes — can gradually damage your blood vessels and the nerves that control your heart.

Secondly, diabetes may increase your risk for other heart-related conditions, specifically:

High blood pressure, which occurs when the force of the blood flowing through your arteries is consistently too high, causing the heart to work harder. Damaged blood vessels as the result of diabetes can lead to high blood pressure. According to the American Diabetes Association, two out of three individuals with diabetes have high blood pressure or take blood pressure-lowering medication.

High levels of LDL cholesterol, which can also damage blood vessels over time, increasing the risk for heart disease and stroke. Elevated levels of cholesterol and other blood fats like triglycerides often go hand in hand with diabetes.

High blood pressure and high cholesterol are not accompanied with visible symptoms in many cases. For this reason, it’s important to stay on track with preventative screenings and to monitor your blood pressure and cholesterol levels.

If you have any condition that falls under the umbrella of diabetes — including prediabetes, type 1 diabetes, or type 2 diabetes — it’s important to learn the symptoms of heart disease. These are among the most common:

Heart disease presents differently from one individual to another. However, if you have diabetes and experience any of the symptoms above — especially chest pain or pressure, shortness of breath, or fatigue — it’s important to seek prompt medical care.

If you have diabetes, there are several steps you can take to lower your risk for heart disease. First and foremost, stay proactive about your diabetes treatment and work with your doctors to keep blood sugar levels in a healthy range.

There’s a useful acronym to help you remember important diabetic preventative actions — aka the ABCs:

A: Staying on track with the A1C test, which measures your average blood sugar levels over the past three months. Work with your doctor to identify your personal target range.

B: Staying on track with blood pressure screenings. Your doctor can help you understand your personal goal, however, a healthy range for those with diabetes is typically considered under 140/90 mm Hg.

C: Staying on track with cholesterol screenings and keeping LDL levels in a healthy range. As with your A1C and blood pressure levels, follow your doctor’s guidance regarding your personal target for cholesterol.

S: Avoid smoking, as it narrows your blood vessels, worsening diabetes and increasing your risk for heart disease. Ask your doctor for support with smoking cessation if needed.

In addition, follow a heart-healthy diet:

Opt for foods that are low in saturated fats and trans fats, which increase LDL cholesterol levels. Low-fat dairy products and chicken are healthier alternatives to full-fat dairy products and red meats.

Try to limit your sodium intake to 1,500 mg/day. Common sources of sodium include processed or prepackaged foods like soups, cold cuts, bread, and frozen meals.

When it comes to nutrition and diabetes, there isn’t a one-size-fits-all approach. The ideal balance of calories from carbohydrates, proteins, and fats varies significantly by individual, so it’s important to consult your doctor about the approach that best supports your treatment plan. Consider working with a nutritionist or diabetes educator, a healthcare professional with extensive knowledge of diabetes who is certified to provide individualized coaching.

In some cases, your doctor may recommend medication to treat or prevent heart disease, in tandem with the above lifestyle changes. Heart disease medications commonly prescribed to individuals with diabetes include:

Empagliflozin (Jardiance®) and dapagliflozin (Farxiga®) help those with type 2 diabetes maintain healthy blood sugar levels and manage heart disease.

Statins such as atorvastatin (Lipitor®), fluvastatin (Lescol®), lovastatin (Mevacor®, Altoprev®), pitavastatin (Livalo®), pravastatin (Pravachol®), rosuvastatin calcium (Crestor®), and simvastatin (Zocor®) help maintain healthy cholesterol levels.

Blood pressure-lowering medications including beta blockers, ACE inhibitors, ARBs, and diuretics may also be used to prevent or manage heart disease in individuals with diabetes.
undefinedundefinedundefinedundefined

At Alto, we make it as simple as possible to manage your risk for heart health issues and stay on track with your individual treatment plan, whether it includes medications for diabetes, high cholesterol, or high blood pressure.

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 secure in-app messaging or by phone at 1-800-874-5881.

All air quality significantly impacts your respiratory health, not just outdoor air pollution. Indoor air is often filled with irritants including smoke, allergens, and chemicals. These substances can irritate the lungs and airways, causing inflammation and reducing lung function, which refers to how well your lungs work.

How to Improve Indoor Air Quality at Home

Given that the average American spends approximately 90% of their time inside, it’s important to keep the air inside your home as clean as possible, especially if you are susceptible to seasonal allergies or have respiratory conditions such as asthma or COPD.

Use the simple precautions below as a starting point for better breathing at home.

Exposure to secondhand smoke, or exhaled cigarette smoke, adversely impacts respiratory health. It is a contributing factor to the development of COPD and may also cause a flare-up of COPD symptoms, also referred to as an acute exacerbation. For some individuals with asthma, secondhand smoke can trigger an asthma attack, which is defined by sudden shortness of breath and difficulty breathing.

Thirdhand smoke, or the residual smoke that remains on clothing or surrounding indoor surfaces after a person smokes, is an additional health risk that affects air quality.

Avoiding all indoor smoking is one of the most important actions you can take to improve indoor air quality at home. Of course, outdoor smoking also contributes to lung diseases. In addition to limiting your exposure to secondhand and thirdhand smoke at home, ask your doctor for support with smoking cessation if needed.

2. Avoid cleaning products with certain chemicals and strong scents.

Certain household products are worse for your respiratory health than others. Some disinfectants, personal hygiene products, and cleaning supplies contain chemicals known as volatile organic compounds (VOCs), which can tighten the airways and make it more difficult to breathe. Examples of common VOCs include formaldehyde, benzene, and toluene.

Ammonia, hydrogen peroxide, and chlorine bleach are other chemicals that should be avoided, along with scented products.

As an alternative, opt for natural, non-toxic products. You may even be able to create cleaning solutions from ingredients that are already in the house. Try using baking soda or a mixture of soap and water to scrub and wipe down surfaces. A combination of vinegar and water can be used to clean glass.

If you are using a product that contains a VOC or other harmful chemicals inside of your home, ventilate the area as much as possible by using exhaust fans and opening windows and doors. ​​You may also want to invest in an air purifier, which extracts irritants from the air.

Household allergens including dust mites and animal dander can trigger asthma symptoms and COPD exacerbations. Unfortunately, dust mites love to make themselves comfortable in your pillows and blankets as much as you do, so regularly wash pillows and bedding. Consider using dust mite pillow and mattress covers.

It’s best to vacuum at least once a week, ideally with a high-efficiency particulate air (HEPA) vacuum that catches smaller particles like allergens. An air purifier can also be used to remove allergens from indoor air.

During prime allergy season, avoid bringing pollen inside by changing and washing your clothes and removing your shoes after time outdoors. Dry clothes in a dryer instead of on a clothesline, where they’re likely to gather more pollen.

Dust mites aren’t the only indoor allergen to avoid. Mold exposure can also intensify symptoms of allergies, asthma, and COPD.

Moisture is typically the underlying cause of mold growth inside the home. As part of your allergy-proofing efforts, use a dehumidifier to keep indoor air dry during more humid seasons. (This can also help keep the dust mites away!) Keep bathrooms well ventilated and remove any visible mold as quickly as possible.

In addition, try to increase ventilation in the bathroom and kitchen, as well as other areas where steam accumulates. Use a fan or crack open a window when showering or cooking.

5. Clean air filters and increase ventilation.

There are steps you can take to keep clean air flowing throughout your home as much as possible.

First, change any filters in your home’s heating and cooling systems on a regular basis. If your house or apartment has a forced-air heating system — which uses air ducts and vents to circulate temperature-controlled air throughout your house or apartment — it’s especially important to change the filters regularly.

In addition, make sure that any air ducts inside of your home are clean, since they are a frequent source of dust accumulation.

If pollen is low, opening windows to let outdoor air flow throughout the building may also help improve indoor air quality. Most weather apps include a local daily pollen count.

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

Reach out by phone at 1-800-874-5881 or in-app messaging to learn how we can support your treatment plan.

While fertility treatments like in vitro fertilization (IVF) have become an increasingly common path to parenthood, helping millions of individuals conceive throughout the past four decades, they remain a significant financial investment.

How Alto Lowers the Cost of Fertility Treatment Through Better Medication Management

Fertility medications used to support egg production, retrievals, and implantations frequently factor heavily into the overall cost of treatment. An average IVF cycle costs between $10,000 and $15,000, with medications an additional $5,000 or more depending on factors like a patient’s age and health history and a clinic’s treatment approach. Unfortunately, a portion of these medications often go unused, as many fertility treatment plans involve last-minute medication changes unsuited for the traditional retail pharmacy model.

As part of our commitment to your financial well-being, we offer a medication management experience that reduces fertility medication waste to lower the cost of treatment, developed in collaboration with Progyny. Take a closer look at our approach.

IVF is a process in which eggs and sperm are fertilized and then placed into the uterus with the potential outcome of a pregnancy. Multiple medications are used on a precisely timed schedule to grow follicles — fluid-filled sacs in the ovaries that potentially contain an egg — retrieve eggs, and, finally, implant a fertilized egg into the uterus. 

Here’s a snapshot of a typical IVF medication schedule:

Days 1-4: stimulation medications such as Gonal-f®, Follistim®, Menopur®, or Low-Dose hCG to stimulate egg production, so that you produce multiple follicles

Days 5-10: continuation of stimulation medications and introduction of antagonists such as Fyremadel™ (ganirelix acetate) and Cetrotide® to prevent premature ovulation

Days 10+: trigger shots of leuprolide acetate, Ovidrel®, and/or Novarel®/Pregnyl® to stimulate final growth spurt and ovulation

After transfer: estrogen and progesterone to support successful implantation of the embryo

Fertility medications are complex, with nightly dosages dependent upon hormone levels measured through bloodwork and ultrasounds. Not only do medication protocols vary from one individual to another, they are typically adjusted throughout the course of a cycle as hormones fluctuate.

Unused medication during fertility treatment

To prevent any missed doses, providers typically prescribe all medications that could be needed in bulk at the beginning of fertility treatment. However, dosages often decrease once a cycle is underway based on a provider’s discretion, ultrasounds, and bloodwork.

At traditional pharmacies, patients undergoing fertility treatment might end up paying for unused medication, as all potential medications are filled upfront. This contributes to the $5.4 billion epidemic of medication waste in the U.S. — one that is particularly acute in fertility, leading some individuals to buy and sell excess medication to each other on social media sites.

Our approach to fertility medication management

Alto has partnered with fertility benefits manager Progyny on an algorithm-powered, app-based medication management experience that reduces unneeded fertility medications while protecting the integrity of time-sensitive and personalized treatment plans.

First, we collect fertility cycle information through the Alto app and run the data through the Progyny algorithm to determine exactly what medication volumes are needed for the next phase of treatment. We then prepare a custom order for just the medications that are immediately needed, which are then delivered directly to your doorstep by our courier team. 

You will receive multiple deliveries throughout the course of your cycle, determined by your specific dosing, trigger schedule and other inputs from your clinical team. Carefully timed check-ins and local courier delivery make last-minute adjustments possible. This approach allows you to manage your medications as your IVF cycle progresses, giving you more control over the total amount of medication that you fill.

Additional financial resources for fertility medications

Alto is committed to helping you save as much as possible on your fertility medications. In addition to our personalized medication management approach, we’ll automatically search for savings and connect you with programs that require you to apply directly, including patient assistance programs from fertility medication manufacturers.

Blog

How to Manage an Overactive Thyroid

Meet the Innovation Team Building Alto's Next Big Bets

Endometriosis: A Leading and Treatable Cause of Female Infertility

Understanding the Diabetes-Heart Health Connection

How to Improve Indoor Air Quality at Home

How Alto Lowers the Cost of Fertility Treatment Through Better Medication Management

Get to know Jake Moffatt, Engineering Manager on the Alto Assistant Team

Osteoporosis, Explained

How We’re Making It Easier (and More Fun!) to Give Teammates Feedback

How Polycystic Ovary Syndrome (PCOS) Affects Fertility

A Full Pharmacy At Your Doorstep: Introducing Essentials from Alto

Navigating Pregnancy With Type 1 or Type 2 Diabetes

Switch to a better pharmacy.