As a patient at our pharmacy, your health is our priority. Another priority of ours? The privacy and security of our patients’ health information. The Importance of Health Information Safety Keeping personal information secure is no longer as simple as keeping your files in a lock box. With technology being a go-to way to store and access information, it is easier than ever before for your data to be stolen, leaked, and misused. This can lead to negative consequences like: Medical identity theft. Identity thieves can try to use your personal and/or insurance information to get things like medical treatments, prescription drugs, or surgery.¹ Job discrimination. Employers having access to health information can influence hiring and firing decisions.¹ Legal disputes. Some health information can affect the outcome of a legal dispute.¹ Victim targeting. Certain types of patients can be targeted by scammers based on their medical diagnosis.¹ Because of these potential consequences, our government put in place the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This includes Privacy and Security Rules to protect individually identifiable health information. Entities subject to the Privacy Rule include: Healthcare providers. Every healthcare provider, regardless of size of practice, who electronically transmits health information in connection with certain transactions.² Health plans. Including health, dental, vision, and prescription drug insurers.² Healthcare clearinghouses. An institution that electronically transmits different types of medical claims data to insurance carriers.² Business associates: Organizations using or disclosing individually identifiable health information to perform or provide functions, activities, or services for a covered entity.² It is important to note that not all organizations are covered by HIPAA. For example, when you store health information in a mobile app, on a mobile device, or in a personal health record that is not offered through a healthcare provider or plan, your health information is not protected by HIPAA.³ This can look like wearable technology like FitBit or Apple Watch and Health apps like Noom. What Health Information is Protected by HIPAA? The HIPAA Privacy Rule protects your health information by placing some limits on how it may be used and shared. Individually identifiable health information is protected by the HIPAA Privacy Rule. This is information that relates to your past, present, or future physical or mental health or condition; to the provision of health care to you; or to past, present, or future payment for the provision of health care to you.⁴ This also includes information that identifies you or for which there is a reasonable basis to believe it can be used to identify you. Examples of individually identifiable health information include: Information your doctors, nurses, and other health care providers put in your medical record⁴ Conversations your doctor has about your care or treatment with nurses and others⁴ Information about you in your health insurer's computer system⁴ Billing information about you at your clinic⁴ Information used by companies or individuals that provide data, billing, or other services to doctors, hospitals, health insurers, and other healthcare care organizations.⁴ Protect Your Health Information: Dos and Don’ts While HIPAA exists to protect health information held by health care providers, health insurers, and more, it is important to take precautions to protect the health information that you control. DO secure your information with passwords. Use a strong password and update it often. A strong password should be at least sixteen characters, random, and unique from other account passwords.⁵ DON’T post health information online. Never post anything online that you do not want to be made public and never assume that an online public platform is private or secure. Information posted online is permanent. DO use multi-factor authentication. Passwords can be vulnerable to hackers, so further protect your accounts by setting up multi-factor authentication. Common methods of authentication include a one-time passcode sent via text message, email, or authenticator app, security questions, face ID, and more.⁶ DON’T give your personal information to unverified callers. There are identity thieves who try to use personal health information to receive medical treatment, prescription drugs, and more. Verify the legitimacy of the caller before sharing your information.⁷ DO avoid using public wi-fi networks. Most free public wi-fi networks lack security measures, meaning, others using the same network could easily access your online activity. Avoid using public networks when accessing personal information or entering payment information. DON’T fall for phishing attempts. Never click on unfamiliar links sent via email or text. Clicking on phishing links can result in your device being infected with malware and make your information vulnerable. DO shred paper documents that contain personal health information. Shredding not only frees up space and helps the environment, it can also prevent unwanted parties from getting a look at your personal information. DON’T use apps and websites without doing research. Use known and reputable apps and websites, especially those that involve sharing personal information. Read the terms of service and privacy notice to verify that the app/website will only perform the functions you approve.⁷ Privacy and security of our patients’ health information is a top priority. If you believe your information was used or shared in a way that is not allowed under the HIPAA Rules, or if you were not able to exercise your rights, you can file a complaint with the U.S. Department of Health and Human Services (HHS) or your State's Attorneys General Office. Sources: 1.       https://www.jotform.com/what-is-hipaa-compliance/ 2.       https://www.cdc.gov/phlp/publications/topic/hipaa.html 3.       https://www.healthit.gov/sites/default/files/how_to_keep_your_health_information_private_and_secure.pdf 4.       https://www.healthit.gov/topic/your-health-information-security 5.       https://www.cisa.gov/secure-our-world/use-strong-passwords 6.       https://consumer.ftc.gov/articles/use-two-factor-authentication-protect-your-accounts 7.       https://www.healthit.gov/topic/privacy-security-and-hipaa/what-you-can-do-protect-your-health-information

It’s been a long day, you’re ready to go home and have some drinks to unwind when you remember you’re taking an antibiotic. The bottle says, “Do not consume alcohol while taking this medication,” but a few drinks should be fine, right? Wrong – here’s why! Why is combining drugs and alcohol a bad idea? It may come as a surprise for some, but drinking alcohol while taking medications (prescription or over-the-counter) can lead to potentially severe side effects and even death. We often forget that alcohol is in fact a drug, and if mixed with other drugs can cause unwanted side effects such as nausea, headaches, fainting, loss of coordination, and more. ¹ Not only can mixing drugs and alcohol have a negative effect on your body, but it can also interfere with how the medication works. Alcohol can cause your medication to have several different effects: ² The medication may become less effective. The concentration of the medication may reach toxic levels. Side effects may worsen. New symptoms may arise. Talk to your pharmacist about the potential side effects of mixing your medication with alcohol, even if the label does not come with a warning. It’s important to be honest with your pharmacist about your drinking habits so they can accurately judge any risks. What can happen if I mix drugs and alcohol? Mixing alcohol with prescription or over-the-counter medications can have serious side effects. Some common symptoms include: ² Blood pressure changes Mood and behavior changes Dizziness and fainting Nausea and vomiting Headaches Seizures More serious complications caused by mixing alcohol with medications are liver damage, heart problems, internal bleeding, and could lead to an overdose or alcohol poisoning. ³ Drug and alcohol interactions may depend on the type of medicine, the amount of alcohol, and your genetics, sex, and overall health. ³ Often, older adults, women, and children and teens may experience more severe side effects of alcohol and drug interactions for a number of reasons. ⁴ Older Adults Alcohol does not break down as quickly in older adults and their body’s water to fat ratio is decreased. According to a study by the National Institutes of Health (NIH), 78% of surveyed adults over the age of 65 were current drinkers and also taking a medication that could interact with alcohol. ⁴ This can lead to drowsiness, dizziness, confusion, and a greater risk of falls and injury. Women Women may be at greater risk of side effects from mixing alcohol and drugs than men due to having a lower percent of body water compared to body fat. This causes alcohol to break down slower, resulting in a higher blood alcohol level after drinking the same amount as a man. This increases the risk of experiencing negative side effects. Children and Teens While seemingly at a lower risk for drug interactions with alcohol, it is still a concern. Alcohol abuse in youth can cause life-long complications and can especially be a risk when mixing alcohol with ADHD medications. Another concern is how the younger population is consuming their alcohol. Energy drinks are a common alcohol mixer among college students, which can lower the feeling of intoxication resulting in excessive drinking and alcohol-related injuries. ⁴ What medications can interact with alcohol? Many medications, including over-the-counter products, can vary in severity of symptoms. The most common medicines that react with alcohol include: ³ Opioids Antidepressants Antipsychotic medicines Sleeping aids Cold and flu medicines Antibiotics Pain medicines Sedative medications, including those that help you sleep, can cause your breathing to slow or stop when consumed with alcohol. This can be extremely dangerous and is a common cause of death. ² Certain medications including painkillers, allergy relief, and cold medicine may contain multiple ingredients that can react with alcohol. ¹ Some medications can even contain up to 10 percent alcohol, such as cough syrup and laxatives. If you are unsure of your medication ingredients, talk to your pharmacist to get a better understanding of what your medicine contains. Most over-the-counter medications will have sections on the label listing various things such as active ingredients, purpose, uses, warnings, directions, other information, inactive ingredients, and can even include a phone number to call with questions. ⁵ Below are symptoms or disorders that are commonly remedied with medication (both prescription and over-the-counter) and the possible drug alcohol interaction side effects. ¹ Allergies, cold and flu. Common side effects of consuming alcohol while taking these medications may include drowsiness, dizziness, and increased risk for overdose. Many cold medications already have alcohol in them, so combining that with drinking alcohol can induce severe drowsiness. Anxiety. Taking anxiety medications may heighten your anxiety symptoms if mixed with alcohol. Some side effects include drowsiness, dizziness, difficulty breathing, unusual behavior, memory problems, and impaired motor control. ADHD. When mixed with alcohol, many ADHD medications can have contradictive side effects including impaired concentration, increased risk for heart problems, liver damage, dizziness, and drowsiness. Heartburn. Rapid heartbeat, increased alcohol effect, and sudden changes in blood pressure are just a few side effects of consuming alcohol while taking heartburn medications. High cholesterol. A few side effects of mixing alcohol with high cholesterol medications include liver damage, increased flushing and itching, and increased stomach bleeding. Infection. Alcohol should not be consumed if you are taking an antibiotic. Not only can the alcohol reduce the effect of the antibiotic, but it can also result in a fast heartbeat, stomach pain, vomiting, liver damage, and more. Pain. Common pain killers, when mixed with alcohol, may result in upset stomach, ulcers, liver damage, and rapid heartbeat. Sleep issues. Mixing alcohol with sleeping aids can result in increased drowsiness, slow breathing, impaired motor control, memory problems, and much more. If you are currently taking any type of medication, even an over-the-counter cold medicine, talk with your pharmacist about the potential interactions your medication may have with alcohol. If you or a loved one is struggling with alcohol or drug addiction, please call the SAMHSA National Helpline for free, confidential help at 1-800-662-4357, or visit samhsa.gov for more information on how to get help. Sources: ¹ https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/harmful-interactions-mixing-alcohol-with-medicines ² https://www.verywellmind.com/mixing-alcohol-and-medication-harmful-interactions-67888 ³ https://www.healthdirect.gov.au/medicines-and-alcohol ⁴ https://www.drugs.com/article/medications-and-alcohol.html ⁵ https://www.fda.gov/drugs/resources-drugs/drug-interactions-what-you-should-know

February is American Heart Month and a time when all people are encouraged to focus on their cardiovascular health. Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States. People who are most at risk for heart disease are those with high blood pressure, high blood cholesterol, and those who smoke. Several other conditions and lifestyle choices can put you at a higher risk of heart disease, such as: (1) Diabetes Overweight and obesity Unhealthy diet Lack of physical activity Excessive alcohol use Symptoms of Heart Disease Heart disease may be “silent” and not diagnosed until a person experiences signs or symptoms of a heart attack, heart failure, or an arrhythmia. Symptoms may include: (2) Heart attack: chest pain or discomfort, upper back or neck pain, indigestion, heartburn, nausea or vomiting, extreme fatigue, upper body discomfort, dizziness, and shortness of breath Arrhythmia: fluttering feelings in the chest or palpitations Heart failure: shortness of breath, fatigue, or swelling of the feet, ankles, legs, abdomen, or neck veins What Behaviors Increase the Risk of Heart Disease Lifestyle choices can greatly increase your risk for heart disease. Things like: Eating a diet high in saturated fats, trans fat, and cholesterol has been linked to heart disease and related conditions. Too much sodium in your diet can raise your blood pressure which increases your risk for heart disease. Not getting enough physical activity can lead to heart disease and increase the risk for other conditions such as obesity, high blood pressure, high cholesterol, and diabetes. Drinking too much alcohol can also raise blood pressure and increase your risk for heart disease, and any tobacco use increases your risk of heart disease and heart attack. Genetic factors likely play some role in high blood pressure, heart disease, and other related conditions as well. However, it is also likely that people with a family history of heart disease often share common environmental factors that may increase their risk. (3) Diet and Lifestyle Recommendations for Heart Health A healthy diet and lifestyle are the keys to preventing and managing cardiovascular disease, along with many other conditions. It doesn’t have to be hard! Even just small changes can make a big difference if you are consistent. Don't think of these changes as a temporary diet but as a change in your overall pattern. Make some of these simple steps below for long-term benefits to your overall health and your heart: (4) Know how many calories you should be eating and drinking to maintain a healthy weight. This will account for several factors such as your age, gender, and level of activity. A good starting point could be a calorie calculator online, but it is best to speak with your provider so they can help you take your personal factors into account. Increase the amount and intensity of your physical activity. You should aim for at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity per week. Being physically active is a major step toward good heart health. Not only will it help you keep your weight under control, but it strengthens the heart muscle and wards off any artery damage. Here's how different exercises can benefit your heart health: (5) Aerobic Exercise improves circulation which results in lowered blood pressure and heart rate. It also reduces the risk of type 2 diabetes. Ideally, you should perform some type of aerobic exercise at least 30 minutes a day, five days a week. Examples of this type of exercise include brisk walking, running, swimming, cycling, or playing tennis. Resistance Training (Strength Work) can help reduce fat and create leaner muscle mass. Research shows that a combination of aerobic exercise and resistance work may help your good cholesterol and lower the bad. You should aim for at least two nonconsecutive days per week of strength training. Examples include working with free weights such as dumbbells or hand weights, weight machines, resistance bands, or body-weight exercises like push-ups and squats. Stretching, Flexibility and Balance don't directly contribute to heart health but they allow you to stay flexible and free from joint pain, cramping, and other muscle issues which in turn helps you maintain your aerobic exercise and resistance training. You should stretch every day before and after every other exercise. Eat an overall heart-healthy diet such as: (6) Vegetables such as leafy greens (spinach, kale, cabbage), broccoli, and carrots Fruits like apples, bananas, oranges, pears, grapes, and prunes Whole grains such as oats, brown rice, and whole-grain bread Protein-rich foods: Fish high in omega-3 fatty acids like salmon, tuna, and trout Lean meats such as 95% lean ground beef, pork, chicken, or turkey Eggs Nuts and seeds Legumes such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans Foods high in healthy fats: Olive oil Walnuts, almonds, and pine nuts Nut and seed butters Sesame, sunflower, pumpkin, or flax seeds Avocados Tofu Foods and drinks to limit include processed foods, added sugars, high-sodium items, soda, and alcohol. Live tobacco-free. Cigarette smoking and using other tobacco products greatly increases your risk for heart disease. If you currently smoke but would like to quit, you can follow the below five steps: (7) Set your “Quit Day” within the next 7 days and make a pledge in front of people who will support you. Choose your method whether it’s “cold turkey”, or cutting down the number of cigarettes per day until you reach zero. Talk with your healthcare professional to decide if you’ll need medicines or other help to successfully quit. Make a plan for your quit day and afterward such as having healthy snacks available, keeping yourself busy with activities you enjoy, etc. And finally, quit tobacco on your quit day! As always, you can and should consult a healthcare professional such as your physician or pharmacist who can also help you take the proper steps to quit for good. Work with your healthcare team. You and your healthcare team, like your physician and pharmacist, can work together to prevent or treat any conditions that may lead to heart disease. Discuss this treatment plan regularly, and bring any questions you have to all your appointments. If you've already had a heart attack, your healthcare team will work with you to prevent another one. If your treatment plan includes medications, be sure to take any medications as directed and tell your pharmacist if you are experiencing any side effects. Sources 1.       https://www.cdc.gov/heartdisease/facts.htm 2.       https://www.cdc.gov/heartdisease/about.htm 3.       https://www.cdc.gov/heartdisease/risk_factors.htm 4.       https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/aha-diet-and-lifestyle-recommendations 5.       https://www.hopkinsmedicine.org/health/wellness-and-prevention/3-kinds-of-exercise-that-boost-heart-health#:~:text=Aerobic%20Exercise,-What%20it%20does&text=How%20much%3A%20Ideally%2C%20at%20least,per%20week%20of%20moderate%20activity. 6.       https://www.nhlbi.nih.gov/health/heart-healthy-living/healthy-foods 7.       https://www.heart.org/en/healthy-living/healthy-lifestyle/quit-smoking-tobacco/5-steps-to-quit-smoking

For many, the new year marks an opportunity to reflect on the past year and start fresh. We make New Year’s resolutions to change for the better, whether that be getting in shape, eating healthier, saving money, or getting organized. However, sometimes we make resolutions we cannot keep up with. Say goodbye to unrealistic goals and the pressure that comes with them! Let’s embrace setting attainable resolutions that make room for healthier habits for 2024 and beyond. Goal: Eat a Healthy Diet Fueling your body with healthy nutrients is one of the easiest and most sustainable ways to help manage weight and improve overall health. Instead of trying an unrealistic fad diet, opt for slowly incorporating healthier options into your diet to develop life-long healthy eating habits. Not sure where to start? According to the Dietary Guidelines for Americans 2020-2025, a healthy eating plan includes:¹ Fruits Vegetables Whole grains Fat-free or low-fat milk and milk products Protein-rich foods like seafood, lean meats and poultry, eggs, legumes (beans and peas), soy products, nuts, and seeds Low amounts of added sugar, sodium, saturated fats, trans fats, and cholesterol Staying within your daily calorie needs. Not sure what your daily calorie needs are? Try Mayo Clinic’s Calorie Calculator! Goal: Improve Physical Health Taking care of your body is one of the most important things you can do to be your healthiest self in 2024. Maintaining adequate physical activity, being proactive in your health, and getting a good night’s rest are all key to ensuring your body looks, feels, and works its best. Get Active Physical activity benefits everyone. No matter your age, ability, race, ethnicity, shape, or size, physical activity can provide immediate health benefits like improved sleep, reduced stress, improved weight management, and lowered risks for many chronic diseases like heart disease and type 2 diabetes.² According to the CDC, adults need at least 150 minutes of moderate activity.² Not sure where to start? Incorporate physical activity into your daily routine like walking your dog, parking further away, or opting to take the stairs. You can also schedule time into your week to do physical activities you enjoy like going on a walk, dancing, swimming, or riding a bike. Get Better Sleep While sleep is vital for a person’s well-being, many of us struggle to fall asleep when our head hits the pillow or wake up without getting any quality sleep. This struggle can leave us feeling tired during the day and lead to physical and mental health problems; chronic health issues like heart disease, high blood pressure, and obesity; and interfere with daily functions.³ Not sure how you can start implementing better sleep in 2024? Try the following: Wake up at the same time every day. Being consistent reinforces the body’s sleep-wake cycle, and waking up at different times every day will throw off that cycle.⁴ Get enough sleep. The recommended amount of sleep is 7-8 hours per night. Allow for that time in your sleep schedule by going to bed early enough to still wake up at your chosen wake-up time.⁴ Ease into your target sleep schedule. If you are making larger changes to your sleep schedule, make small adjustments over time. This will help your sleep schedule be more sustainable in the long run. Be Preventative Improving overall physical health is easier when you feel your best. Prevent disease and falling ill by staying proactive with your health. Go to your annual check-ups. Scheduling an annual exam with your doctor and screening for diseases can help you find problems early when your chances for treatment are better. Stay up to date on vaccinations. Vaccines not only protect you from preventable diseases—they keep your community safe, too! We offer a variety of vaccines including flu, shingles, COVID-19, and more. Not sure if you’re current on your vaccines? Check out the CDC’s vaccine schedule. Wash your hands. Say no to pesky germs and prevent the spread of infection and illness by washing your hands frequently. Remember: wet, lather, scrub, rinse, and dry! Review your medications. Whether your regimen includes a short-term prescription or has multiple maintenance medications, making sense of it all can be challenging. Review your medications with your pharmacist to simplify your regimen, decrease side effects, check for drug interactions, and more. Goal: Improve Mental Health Mental illness is among the most common health concerns in the United States affecting more than 1 in 5 adults and over 1 in 5 youth and it can affect your overall well-being.⁵ Take better care of your mental health and boost your mood in 2024 by investing in self-care: Manage stress by getting enough sleep, exercising regularly, and practicing mindfulness activities like yoga. Build healthy support systems by spending time with loved ones, participating in group activities, and participating in your community. Make time for you. Whether it’s going for a walk or carving time out of your schedule to take a relaxing bath, take time to focus on you and only you. Make Your Resolutions Stick In 2024, we are embracing attainable resolutions that stick. No more unrealistic goals that we forget about by February. Sticking with New Year’s Resolutions is easier said than done, but still very possible. Try these tips in tricks to stick with your resolutions in 2024 and beyond:⁶ Set realistic goals. Start small. Setting a huge goal can be overwhelming, so try taking baby steps to start. For example, set a goal to lose 5 pounds instead of 30 pounds. You can always expand the goal later. Plan for obstacles. Obstacles are often unavoidable, but you can overcome them. Don’t give up! Track your progress. Hold yourself accountable by tracking your progress. Keep track in a journal or take photos of your progress. This will help you stay motivated. Get help. Lean on your support system when times get tough. Reward yourself. Celebrate your accomplishments when you achieve small goals or milestones. Splurge on a treat or something you have been wanting. Keep things interesting. Doing the same things can get boring. Keep things interesting by changing up activities or expanding goals. Healthy habits are not something we can only implement in the new year. Practice healthy habits all year long with changes that are attainable and sustainable for you. And don't forget that people are rooting for you and happy to offer you support. Sources: 1.       https://www.cdc.gov/healthyweight/healthy_eating/ 2.       https://www.cdc.gov/physicalactivity/activepeoplehealthynation/moving-matters.html 3.       https://www.nhlbi.nih.gov/health/sleep-deprivation 4.       https://sleepeducation.org/healthy-sleep/healthy-sleep-habits/ 5.       https://www.cdc.gov/mentalhealth/learn/index.htm 6.       https://newsinhealth.nih.gov/2010/12/making-your-resolutions-stick

Your medications are personal – and having your prescriptions filled from a warehouse across the country by strangers is the opposite of personal. Choosing the right pharmacy for you and your family is as important as choosing the right doctor, and you should trust your health to someone who gets to know you. National chain pharmacies often seem like the most convenient option for pharmacy care, and insurance companies may indicate they are the best or only choice for patients to use. In fact, they are owned and operated by billion-dollar conglomerates that prioritize their shareholders over their patients.¹ Patients deserve to be their pharmacy's priority. Be the priority by choosing your local, community pharmacy. Looking for more reasons? Here’s five more. Accurate and Reliable Care When it comes to your health, it’s a priority that your medications are handled with accuracy and the utmost care. As chain pharmacies are often understaffed with overworked employees and have an increased number of medications to fill, more mistakes like miscalculations and misfiled information are likely to be made. Mail-order pharmacy also comes with their fair share of risks with late refills, outdated information, and destroyed medications during shipment. On the other hand, independent community pharmacies with smaller, experienced staff are much less likely to make these mistakes, so you can order and pick up your medications with confidence. According to a 2018 Consumer Reports Survey, “Independent pharmacies earned high scores on such measures as courtesy, helpfulness, and speed of checkout and filling prescriptions, as well as pharmacists’ knowledge and accuracy. At the bottom, large national chain pharmacies.”² Affordable Care A common misconception is that chain pharmacies offer the lowest available prices on medications. False! A 2018 Consumer Reports Survey reported that 21% of consumers reported that independent pharmacies recommended lower-cost medication solutions while only 9% reported chain pharmacies offered lower-priced options. In that same survey, consumers reported that chain pharmacies tended to have higher out-of-pocket prices.³ Community pharmacies know the struggles that their patients face, such as lack of insurance options and fixed income. In order to stay open, independent pharmacies strive to offer options that they know patients need. Convenience Often patients report that convenience is their top reason for choosing a chain pharmacy over an independent, but did you know independent community pharmacies can take convenience to the next level? Independent pharmacies have the flexibility to serve patients at the individual level by customizing each patient’s service to what they need. Need a last-minute emergency refill? Community pharmacies are more likely to go out of their way to fill prescriptions faster. Don't have time to wait in pharmacy lines? Only 3% of independent pharmacy patients reported long wait times compared to 18% of chain pharmacy patients reporting the same. ³ Do you prefer the convenience of your medication being delivered to your home? This isn’t a service unique to chain pharmacies. Many independent pharmacies offer more convenient delivery options like home delivery, mail order, curbside, and drive-through—and they’ve been doing it for years. Enhanced Services and Patient Education Chain and mail-order pharmacies are often only able to provide you with your prescribed medications. Local, independent pharmacies take service to the next level by offering services to address your health as a whole. You can count on your local independent pharmacy to provide personalized supplement recommendations, access to a pharmacist who can answer any questions and address any issues you may have, and regular follow-ups to ensure you get the quality care that you deserve. Need medication adherence help? Non-adherence to a medication regimen has been found to have significant financial costs (Cutler, Rachelle Louise et al. “Economic impact of medication non-adherence by disease groups: a systematic review.” BMJ open vol. 8,1 e016982. 21 Jan. 2018, doi:10.1136/bmjopen-2017-016982)—and beyond that, it can have a significant impact on treatment failures that are costly in other ways. (Kim, Jennifer, et al. “Medication Adherence: The Elephant in the Room.” US Pharmacist, vol. 1 (2018), 19 Jan. 2018, pp. 30–34., www.uspharmacist.com/) While chain pharmacies are providing medication packaging as an online-only service or phasing the service out entirely, independent pharmacies often step up to offer the medication packaging services their patients need. Need customized medication? Most independent pharmacies offer some compounding services to tailor your medications to your specific needs or have a connection to another community pharmacy that can assist. Whether you have allergies to certain ingredients in your medication or need a different dosage form or strength, you can often count on an independent pharmacy to help.³ Need extra one-on-one guidance? Community pharmacists prioritize patient education by working one-on-one with their patients to explain the “why” and “how” of their prescriptions, simplifying medication regimens, checking for drug interactions, creating wellness plans to ensure each patient reaches their health goals, and more. Independent pharmacists also work closely with patients’ providers to have the most up-to-date information on both sides so that patients receive the best possible care. If you think you would benefit from a medication review, ask our local pharmacy team about scheduling a consultation today. Support Your Community Choosing your local independent pharmacy means directly supporting your local community. While making quality care accessible to their communities, independent pharmacies also help their communities thrive economically by generating jobs and tax revenue and playing a major role through civic contributions.⁴ Not only do independent pharmacies support their local communities, the money you spend at the pharmacy stays in the community. From accurate and reliable care to enhanced services and affordability, choosing an community pharmacy is the obvious choice. As an independent pharmacy patient, you can rest assured know you are the priority — not a script number without a name. Choose local by supporting an independent pharmacy. Sources 1. https://www.truthrx.org/patientinformation 2. https://www.consumerreports.org/pharmacies/consumers-still-prefer-independent-pharmacies-consumer-reports-ratings-show/) 3. https://www.consumerreports.org/money/pharmacies/buying-guide/ 4. 2021 NCPA Digest, sponsored by Cardinal Health

Antibiotics are an essential part of treatment for many infections and can save lives, but any time antibiotics are used, they can cause side effects and contribute to the development of antibiotics resistance. In U.S. doctors’ offices and emergency departments, at least 28% of antibiotic courses prescribed each year are unnecessary, which makes improving antibiotic prescribing and use a national priority. (1) Antibiotics are medicines that fight bacterial infections by either killing the bacteria or making it difficult for the bacteria to grow and multiply. (2) Antibiotics ONLY treat certain infections caused by bacteria, such as: Strep throat Whooping cough Urinary tract infection (UTI) Sepsis Antibiotics DO NOT work on viruses and some common bacterial infections, such as: Colds and runny noses Sore throats (except strep throat) Flu Chest colds such as bronchitis Sinus infections Some ear infections The Importance of Antibiotic Compliance It’s important to use antibiotics only when they are needed, and to use them properly. The misuse of antibiotics can be categorized as taking the wrong antibiotic, taking the wrong dose of an antibiotic, or taking an antibiotic for the wrong length of time. (2) When antibiotics are needed, the benefits usually outweigh the risks of side effects. It’s very important that you take the correct dose for the entire length that was prescribed by your doctor. One of the most common reasons for stopping antibiotic use prematurely is that patients feel better and think they no longer have to take their medication. Straying from the instructions on an antibiotic prescription not only can lead to a flare-up of the infection, but also to the development of resistance bacteria. Antimicrobial Resistance Antimicrobial resistances happens when germs like bacteria and fungi can defeat the antibiotics designed to kill them. That means they aren’t killed and continue to grow. It does not mean our body is resistant to antibiotics or antifungals. Resistant infections can be difficult, and sometimes impossible, to treat. (3) Antimicrobial resistance is a naturally occurring process but is accelerated when the presence of antibiotics or antifungals pressure bacteria and fungi to adapt. Antibiotics and antifungals kill some germs that cause infections, but they also kill helpful germs that protect our body. The resistant germs then survive and multiply and have resistance traits in their DNA that can spread to other germs. (4) Resistant germs do not only affect you. Resistant germs can spread between people, animals, and the environment, and can cause deadly infections. Antimicrobial resistance has been found in every U.S. state. We all have a responsibility to act against antimicrobial resistance, including: (5) Prevent infections in the first place by: Keeping your hands clean Getting vaccinated Using antibiotics appropriately Recognizing signs and symptoms of infections Practicing healthy habits around animals Preparing food safely Staying healthy when traveling abroad Preventing STDs Improve antibiotic and antifungal use. Stop the spread of resistance when it does happen. Side Effects of Antibiotics Another common reason for stopping antibiotic use early is experiencing negative side effects. Common side effects of antibiotics include: (7) Digestive problems such as nausea, indigestion, vomiting, diarrhea, bloating, loss of appetite, and stomach pain or cramping Fungal infection Yeast infections Drug interactions Sensitivity to the sun Staining of skin, nails, teeth, and bones A patient should always speak with their pharmacist about possible side effects and how best to take their antibiotics, as some are recommended to take with food to avoid possible digestive issues. If you experience any side effects, call your doctor right away to discuss possible alternative therapy. More rare and severe side effects could include anaphylaxis. Signs of anaphylaxis include: Rapid heartbeat Hives or a red, itchy rash Feelings of uneasiness and agitation Tingling sensations and dizziness Swelling of the face, mouth, and throat Rapid swelling of the lips Severe wheezing, coughing, or trouble breathing. Low blood pressure Fainting Seizures Anaphylaxis can be fatal without immediate emergency care. If you suspect anaphylaxis, call 911 immediately. (7) U.S. Antibiotic Awareness Week U.S. Antibiotic Awareness Week is observed November 18-24, 2023. It is an annual one-week observance that raises awareness of the importance of proper antibiotic use to combat the threat of antimicrobial resistance. One of the main goals of Antibiotic Awareness Week is to share the key messages of antibiotics. Those key messages are: (8) Antibiotics can save lives. When a patient needs antibiotics, the benefits outweigh the risk of side effects. Antibiotics do NOT treat viruses such as colds, flu, RSV, and COVID-19. Antibiotics are only needed for treating certain bacterial infections, but even some bacterial infections get better without antibiotics. An antibiotic will not make you feel better if you have a virus. If an antibiotic is not needed, they won’t help you and the side effects could still cause harm. Taking antibiotics can contribute to the development of antimicrobial resistance. If you need antibiotics, take them exactly as prescribed. Talk with your healthcare provider if you develop any side effects. Do your best to stay healthy and keep others healthy. This helps reduce antibiotic use and fights antimicrobial resistance. Antibiotics aren’t always the answer. As always, if you ever have any concerns about an antibiotic that was prescribed to you, talk to your trusted local pharmacist! You can also use the CDC's Antibiotic Knowledge test found here https://www.cdc.gov/antibiotic-use/quiz.html. Sources: https://www.cdc.gov/antibiotic-use/index.html https://www.cdc.gov/antibiotic-use/q-a.html https://www.cdc.gov/drugresistance/about.html https://www.cdc.gov/drugresistance/about/how-resistance-happens.html https://www.cdc.gov/drugresistance/protect-yourself-family.html https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4269991/#:~:text=Antimicrobial%20resistance%20results%20from%20inappropriate,required%20to%20prevent%20antimicrobial%20resistance. https://www.medicalnewstoday.com/articles/322850#rare-side-effects https://www.cdc.gov/antibiotic-use/week/toolkit.html

Many people around the world struggle with their mental health and although some individuals struggle more than others, resulting in a mental health disorder (1), it all ties into our emotional, psychological, and social well-being.(2) Our mental health affects the way we think, feel, act, make choices, and relate to others. Why Invest in Your Mental Health? Investing in your mental health does not just help your mental state, but it may also benefit your overall well-being. As an example, depression can increase the risk of physical health problems such as diabetes, heart disease, and stroke.(2) Not only that, but there are many other benefits of taking care of our mental health such as (3) Improved mood Reduced anxiety Enhanced inner peace Clearer thinking Improved relationships Increased self-esteem According to Talkspace therapist Bisma Anwar, LMHC, “Our mental health is something that impacts our eating and sleeping habits … oftentimes we will feel the impact of [mental health] in other areas of our health as well.”(3) It is also important to note that your mental health can and will change over time and is dependent on many factors. Examples of ways your mental health can change over time include working longer hours than usual, caring for a relative, or experiencing economic hardship.(2) If we neglect our mental health it can lead to further complications, including mental illness, which in return can negatively impact our day-to-day lives. Mental illness can make you feel miserable, effecting your life at school, work, or your relationships. Who is at Risk? As we begin to understand what mental health and mental illnesses are, we need to understand the symptoms that can be present. A few examples of mental illness symptoms are:(1) Excessive fear or worry Extreme mood changes Detachment from reality Alcohol or drug abuse Hostility Suicidal thoughts or actions It is also common that symptoms may appear as physical problems including stomach pain, headaches, back pain, or other unexplained aches and pains.(1) These mental illness symptoms can develop at any time due to a variety of genetic and environmental factors like inherited traits, environmental exposures before birth (toxins, alcohol, or drugs while in the womb), and brain chemistry. Other risk factors include the following (1, 2, 3) A history of mental illness in blood relatives Stressful life situations A chronic condition Traumatic brain injury Traumatic experiences Excessive use of alcohol or recreational drugs Childhood abuse or neglect Few healthy relationships Previous mental illness Sometimes a person may not develop a mental health condition even if they had previously been exposed to these risk factors, while some people with no risk factors still develop a mental health condition.(4) How Common are Mental Health Issues? Mental illness is among the most common health concerns in the United States affecting more than 1 in 5 adults and over 1 in 5 youth (ages 13-18). Serious mental illness, such as schizophrenia, bipolar disorder, or major depression affects about 1 in 25 adults.(2) There are more than 200 types of mental illnesses (2), however, according to Anwar, “Some of the most common mental health conditions include depression, anxiety, PTSD, psychotic disorders, and personality disorders.” A few other common mental health conditions include panic disorder, OCD, and eating disorders. Anxiety disorders are the most common mental health condition in the United States, affecting more than 40 million adults. Out of these 40 million, less than 37% actually seek treatment for their symptoms.(3) It is important for those struggling with their mental health or mental illness to get the help they need. How Can I Get Help? Seeking help for your mental health early on can increase the chances of successful treatment, if necessary. Getting help for a mental illness or mental health is important for your overall health, but it can be difficult for some to reach out. If you are unsure if you should reach out for help, just know there are resources available all around you. Self-Care The first step to helping your mental health is through self-care. Everyone’s self-care routine looks different, it is all about finding what you need and what brings you joy. Try these tips to get you started on your self-care journey:(5) Regular exercise. Find time in your day for a short walk to help boost your mood and improve your health. Just 30 minutes of physical activity a day is sufficient. Eat healthily and stay hydrated. Maintaining a balanced diet and drinking plenty of water can help your energy levels and your focus. Prioritize sleep. To make sure you’re getting enough sleep, try sticking to a schedule and reduce your blue light exposure before bedtime. Engage in relaxing activities. Relaxation or wellness programs and apps can help relax your mood. These could include meditation, yoga, or breathing exercises. Set goals and priorities. Prioritize things that need to get done now and hold off on things that can wait. Learning to say “no” can help you from taking on too much. At the end of the day, reflect on what you have accomplished rather than what you did not get done. Practice gratitude. Creating a list of things you are grateful for can help focus your mind on the positives. Stay connected. Talk with friends and family who can provide emotional support. Professional Help If your self-care routine is not enough and you are experiencing long periods of distress such as difficulty sleeping, lack of appetite, difficulty concentrating, or loss of interest in your typical enjoyable things, seeking professional help is your next step. Talk to your health care provider about the symptoms you have been experiencing and they can refer you to a mental health professional if needed. If a mental illness goes untreated, it can get worse over time and lead to more serious problems. Emergency Services If you are experiencing a mental health crisis or having suicidal thoughts, seek help immediately.(1, 5) Reach out to a close friend or loved one. Contact a minister or someone in your faith community. Call your mental health specialist or primary care provider. Contact a suicide hotline by calling or texting 988. Services are free, confidential, and available 24/7. Call 911 or your local emergency number. Unfortunately, mental health is often stigmatized in our society. However, the more people understand the importance of seeking help no matter how severe your situation is, the more we can work on de-stigmatizing mental health awareness. Everyone has their own struggles, but they should never have to go through it alone. Sources: (1) https://www.mayoclinic.org/diseases-conditions/mental-illness/symptoms-causes/syc-20374968 (2) https://www.cdc.gov/mentalhealth/learn/index.htm (3) https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response#:~:text=It%20is%20an%20integral%20component,community%20and%20socio%2Deconomic%20development. (4) https://www.talkspace.com/blog/why-is-mental-health-important/ (5) https://www.nimh.nih.gov/health/topics/caring-for-your-mental-health

Flu season is almost here and let’s face it — no one has time for sniffles and coughs. Save yourself the time and suffering. You have the power to protect yourself and the ones you love from influenza and as your trusted health resource, we are here to help you do just that. Here is everything you need to know about getting vaccinated against the flu: How do flu vaccines work? Vaccines train our immune systems to create proteins called antibodies, which are responsible for fighting diseases in our bodies.¹ When we get the flu vaccine, our bodies are exposed to a version of the flu that has been already killed or weakened. This helps our immune system create antibodies to fight the flu without getting sick. Once the body processes the vaccine and produces antibodies, it also creates antibody-producing memory cells, which remain alive even after the flu is defeated. If the body is exposed again, the antibody response is faster and more effective than the first time around because the memory cells are ready to pump out antibodies in defense.¹ Getting vaccinated for the flu goes far beyond just protecting yourself. Vaccinations work at their best when we develop herd immunity. This is when many people within a community are vaccinated, lessening the flu’s spread and preventing people that are unable to vaccinate from getting sick.¹ The more people get vaccinated, the more we can keep our communities healthy. How effective are flu vaccines? Flu vaccination can reduce the risk of flu illness by up to 60%, however, how well the flu vaccines protect us against the flu varies from season to season. Protection not only varies depending on characteristics of the person getting vaccinated such as age and overall health.² The effectiveness of flu vaccines each year heavily depends on how well they match with the flu viruses spreading throughout the community.³ Flu viruses change quickly, meaning the vaccine created for last year’s virus may not protect you from the flu viruses this year. The more the flu vaccine matches circulating flu viruses, the better protection we have against getting the flu. If you still get sick even if you received a flu vaccine, flu vaccination has been shown to reduce the severity of the virus. For example, a 2021 study found that vaccinated adults hospitalized with the flu had a 26% lower risk of being admitted to intensive care units and a 31% lower risk of death compares to unvaccinated adults.² Who should get the flu vaccine? Annual flu vaccinations are recommended for everyone 6 months or older, but vaccinations are especially important for those at high risk for flu-related complications:⁴ Children ages 6 months – 2 years old Adults older than age 50 Residents of nursing homes and other long-term care facilities People who are pregnant or plan to be pregnant People with weakened immune systems People who have chronic illnesses, such as asthma, heart disease, kidney disease, liver disease, and diabetes People with a body mass index (BMI) of 40 or higher While everyone 6 months and older should get a flu vaccine, there are some rare exceptions:⁵ Children younger than 6 months of age are too young to get a flu shot. People with severe, life-threatening allergies to any ingredient in a flu vaccine (other than egg proteins) should not get that vaccine. This might include gelatin, antibiotics, or other ingredients. People who have had a severe allergic reaction to a dose of influenza vaccine should not get that flu vaccine again and might not be able to receive other influenza vaccines. If you have had a severe allergic reaction to an influenza vaccine in the past, it is important to talk with your healthcare provider to help determine whether vaccination is appropriate for you. When should you get your flu shot? In the United States, flu season is in the fall and winter. However, influenza viruses are still present and circulating year-round. Flu cases generally peak between December and February and sometimes linger as late as May. With this in mind, flu vaccination is ideal during September or October.⁴ Vaccinating sooner could lead to waning efficacy near the end of flu season in spring. However, don’t wait too long to get your flu shot either as it takes about two weeks after vaccination for antibodies to develop in the body to fully protect against the flu.³ We highly encourage you to talk with our team or your healthcare provider about any additional questions or concerns you may have about flu vaccines. You have the power to protect yourself and the ones you love from influenza by getting your annual flu shot! https://www.hometownfamilystores.com/flu Sources: 1. https://www.who.int/news-room/feature-stories/detail/how-do-vaccines-work 2. https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm 3. https://www.cdc.gov/flu/prevent/keyfacts.htm 4. https://www.mayoclinic.org/diseases-conditions/flu/in-depth/flu-shots/art-20048000

With so many available resources online now, misconceptions about medications are becoming more and more common. But taking medication can be an important part of your overall health, and having the correct information is extremely important to keep you safe and healthy. Here are some of the top myths about medications, and the facts that debunk these myths: Myth: You feel better, so you don’t need to take your medication. Fact: Your doctor prescribed you medication because you need it. If you stop taking your medication early, it can increase your chance of relapsing into the illness that medication is prescribed for. Especially with antibiotics, it’s tempting to stop taking them as soon as you feel better. But you need to take the full treatment to kill the disease-causing bacteria. If you stop taking it, it can also promote the spread of the antibiotic-resistant properties among harmful bacteria.1 If you are taking a maintenance medication, it’s very important you talk to your doctor or pharmacist before you change your medication regimen. Myth: Natural supplements are always a safe choice. Fact: “Natural” doesn’t always mean “safe.” Since the standards for supplements are not as strict, the amount of each ingredient can vary between products. If you’re interested in natural supplements, it’s important you still talk to your doctor or pharmacist about which ones are safe for you to use. Your pharmacist will be able to look at all your medications and be able to recommend which supplements will best fit into your regimen.2 Myth: If you’re really hurting, you can ignore the recommended dosage and take more pills. Fact: If you take more than the recommended dosage on the label, it can hurt you. Pharmaceutical companies and doctors work hard to develop the appropriate dose for every person. Taking your pills in any other way than the recommended amount can do more harm than good. Taking more pills or more frequently than the label states can rob you of the medicine’s benefits and increase the risk of serious side effects. Also, it is very possible that an overdose can occur which can have dangerous or even life-threatening consequences. It’s important to read every label or talk to your pharmacist to be clear on your recommended dosage.2 Myth: Antibiotics are always the answer. Fact: Antibiotics can only treat bacterial infections such as strep throat, not infections caused by viruses such as acute respiratory infections. Taking antibiotics unnecessarily can cause antibiotics to lose its strength and ability to effectively treat bacterial infections going forward.3 Myth: Your healthcare providers don’t need to know what vitamins you take. Fact: Health care professionals should know every medication, prescribed or OTC, you take regularly so that they can warn you about potential interactions. Examples of vitamins with the potential for serious interactions include vitamins A and E, which increase the effects of anticoagulation and should therefore be closely monitored when taking warfarin, and magnesium, which can decrease antibiotic absorption and should be dosed separately by 2 hours before or 6 hours after taking an antibiotic.3 Myth: It doesn’t matter how you ingest the pill. Fact: Taking pills with any other liquid than water – particularly alcohol – can interfere with the manner in which the body absorbs the medication. Also, some medications must be taken with food, which others may have strange or dangerous interactions with certain foods.3 Talk with your pharmacist on drug administration instructions for proper absorption. Myth: It doesn’t matter where you store your medications. Fact: Some medications lose their effectiveness when they are exposed to hot, humid environments. Medications are almost always best stored in a dry place away from heat, direct light, or any source of dampness. If children are around, keep medicine containers out of reach. Some medicines have bright colors and shapes that children can mistake as candy. Managing medications can be complicated, especially if you are taking several. It’s important to understand your regimen, talk thoroughly with your pharmacist, keep up to date on refills, and take medications as prescribed. If you are unsure about any of the medications you are currently taking or plan on taking, it’s always a good idea to talk to your provider or pharmacist about it first. With proper administration and storage, your medication regimen should help you feel your very best! Sources 1. https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/antibiotics/art-20045720#:~:text=Taking%20antibiotics%20responsibly,to%20start%20treatment%20again%20later. 2. https://health.clevelandclinic.org/7-myths-medication-facts-behind/ 3. https://www.pharmacytimes.com/view/7-medication-myths-pharmacists-can-debunk 4. https://www.hopkinsmedicine.org/health/wellness-and-prevention/help-for-managing-multiple-medications

It is likely that you or someone you know has suffered from some type of chronic disease. Chronic diseases, such as diabetes, stroke, or cancer, are more common than one might think and are the leading causes of death and disability in the United States. (1) (image from source 1) What is Chronic Disease? Chronic disease is defined as a condition that lasts 1 year or longer and requires ongoing medical attention, limits daily activities and living, or both. (2) They can affect any part of the body and may or may not be curable (4). In the United States, 6 in 10 adults have some type of chronic disease, and 4 in 10 adults have two or more chronic diseases. Some of the most common chronic diseases, such as heart disease, cancer, and diabetes are the leading causes of death and disability and are the leading drivers of the nation’s $4.1 trillion in annual health care costs. (2) Many chronic diseases are caused by a short list of risk behaviors, but can also result from a combination of genetic, physiological, environmental, and behavioral factors. (3) Other risk factors include raised blood pressure, overweight/obesity, hyperglycemia, and hyperlipidemia. Here are some of the most common lifestyle risks: (1) Tobacco use & exposure to secondhand smoke (2): Using tobacco or being exposed to secondhand smoke increases your risk of poor health and chronic disease. Poor nutrition: Having a well-rounded diet and drinking plenty of water is key to keeping yourself healthy. Lack of physical activity: Staying active is important in maintaining a healthy lifestyle. Excessive alcohol use: This includes binge drinking, heavy drinking, and using alcohol while pregnant. Most Common Chronic Diseases In the United States, chronic diseases are the leading cause of death and disability. Knowing the top offenders can help you understand if you may be at risk, allow time to get an early diagnosis, and start to manage the disease. Here are seven of the most common chronic diseases in the United States. Heart Disease This chronic disease includes many different heart conditions, the most common being heart attacks. Heart disease can affect any part of the heart and can result from a number of reasons. Although this disease is thought of typically only affecting men, it is the leading cause of death for both men and women in the United States. Cancer Cancer occurs when cells become damaged and begin to reproduce rapidly, creating a tumor that can spread to other parts of the body. It can affect any part of the body and comes in many forms. Chronic Lung Disease Also known as chronic obstructive pulmonary disease (COPD), this covers a wide range of conditions affecting the lungs. Breathing becomes more difficult as the airflow to the lungs is restricted. Nearly 16 million Americans have some form of chronic lung disease. (4) Stroke A stroke occurs when blood is blocked from reaching the brain or when a blood vessel in the brain bursts. Affecting nearly 800,000 people each year, around 150,000 of them will die, making stroke the fourth leading cause of death in the United States. (4) Alzheimer’s Disease A disorder of the brain, Alzheimer’s disease is progressive and worsens over time. Patients generally only live an average of eight years after diagnosis, making this the sixth leading cause of death in the Unites States. (4) Symptoms of Alzheimer’s disease include memory loss, strange behavior, disorientation, poor judgement, and more. Diabetes This chronic disease happens when there is consistently too much glucose in the blood, resulting in high blood sugar levels which may lead to even more health issues. Type 1 diabetes is genetic and can be passed down to offspring, while type 2 diabetes is developed over time through poor diet, especially from consuming too much sugar. Chronic Kidney Disease When kidneys are damaged, they are unable to filter your blood correctly, leading to kidney disease. Symptoms of Chronic Kidney Disease include nausea, vomiting, fatigue, and urination frequency. If you or a loved one are experiencing any of the symptoms mentioned above, seek medical attention to check for indicators of chronic illness. (4) Prevention & Control Early identification of a chronic disease is crucial to ensure you get the maximum support. It is also important to follow these seven steps to help reduce the risk of chronic disease and manage current chronic diseases. (5) Managing your blood pressure. A major risk factor for heart disease, stroke, and other chronic conditions is having high blood pressure. Understanding what high blood pressure is, what it looks like, and how it can affect your body and heart will help you stay healthier and prevent you from a possible heart attack or stroke. Controlling your cholesterol. Having high cholesterol increases your risk for cardiovascular disease. Talk with one of our pharmacists about what high cholesterol is and what your cholesterol levels mean. We can give you tips on how to improve your levels. Reducing blood glucose levels. High levels of blood glucose can lead to diabetes. Gaining a better understanding of what raises your glucose levels, such as what foods you should or should not eat, can help manage your sugar intake. Watching what you eat is an important step towards eating healthier and living a healthy lifestyle. Getting active. About 80 percent of adults and adolescents in the United States do not get as much physical activity as they should. While it may be hard for some to incorporate physical activity into their daily lives, it is important to get at least 150 minutes per week. (5) Being physically active, even if it’s taking a short walk or doing yoga, can significantly improve your quality of life. Staying active can help with heart health, improve thinking skills, control weight, and boost energy levels. (6) Eating healthier. Maintaining a healthy diet is one of the best ways to prevent and manage chronic disease. Making simple changes to your diet, such as consuming less sodium and sugar, can help prevent high blood pressure and lower your glucose levels. Losing weight. Having a high body mass index can lead to increased risk of chronic disease. Taking steps to lose weight through diet and exercise can make a huge difference in your overall health, even if it is only a 5 percent weight loss. Stop smoking. Smoking cigarettes rapidly increases your chances of developing cardiovascular disease, which may lead to other chronic diseases. Many individuals turn to electronic cigarettes or vapes, but these often contain harmful chemicals. Chronic Diseases can be difficult to understand and manage, especially if you or a loved one was recently diagnosed. Living a healthy lifestyle and knowing the risks can be beneficial to understanding the condition and learning how to manage it. Sources: (1) https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm (2) https://www.cdc.gov/chronicdisease/about/index.htm (3) https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases (4) https://www.afcurgentcare.com/bridgeport/blog/the-top-7-most-common-chronic-diseases-in-the-us/ (5) https://www.ama-assn.org/delivering-care/public-health/7-steps-patients-should-follow-reduce-manage-chronic-disease (6) https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise-and-chronic-disease/art-20046049

For most, having a healthy lifestyle is a top priority. Eating a balanced diet and exercising regularly are often the first things people think of when looking to make positive lifestyle changes. However, many people who are active and eat well can still be missing out on certain nutrients without realizing it. Drug-Induced Nutrient Depletion While we take prescription medications to improve health, many medications (prescription and over-the-counter) can also deplete the body of essential vitamins, minerals, and enzymes the body needs to function optimally. This depletion in nutrients is more specifically a result of drug-nutrient interactions that influence food intake, nutrient digestion, absorption, distribution, metabolism, and much more.¹ Some medications interfere with the absorption of nutrients, others lead to increased excretion of nutrients, and some block the body’s production of certain nutrients. The list goes on. Eventually, these nutritional deficiencies can become significant and cause severe side effects, especially when the medications are taken for long periods as nutrient deficiencies tend to develop gradually over time.² How to Avoid Drug-Induced Nutrient Depletion With America’s increasing reliance on prescription medications (50% of adults regularly take one prescription medication and 20% take three or more), avoiding nutrient depletion can be difficult, but it’s possible.¹ The best way to avoid drug induced nutrient depletion is to talk with your pharmacist. Be honest about what side effects you are experiencing and ask them to review which nutrients might be depleted by your regimen. Consult with your doctor or pharmacist about what supplements may be right for you, or if your regimen can be modified to reduce your risk. Common Nutrient Deficiencies and How to Avoid Them To make up for nutrient deficiencies, there are many over-the-counter vitamin and supplements options — so many that it can be hard to figure out which ones could benefit you. Choosing the vitamins and supplements that are right for your body and lifestyle can be overwhelming, but educating yourself on the nutrient effects from your current medication regimen and learning about the most common nutrient supplement options and their properties can help to alleviate this stress. 1. Iron Iron is crucial for growth and development, increased energy, better brain function, and healthy red blood cells.³ If you typically incorporate red meats in your diet, you should get enough iron. However, the amount of iron you need may increase during times of rapid growth and development, like puberty and pregnancy.³ Vegetarians and vegans may also need more iron if they are not incorporating plant-based iron-rich foods like white beans, lentils, spinach, kidney beans, and nuts.⁴ 2. Vitamin D Vitamin D helps the body absorb calcium, which is vital for our bone health. But don’t we get Vitamin D from the sun? Yes, we do, however, more than 40 percent of Americans don’t spend enough time in the sun each day to achieve this. Vitamin D intake is also diminished by wearing sunscreen, taking anticonvulsants, and it is not commonly found in food.³ Consult your doctor or pharmacist today about whether you should add a Vitamin D supplement to your daily regimen. 3. Vitamin B12 A B-complex vitamin is made up of eight different B vitamins, most notably vitamin B-12. Vitamin B-12 creates and sustains your energy supply by breaking down foods and identifying the micronutrients your body needs. Vegans and vegetarians are most susceptible to vitamin B-12 deficiency because many B vitamins are found in animal products.³ Vitamin B-12 deficiency is prevalent in those that have metabolic abnormalities like type 1 and type 2 diabetes patients. Additionally, B-12 deficiency is also associated with gestational diabetes.⁴ If you are at risk, consult with your doctor of pharmacist about incorporating a B-12 supplement and/or modifying your diet to include more B-12 rich foods. 4. Calcium Calcium is a mineral necessary for fortifying bones and teeth. As individuals age, their bone density decreases, making supplement with calcium crucial for bone health. However, more than 40 percent of the U.S. population does not consume enough calcium in their diet.³ If your diet is not rich in dairy, broccoli, nuts, and beans, it is recommended to incorporate a calcium supplement in your daily regimen. Note: For patients that take corticosteroids long-term for conditions like rheumatoid arthritis, calcium supplementation is crucial and highly recommended.⁴ 5.CoQ10 Co-enzyme Q10 (CoQ10) is an antioxidant and heart support nutrient that your body uses to promote cell growth and maintenance. It is found in meat, fish, and nuts, but not in enough quantity to significantly increase CoQ10 levels in your body. Studies have shown that supplementing with CoQ10 may be beneficial in restoring optimal levels of energy, reducing oxidative damage, and improving heart function. Most people have enough CoQ10 naturally, but it is often depleted in those who take medication to support healthy cholesterol level.⁵ If you are taking prescription cholesterol medication, talk to your pharmacist about nutrient depletion and the benefits of adding a CoQ10 supplement to your daily routine. 6. Magnesium Magnesium is essential for bone health and energy production as it regulates the nervous system, eases sleep problems, balances blood sugar, and makes proteins in the body. Magnesium is in many foods, but these foods may not be part of your regular diet. To get more magnesium into your system without a supplement, try eating more: ³ Artichokes Beans Brown rice Nuts Pumpkin Soybeans Spinach Tofu Magnesium deficiency has been associated with increased cardiovascular risk, such as hypertension, stroke, and heart attack.⁴ If you are not getting magnesium in your regular diet, consider consulting with your doctor and/or pharmacist about taking a magnesium supplement. 7. Zinc Zinc is a major player in supporting the immune system. The average American diet is not rich in zinc, so adding a zinc supplement can compensate for this and help boost your body’s ability to fight off infections and heal wounds.⁴ In addition to adding a Zinc supplement to your regimen, you can also incorporate more zinc rich foods in your diet: Spinach Brown rice Grass-fed beef Pumpkin Seeds Patients should never begin taking a supplement to address nutrient depletion before talking with their pharmacist or physician. Some supplements may reduce the effectiveness of certain medications and may not be recommended based on the medications a patient is taking. With the help of your local community pharmacy team, you can break the cycle of nutrient depletion and get the most benefit out of your medication regimen. Sources https://nutritionreview.org/2016/12/practical-guide-avoiding-drug-induced-nutrient-depletion/ https://www.naturalawakeningsnj.com/2013/06/28/226398/drug-induced-nutrient-depletion-beware-of-medications-that-rob-your-body-of-vital-nutrients- https://www.healthline.com/health/food-nutrition/best-vitamins-to-take-daily https://www.uspharmacist.com/article/druginduced-nutrient-depletions-what-pharmacists-need-to-know https://www.webmd.com/diet/supplement-guide-coenzymeq10-coq10#1

What are Hormones? ¹ Hormones are your body’s chemical messengers that travel in your bloodstream to tissues or organs. Endocrine glands, which are a special group of cells, make your hormones. The major endocrine glands are pituitary, thymus, thyroid, adrenal, and pancreas. Additionally, women produce hormones in their ovaries. Hormones are very powerful and affect many different aspects of your life, including: Growth and development Metabolism Sexual function Reproduction Mood Too much or too little of a certain hormone, also known as hormone imbalance, can seriously disrupt the way your body functions. Signs of Hormonal Imbalance ² The symptoms of hormonal imbalance in women can vary depending on which gland is affected. The more common symptoms include: Mood swings Constipation or diarrhea Irregular menstrual cycle Infertility Abdomen or back pain during menstruation Low sex drive Insomnia Unexplained weight gain or loss Brittle bones Excessive hair growth Rashes or acne Causes of Hormonal Imbalance There are many medical conditions that can affect hormone production including, but not limited to – diabetes, hyperthyroidism and hypothyroidism, Addison’s disease, Cushing’s syndrome, hyperglycemia and hypoglycemia, and certain cancers.² Aside from having a medical condition, there are other factors that could be causing a hormonal imbalance in your body, including: ³ Chronic stress Poor diet and nutrition High percentage of body fat Toxins, pollutants, herbicides, and pesticides Severe allergic reactions Misuse of anabolic steroid medications Certain medications Puberty Menstruation Pregnancy, childbirth, and breastfeeding Menopause Treating Hormonal Imbalance If you are experiencing new or persistent symptoms that you believe may be caused by hormonal imbalance, it is important to talk to a healthcare provider. Your doctor may evaluate you by blood testing, imaging, or urine testing, depending on what condition they believe is causing your symptoms. There are medical treatment options for women with hormone imbalances, including: birth control medications, hormone replacement medications, anti-androgen medications, vaginal estrogen, clomiphene and letrozole, assisted reproductive technology, metformin, and levothyroxine. ³ There are also natural supplements commonly used to reduce symptoms of hormonal imbalances. Before taking any natural or herbal treatment, it is important to check with your pharmacist to ensure safety and avoid negative interaction with any other medications you are currently taking. If you believe you’re experiencing hormonal imbalance and would like to make some lifestyle changes to help reduce symptoms, there are some steps you can take to help, including: ² Maintaining a moderate body weight Eating a nutritious and balanced diet Exercising regularly Practicing good personal hygiene Reducing and managing stress Practicing meditation Limiting sugary foods and refined carbohydrates Avoiding packaged foods Restricting the use of cleaning products that contain toxic chemicals In addition to eating a nutritious and balanced diet, it may be beneficial to also shop organic for certain foods, such as those foods found on the “Dirty Dozen” list which are foods that are most affected by pesticides. The EWG analyzed 46 items, and found that the following 12 fruits and vegetables were most contaminated with pesticides: ⁴ Strawberries Spinach Kale, collard, and mustard greens Peaches Pears Nectarines Apples Grapes Bell and hot peppers Cherries Blueberries Green beans Most women will experience periods of hormonal imbalance in their lifetime. Imbalances are common during puberty, menstruation, pregnancy, menopause, and aging. But if you experience continual, irregular hormonal imbalances, especially those symptoms that cause pain or discomfort, it is important to talk to a trusted healthcare provider about the symptoms you experience and the best treatment plan. Sources https://medlineplus.gov/hormones.html https://www.medicalnewstoday.com/articles/321486#symptoms https://www.baptisthealth.com/care-services/conditions-treatments/hormonal-imbalance#:~:text=Medical%20conditions%20that%20can%20cause,primary%20ovarian%20insufficiency%20(POI). https://www.ewg.org/foodnews/summary.php