Thyroid Awareness Month

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The butterfly shaped gland in your neck known as your thyroid, plays a crucial role in so many of the body’s systems. January is Thyroid Awareness Month. This month is dedicated to sharing information about thyroid health and how your thyroid functions in the body.

About Your Thyroid

The thyroid is the engine of the body’s metabolism. Located at the base of the neck, the thyroid impacts the function of many important organs such as the heart, brain, liver, kidneys and skin. It secretes two hormones, triiodothyronine, commonly referred to as T3 and thyroxine, commonly referred to as T4. These hormones help regulate how the body uses and stores energy. When your body produces too much or not enough hormones, dysfunction occurs.

There are two versions of thyroid disease, hypothyroidism and hyperthyroidism. Hypothyroidism is the underproduction of thyroid hormone, and hyperthyroidism is overproduction of the thyroid hormone. Hypothyroidism is the most common form of the disease.

Hypothyroidism

Hypothyroidism happens when certain factors stop the thyroid gland from producing enough thyroid hormones. This disease develops slowly, and symptoms are difficult to notice, especially in the early stages.

As thyroid hormone production continues to decrease, and the body’s metabolism slows, patients with hypothyroidism may experience these symptoms:

  • Fatigue
  • Drowsiness
  • Forgetfulness
  • Dry, brittle hair and nails
  • Dry itchy skin
  • Sore muscles
  • Weight gain and fluid retention
  • Heavy and/or irregular menstrual cycles
  • Increased sensitivity to medications

Hypothyroidism is diagnosed with blood tests. It can be treated with thyroid hormone replacement therapy, which will alleviate symptoms, in most cases, within two weeks of starting therapy. Patients with severe symptoms may require several months of treatment before they fully recover.

Hyperthyroidism

When your thyroid keeps producing too much thyroid hormone and pushes your metabolism into overdrive, this is hyperthyroidism. Hyperthyroidism causes the thyroid to be enlarged as it is trying to overproduce thyroid hormones. Symptoms of hyperthyroidism include:

  • Increased heart rate (greater than 100 beats per minute)
  • Increased anxiety and irritability
  • Trembling hands
  • Weight loss despite eating the same amount or more than usual
  • Heat intolerance
  • Muscle weakness, especially in upper arms and thighs
  • Smooth skin
  • Change in menstrual pattern
  • Increased risk for miscarriage
  • Protrusion of the eyes, with or without double vision
  • Irregular heart rhythm, especially at greater than 60 years of age
  • Increased risk of bone fracture and osteoporosis

If you experience symptoms of either hypothyroidism or hyperthyroidism, find an endocrinologist in your area: AACE Find An Endo | American Association of Clinical Endocrinology

Questions to ask your Pharmacist

  1. What is the difference between a generic thyroid hormone pill and a brand name thyroid hormone pill?5
  2. What time of day is best to take my thyroid hormone pill?5
  3. Can I take my thyroid medication with food, other medications, vitamins or supplements?5
  4. Can any of my other medications affect my thyroid?5

Statistics on Thyroid Disease

  1. More than 30 million Americans will develop some form of thyroid condition3
  2. Up to 60% of people with thyroid disease are unaware of their condition3
  3. Women are 5 times more likely to suffer from hypothyroidism3
  4. 30-50% of people with thyroid disease have eye symptoms that may impair their vision3

Risk Factors

There are a few common risk factors associated with thyroid disorders:3

  1. Type 1 diabetes
  2. Family History
  3. Recent Pregnancy
  4. Past radiation treatment to the neck or head area

Tria Health can help

As with many chronic conditions, effectively managing your medication is extremely important in treating thyroid disease. Tria Health provides one-on-one confidential counseling with a pharmacist for any of your medication related questions. If Tria Health is currently a part of your healthcare plan, call the Tria Health Help desk today for any of your questions.

Have any questions for us?

Contact the Tria Health Help Desk at 1.888.799.8742

Sources:

  1. THYROID AWARENESS MONTH – January 2021 | National Today
  2. Home Page | thyroidawareness.com
  3. AACE-Up to Here-Infographic (thyroidawareness.com)
  4. Thyroid Awareness Month | The Bariatric Experts Denton TX (expertsurgical.com)
  5. Ten Questions to Ask About Your Thyroid Health | thyroidawareness.com

National Pharmacist Day

Image Source: Canva

Pharmacists do so much more than dispense medicine. They have a wealth of knowledge to assist patients with safe medication use, potential drug interactions, preventative services and over-the-counter medications. Today is National Pharmacist Day, a day to recognize the importance of pharmacists and how they impact our health.

Why National Pharmacist Day is Important

This day honors more than 300,000 pharmacists for the significant role they play in effective medication management, patient education and overall medication safety.

A pharmacist can look at all your prescription medications as a whole to determine if your medications are safe, appropriate and effective to manage your health condition(s). They may also be able to assess if you are taking medications you no longer need, if you have therapy duplication, if you are missing a certain medication that is proven to help your specific condition(s), or if you are taking something that could potentially be harmful to your health. Pharmacists may also be able to suggest alternative drug options to lessen side effects or reduce your drug costs.

Pharmacists play a major role in monitoring or managing multiple chronic conditions, such as asthma, diabetes, high cholesterol, high blood pressure, weight loss, and tobacco use.

How Pharmacists Can Help You

  • Providing guidance on preventative services: More than 300,000 immunization-trained pharmacists administer vaccines, and nearly one in four adults receive their influenza vaccinations at their community pharmacy?Pharmacists can provide guidance on all vaccine-preventable diseases and which immunizations are best for you.
  • Talking with you about your medicine. They help minimize side effects and safeguard against any possible interactions with other medications that lead to more expensive health care costs such as emergency room visits, hospitalization, etc.
  • Increasing medication adherence. When you are medication adherent and compliant, you save money, healthcare resources, and have better health outcomes. Pharmacists can help you maintain medication adherence by regularly checking in on you to see how you are doing. It is difficult to manage multiple medications, so it is great to have pharmacists there to help. To learn more about the importance of medication adherence check out: https://triahealthblog.com/2020/10/05/the-benefits-of-medication-reminders-for-non-adherent-and-non-compliant-patients/
  • Coordinating care with your physician. Pharmacists are the best resource to optimize medication use and provide care coordination with physicians. For patients with chronic conditions, care coordination is especially helpful for adjusting prescriptions and medication management accordingly.

How Tria Health Pharmacists Can Help

Tria Health was founded on the belief that pharmacists play a vital role in the management of high-risk patients that drive most of the health care spend. If you have one or more chronic conditions and take multiple medications, Tria Health has a Pharmacy Advocate Program available for you. The PA program offers one-on-one confidential counseling with a Tria Pharmacist to discuss how effective your medications are in treating your conditions. Your Tria Pharmacist will work with you and your physicians to reduce the risk of medication-related problems.

Want to learn more about Tria Health Pharmacists?

Call us toll-free at 1.888.799.8742 or visit our website at www.triahealth.com.

Tria Help Desk: 1.888.799.8742

Sources:

  1. NATIONAL PHARMACIST DAY – January 12, 2021 | National Today
  2. How Much Do You Know About American Pharmacists Month? (caringpeopleinc.com)
  3. Pharmacists can help | APhM –
  4. 4 Ways a Pharmacist Can Help You (ecopharmacyllc.com)

Safety of Vaccinations

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The CDC considers vaccinations to be one of the top 10 public health achievements of the 20th century.1-3 Thanks to vaccines, the incidence, morbidity, mortality, and prevalence of vaccine-preventable diseases have considerably diminished since vaccinations became available. However, now that the COVID-19 vaccine has finally arrived, consumers are wondering whether it will be safe.

If you are having COVID-19 vaccine hesitation, know that the FDA has considered the vaccine adequately safe and effective. The Pfizer and Moderna vaccine have both received Emergency Use Authorization (EUA) from the FDA for public use. To further ease any vaccine fears, below is information about vaccine safety, facts and myths about the COVID-19 vaccine and the benefit vaccines have on your health.

How the COVID-19 Vaccine works

This new vaccine works unlike any previous vaccinations, using a molecule called messenger RNA (mRNA) in a mechanism researchers have been developing for over 30 years. When infected with COVID-19, the virus uses a “spike protein” to attach and enter human cells. The vaccine uses mRNA to provide the body with a blueprint which stimulates human cells to make their own version of a spike protein (not the real virus) that triggers the immune system to make antibodies against it. Once the body makes antibodies against this synthetic spike protein, the body will be able to recognize the actual COVID-19 viral protein and quickly fight the real virus before it attaches to human cells and causes harm.

Herd Immunity

Herd immunity is when a large portion of a community (herd) becomes immune to a disease, lessening the spread of the disease from person to person. Current research shows that the development of natural immunity in people who have previously built-up antibodies from COVID-19 is not going to be enough to cause herd immunity within the community. Not everyone with a previous COVID-19 diagnosis is developing natural antibodies which protect against the spread of the virus, and those who do develop antibodies may begin to lose them over time. Therefore, routine vaccination against COVID-19 is essential to prevent living through another pandemic a year full of face masks and social distancing. Vaccines will first be prioritized to high-risk populations, including healthcare personnel and long-term care facilities. Recommendations suggest 2 shots into the muscle of the upper arm 3-4 weeks apart depending on the manufacturer (Pfizer vs Moderna). Per the FDA, available data currently shows receiving 2 doses of the vaccine is between 90.3% to 97.6% effective at preventing COVID-19.

The benefits vaccines have on health

There are two main benefits for vaccination:

  1. You can help lower your chance of getting certain disease
    • Hepatitis B vaccine lowers your risk of liver cancer.
    • HPV vaccine lowers your risk of cervical cancer.
    • Flu vaccine lowers your risk of flu-related heart attacks or other flu-related complications from existing health conditions like diabetes and chronic lung disease.
  2. You can lower your chance of spreading disease.
    • Some people in your family or community may not be able to get certain vaccines due to their age or health condition. They rely on you to help prevent the spread of disease.
    • Infants, older adults, and people with weakened immune systems (like those undergoing cancer treatment) are especially vulnerable to infectious disease.10

Facts surrounding the COVID-19 vaccine

There is now an authorized and recommended COVID-19 vaccination in the Unites States and many people are concerned about its safety. It is crucial to make sure you are getting accurate information about the vaccination. Below are FACTS from the CDC about COVID-19 vaccines:

  1. The COVID-19 vaccine will not give you COVID-19. It is not a traditional vaccination, currently none of the COVID-19 vaccines use the live virus that causes COVID-19. This vaccination helps our bodies fight the virus without us having to get the illness.
  2. Even if you have gotten sick with COVID-19, you may benefit from getting vaccinated. Re-infection is possible; therefore, it is advised to get a vaccination even if you have had COVID-19 before.
  3. Right now, there is a limited supply of the vaccine in the United States, but more will come in the following weeks and months.
  4. Getting a vaccine that uses mRNA will not change your DNA.  The COVID-19 vaccine contains mRNA or messenger ribonucleic acid which is best described as instructions for how to make a protein. It is important to know that that mRNA is not able to alter a person’s DNA. The mRNA from the COVID-19 vaccine will not enter the nucleus of the cell, where our DNA is found.

Myths surrounding the COVID-19 vaccine

There is a lot of misinformation about the COVID-19 vaccination. Below are MYTHS about the vaccine:

  1. Other immunizations such as the flu shot will prevent COVID-19.
  2. Infertility or other serious medical problems will occur if you get the COVID-19 vaccine.
  3. You will get a positive COVID-19 viral test if you get the COVID-19 vaccine.
  4. There will not be enough vaccinations for everyone.

If you are struggling to find credible vaccine information, use this link for recommendations of trustworthy sources: https://www.cdc.gov/vaccines/vac-gen/evalwebs.htm.

Stats on the safety and effectiveness of vaccines

Vaccines are both safe and effective. They go through years of testing before the FDA licenses them for use. Both the CDC and FDA continue to track the safety of all licensed vaccines.6 The CDC tracks the safety of vaccinations through The Vaccine Adverse Event Reporting System (VAERS). VAERS was created in 1990 to detect any potential safety issues with U.S. vaccines. If anyone experiences problems after an immunization, they can submit a report to VAERS. This monitoring system makes it possible to spot any unusual side effects from vaccinations as well as identify any risks for health issues related to vaccinations. If you are ever concerned about the safety of immunizations, you can have peace of mind knowing they are constantly being monitored.9

Below are the facts and figures that show the safety and effectiveness of vaccinations:

  • According to the World Health Organization, immunizations prevent 2-3 million deaths every year from vaccine-preventable diseases.5
  • Most childhood vaccinations are 90% to 99% effective in preventing diseases.7
  • The flu vaccination can reduce the risk of flu illness by between 40% and 60%.6
  • The CDC estimates that immunizations will prevent more than 21 million hospitalizations and 732,000 deaths among children born in the last 20 years.8
  • About 85-90% of vaccine side effects are mild and not serious.9

How Pharmacists can Help

Pharmacists are also in a unique position to identify those patients who are in target groups for certain vaccinations. They may also be able to ease the fears of many patients by providing them with facts such as clinical data and by dispelling common misconceptions and myths about vaccinations; they can also stress the significant risks associated with not being vaccinated.4

Tria Health was founded on the belief that pharmacists play a vital role in the management of high-risk patients. With Tria, you have the option of receiving a one-on-one private consultation with one of Tria Health’s pharmacists over the phone. During your consultation, your pharmacist will review all your current medications, including vitamins, supplements and lifestyle habits. Your pharmacist will be able to answer any questions you may have regarding vaccinations.

Sources:

  1. Oldfield BJ, Stewart RW. Common misconceptions, advancements, and updates in pediatric vaccine administration. South Med J. 2016;109(1):38-41. doi: 10.14423/SMJ.0000000000000399.
  2. Ventola CL. Immunization in the United States: recommendations, barriers, and measures to improve compliance: part 2: adult vaccinations. P T. 2016;41(8):492-506.
  3. Temoka E. Becoming a vaccine champion: evidence-based interventions to address the challenges of vaccination. S D Med. 2013;(theme issue): 68-72.
  4. https://www.pharmacytimes.com/publications/issue/2019/january2019/adult-vaccination-rates-are-rising-but-fall-short
  5. https://www.who.int/news-room/facts-in-pictures/detail/immunization
  6. https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm#:~:text=Recent%20studies%20show%20flu%20vaccine,to%20the%20flu%20vaccine%20viruses.
  7. https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/Vaccine-Safety-The-Facts.aspx
  8. https://www.cdc.gov/media/releases/2014/p0424-immunization-program.html
  9. https://www.cdc.gov/vaccinesafety/ensuringsafety/monitoring/vaers/index.html
  10. Reasons for Adults to be Vaccinated | CDC
  11. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/vaccine-benefits/facts.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fvaccines%2Fabout-vaccines%2Fvaccine-myths.html
  12. https://coronavirus.ohio.gov/wps/portal/gov/covid-19/covid-19-vaccination-program/19-vaccine-myths-vs-facts
  13. Herd immunity and COVID-19 (coronavirus): What you need to know – Mayo Clinic

How to Survive SAD in the Winter Months

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If you have felt depressed during winter months, you are not alone. As it gets darker earlier each day, and temperatures drop, many people experience “winter blues” or seasonal affective disorder (SAD). This year, seasonal affective disorder could be worse than ever. However, there are ways you can prevent and manage SAD to help you get through the pandemic’s winter months.

What is Seasonal Affective Disorder?

Seasonal affective disorder (SAD) is a type of depression that occurs during a change of seasons, typically in the fall and winter months when there is less sunlight. While the cause of SAD is not known, brain chemicals that affect your mood can change according to the amount of light you get each day.

It is also difficult to diagnose SAD as many other types of mental health conditions cause similar symptoms. According to the National Institute of Mental Health, to be diagnosed with SAD you must meet the following:

  • Have symptoms of major depression.
  • Experience depressive episodes that occur during specific seasons for at least 2 consecutive years. Nevertheless, not all people who experience SAD experience symptoms every year.
  • The depressive episodes are much more frequent than other depressive episodes that the person may have had at other times of the year during their life.

Signs and Symptoms of SAD

SAD is more common in women than in men. It is also more common to those who live farther north where there are shorter daylight hours. Symptoms of SAD last about 4 to 5 months a year and not every person with seasonal affective disorder experiences the symptoms below:

  • Low energy
  • Feeling depressed most of nearly every day
  • Trouble sleeping
  • Difficulty concentrating
  • Experiencing changes in appetite
  • Feelings of hopelessness

Specific symptoms for winter-depression SAD:

  • Oversleeping
  • Overeating (weight gain)
  • Social withdrawal

How is SAD Treated?

There are four primary treatments for SAD:

  1. Light Therapy: A method that mimics natural outdoor light using a special light box with the goal of changing the brain chemicals linked to mood. It typically takes a few days to a few weeks before becoming effective. Your doctor will be able to help determine if this is the best option for you and identify which product would be the most effective.
  2. Medications: Individuals with depression are more susceptible to SAD, making antidepressant treatment a good option. 
  3. Psychotherapy: Psychotherapy, also called talk therapy, is another option to treat SAD. Therapy can help you learn coping mechanisms to manage your stress and changing your negative thoughts and behaviors.
  4. Mind-Body Connection: This includes a variety of techniques such as meditation, guided imagery and music or art therapy.

Coping with SAD

  • Self-care: It is important to take care of yourself and your mental health. Find time to do the things you love. Whether it be reading a book or discovering a new hobby, taking time for yourself will help you feel better.
  • Find something to look forward to: From cooking your favorite meal or watching your favorite show, having things to look forward to aids in regulating your mood.
  • Try to stay active: Exercise is a great way to counteract some main symptoms of SAD such as drowsiness and fatigue because exercising gives you energy and boosts your mood.
  • Be mindful of what you eat: Individuals with seasonal affective disorder tend to eat more starchy and unhealthy foods. It is important to try and eat things that can give you energy. For example, vitamin D can help manage depression but is insufficiently produced in our bodies during winter. Taking vitamin D supplements and consuming foods that are rich in vitamin D can go a long way in helping you feel better.

How Can Tria Health Help?

If Tria Health is offered through your benefits plan, you have the option of receiving a one-on-one, private consultation with one of Tria Health’s pharmacists over the phone. During your consultation, your pharmacist will review all your current medications, including vitamins and supplements. If you are interested in exploring medication treatments for SAD, Tria’s pharmacist will be able to provide you with recommendations and coordinate with your doctor(s).

Questions?

Call the Tria Health Help Desk at 1.888.799.8742

Sources:

  1. NIMH » Seasonal Affective Disorder (nih.gov)
  2. Seasonal affective disorder (SAD) – Diagnosis and treatment – Mayo Clinic
  3. Seasonal affective disorder: How to get through the pandemic’s winter months – CNN
  4. Seasonal affective disorder (SAD) – Symptoms and causes – Mayo Clinic
  5. Seasonal affective disorder: Prevention and coping strategies (medicalnewstoday.com)

Most Common Medication Interactions

An average Tria Health patient takes 8 prescription medications. Most older Americans take multiple medications each day for a variety of conditions. While most patients are aware of potential side effects with prescription medication, it is important to be aware of combining certain drugs and other substances. Being aware of drug interactions can help prevent serious side effects and help ensure medication effectiveness. Below are the most common medication interactions.

Types of Medication Interactions

  • Drug-Drug: There are a multitude of side effects that can occur from drug-drug interactions as there are so many possible drug combinations. Drug-drug interactions can lead to a prescription medication losing effectiveness, allowing for a disease-state to go unmanaged or it can lead to dangerous side effects like heart damage or death.
  • Drug-Food/Beverage: Certain foods can affect the medications you take but medicine can also affect how your body digests and processes food.
  • Drug-Supplement: A common misconception with supplements is just because they are natural, does not mean they are safe. Supplements can change how the body absorbs, metabolizes, or excretes drugs and influence how potent the drug is in the system.

Most Common Drug-Drug Interactions

  • Digoxin and Quinidine: Digoxin is a standard heart medication and Quinidine is used to treat heart rhythm issues. When taking both drugs at the same time, the levels of dioxin in blood plasma is known to rise, resulting is nausea, vomiting, kidney issues, and can be fatal.
  • Warfarin (Coumadin) and Ibuprofen (Advil/Motrin):  Warfarin is a blood thinning medication that is used to prevent the formation of blood clots. Ibuprofen is an over the counter medication used to treat pain and fever. Ibuprofen can increase the risk of significant bleeding events for patients who take Warfarin, and this combination should only be used with the approval of your physician.
  • Clonidine and Propranolol: Both Clonidine and Propranolol are used to treat high blood pressure. Propranolol is also used to prevent migraines. These drugs combined can increase blood pressure instead of lowering it.
  • Amlodipine and Simvastatin: Amlodipine is a medication used to treat high blood pressure and Simvastatin is used to treat high cholesterol. When used together, you must limit the dose of Simvastatin due to the increased risk of side effects such as muscle pain. There are numerous other cholesterol lowering options for patients if they are on Amlodipine.

Most Common Drug-Food/Beverage Interactions

  • Chocolate: Taking MAO inhibitors like Nardil or Parnate for depression and eating chocolate can be dangerous. It may taste good, but it raises blood pressure.
  • Grapefruit: Grapefruit can interfere with certain medications, in particular statins. It can cause these drugs to be absorbed in higher amounts making them more potent, resulting in a greater risk of potential side effects.
  • Licorice: If you are taking Lanoxin (digoxin) for congestive heart failure, licorice can increase your risk of toxicity. Additionally, licorice might also reduce the effects of blood pressure medications.
  • Alcohol: With any medication, avoid alcohol as it can increase or decrease your drugs effect. Some interactions may be more serious than others. Alcohol also affects insulin or oral diabetic pills. It prolongs their effects which leads to low blood sugar.
  • Vitamin K-Rich Foods like Kale, Spinach, and Leafy Greens: Too much of this nutrient can antagonize the anti-clotting effect in blood thinning medications and prevent the drug from working.
  • Dairy: Dairy products like cheese and yogurt can decrease the absorption of antibiotics. If you do eat dairy, try and eat it one to two hours before taking antibiotics.

Most Common Drug-Supplement Interactions

  • St. John’s Wort: This herb can reduce the concentration of medications in the blood.
  • Vitamin E: Taking Vitamin E with a blood thinning medication could increase your risk of bleeding as it can increase anti-clotting activity.
  • Ginseng: Combining ginseng with MAO inhibitors may cause headaches, trouble sleeping, and nervousness. Furthermore, ginseng can increase the bleeding effects of anti-inflammatory drugs such as ibuprofen.
  • Valerian: This herbal supplement has been used to treat insomnia and anxiety. When mixed with drugs however, it can increase dizziness and drowsiness.

Drug Interaction Checker:

If you want to check and see if any of your medications can react with other drugs, foods, beverages, or supplements, check out: https://www.drugs.com/drug_interactions.html

Tria Health can help

If Tria Health is offered through your benefits plan, you have the option of receiving a one-on-one private consultation with one of Tria Health’s pharmacists over the phone. During your consultation, your pharmacist will review all your current medications, including vitamins and supplements. Tria Health will assist you in identifying any possible drug interactions or savings opportunities!

Questions?

Contact the Tria Health Help Desk at 1.888.799.8742

Sources:

  1. https://burtsrx.com/common-drug-interactions/
  2. https://www.pharmacytimes.com/news/5-dangerous-food-drug-interactions
  3. https://www.bvhealthsystem.org/expert-health-articles/common-food-drug-interactions
  4. https://www.heart.org/en/health-topics/consumer-healthcare/medication-information/medication-interactions-food-supplements-and-other-drugs
  5. https://www.drugs.com/slideshow/herb-drug-interactions-1069