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As with many chronic conditions, effectively managing your medication is extremely important in treating thyroid disease. In recognition of Thyroid Awareness Month, we wanted to share a Tria Health Success Story that will teach you a few guidelines for achieving optimal results from your thyroid medication. A patient with hypothyroidism had effectively treated her condition with a medication called levothyroxine for several years without a problem. But she was recently diagnosed with osteopenia, or low bone density, after a routine bone density scan. Her doctor called and recommended that she start taking a calcium and vitamin D supplement to improve her bone health. The patient told her Tria Health Pharmacist that she had been taking the new calcium supplement at the same time as her thyroid medication. But calcium tends to bind to thyroid medication, decreasing its absorption, making it less effective, and potentially causing her to experience symptoms of hypothyroidism again. Her pharmacist recommended that she take the medications at least four hours apart, which will keep the two drugs from interacting. Thyroid medications can be incredibly effective for managing thyroid conditions, like hypothyroidism. But it’s also important to get your thyroid levels checked on a routine basis to make sure that your medication is working as it should be. Calcium is one of several over-the-counter medications that can cause interactions with thyroid medication, including antacids, magnesium salts and aluminum hydroxide. Some prescription medications may also interact with thyroid hormone absorption. Here are a few tips for taking your thyroid medication: Take thyroid medication on an empty stomach (try 30 minutes before eating, or two hours after) and with plenty of water. Take your medication at the same time every day. Always check with your pharmacist if you have any questions or concerns. For more information about Tria Health and the importance of Medication Therapy Management (MTM), visit our website. #thyroiddisease #thyroidmedication #TriaHealthPharmacist #TriaHealthSuccessStory

As Thyroid Awareness Month, January is a perfect time to share some information about Thyroid health. The thyroid – a small, butterfly-shaped gland in the lower neck – is the engine of the body’s metabolism. 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. There are two versions of thyroid disease. Hypothyroidism is the underproduction of thyroid hormone, and hyperthyroidism is overproduction of the thyroid hormone. Hypothyroidism is the most common form of the disease – of the estimated 30 million people in the U.S. who have thyroid dysfunction, the majority have hypothyroidism. It’s not entirely clear what causes thyroid disorders, but they are most common in women, and scientists estimate that as many as 60 percent of thyroid disorders could be undiagnosed. Hypothyroidism When the thyroid gland is unable to produce an adequate amount of thyroid hormone, it results in the “slowing down” of many bodily functions. Hypothyroidism is usually a permanent condition. In the early stages of hypothyroidism, patients may not notice many symptoms – the body is often able to compensate for its loss in function by increasing stimulation. But as thyroid hormone production continues to decrease, and the body’s metabolism slows, patients with hypothyroidism may experience these symptoms: ​Fatigue Drowsiness Forgetfulness Difficulty learning Dry, brittle hair and nails Dry itchy skin Puffy face Constipation Sore muscles Weight gain and fluid retention Heavy and/or irregular menstrual cycles Increased risk for miscarriage Increased sensitivity to medications For patients who carry risk factors for hypothyroidism, a simple blood test can identify low levels of thyroid hormones before symptoms arise. Hypothryoidism is diagnosed with a 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. It is important to never increase or decrease your thyroid hormone replacement dose without first consulting a healthcare provider. Over replacement of thyroid hormone can result in irregular heart rate or accelerated bone loss, commonly referred to as osteoporosis. If you’re interested in more information about hypothyroidism, see this information sheet. Hyperthyroidism Hyperthyroidism, an overactive thyroid, develops when the thyroid is exposed to excess amounts of thyroid hormone. It’s a condition that affects about one percent of Americans and occurs 5 to 10 times more often in women than in men. In mild form, signs and symptoms of hyperthyroidism may be unrecognizable, but they can progress to become discomforting, disabling, and even life threatening. Hyperthyroidism may present the following signs and symptoms: ​​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 Increased perspiration Loss of scalp hair Separation of fingernails from nail bed Muscle weakness, especially in upper arms and thighs Loose and more frequent bowel movements 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 Hyperthyroidism is also treatable using medication, which will alleviate symptoms. As with all medication, consult a healthcare provider before changing your dosage. If you’re interested in more information about hyperthyroidism, see this information sheet. For more information about Tria Health and the importance of Medication Therapy Management (MTM), visit our website.

Working one-on-one with a medical professional may improve the rate at which chronic condition patients take their medications correctly, according to a study published earlier this month in the Journal of the American Board of Family Medicine. After participating in health coaching for a year, medication rates among patients with type 2 diabetes, high blood pressure or high cholesterol had increased. The study looked at patients between the ages of 18 and 75 who had uncontrolled Type 2 Diabetes, high blood pressure or high cholesterol. The patients were split into two groups, the first receiving health coaching for 12 months and the second continuing with their normal care. At the end of the year, adherence reported by the health coaching group had improved significantly while adherence reported by the usual care group did not improve, and in some cases, worsened by the end of the study. Patients who participated in the health coaching reporting reported a 23 percent increase in the number of patients who reported taking their medications exactly as prescribed for at least five of the last seven days. The group that had continued with their usual care reported a 5 percent decrease. Increased patient knowledge, patient counseling and active patient participation are already known to improve medication adherence. Health coaches may have more time to spend with patients, and this may have impacted the participants’ engagement with their treatment and influenced their medication adherence. The health coaches also worked with patients on healthy lifestyle changes, which also may have impacted change. The study cites statistics about the high cost to the U.S. healthcare system caused by medication nonadherence. About half of medications prescribed for chronic conditions aren’t used correctly, which contributes to more than $200 billion in avoidable costs to the health care system each year. For more information about how Tria Health works to improve medication adherence among our patients, visit our website. #healthcoaching #chronicconditions #JournaloftheAmericanBoardofFamilyMedicine #Diabetes #Highcholesterol #medicationnonadherence #HighBloodPressure

Has a physician ever recommended that you follow a heart healthy diet?  A lot of people with heart disease or diabetes are encouraged to eat a heart healthy diet but aren’t given guidance on what this means. We’ve compiled some of the best tips here so you can get started on your heart healthy lifestyle. DO eat: Fruits and vegetables Whole grains such as brown rice and oatmeal Low-fat dairy such as cheese, milk, or yogurt Poultry such as chicken and turkey Fish Beans and peas Vegetable oils such as canola or olive Nuts LIMIT the following: Sweets like candy, ice cream or baked goods Sugar-sweetened beverages such as soda, sweet tea or coffee drinks Red meats such as beef and pork Saturated fats found in processed meats, animal fat, coconut oil, etc. Reducing sodium intake is an important component of a heart healthy diet. Aim for no more than 2400mg of sodium or one teaspoon of tablet salt, per day. For most people, the salt in their diet doesn’t come from the salt shaker but from certain foods they buy. Use these tips when shopping and cooking: Buy fresh, plain frozen, or canned “no salt added” food. Avoid canned or processed foods. Cut back on frozen dinners, pizza, canned soups or broths, and salad dressings. Rinse canned foods to remove some salt. Choose ready-to-eat breakfast cereals low in sodium. Remember the kind of food that has more than 1000mg of sodium: fast food burger or hot dog, one large slice of pizza, or one can of soup. The following apps can be helpful to track what you eat: MyFitnessPal Calorie Counter & Diet Tracker for iphone MyDashDiet for iphone Sodium Tracker for iphone EZ Sodium Tracker for iphone and Android Following a heart healthy diet is good for anyone, whether or not your doctor has recommended one. A healthy lifestyle, including a good diet, is the first line of defense for many common health conditions, like heart disease and diabetes. The American Heart Association also lists guidelines for a heart healthy diet and simple healthy recipes to try. For more information about Tria Health, visit our website. #AmericanHeartAssociation #healthylifestyle #hearthealthy

Achieving or maintaining a healthy weight and lifestyle is always a popular New Year resolution. Weight loss can seem overwhelming for many individuals, so as we quickly approach 2015, we wanted to remind you of these tips to help you plan for success. Set goals and be realistic – healthy weight loss is 1-2 pounds per week. Write down your reasons for wanting to lose weight and post it in your home. Keep a food journal for at least a week or two to have a better understanding of your caloric consumption. Avoid bad habits such as eating too fast, eating when you’re not hungry, skipping meals, or always having desert. Eat more fruits, vegetables, whole grains and lean meats. Read nutrition information on food labels and pay close attention to serving sizes. Bake or grill foods instead of frying. Set specific exercise goals, including how often and time spent per week. You don’t have to run a marathon, walking is a great first step. Identify a friend or family member to join you, it’s a great way to stay motivated. Happy New Year!! #maintainingahealthyweight #NewYearresolution #weightloss

Every year nearly 800,000 Americans suffer a stroke.  Currently, there are approximately 6.8 million stroke survivors in America.  The American Heart Association and American Stroke Association recently updated their recommendations on ways to reduce the risk of having a stroke in people that have not previously had a stroke. (Learn warning signs of a stroke) What are your risk factors? In order to reduce your risk of having a stroke you need to know what risk factors you have.  The new recommendations urge people to learn their risks.  Some risk factors you cannot control such as your age, gender, ethnicity, or having family members that have had a stroke or heart attack.  Other risk factors include disorders such as atrial fibrillation and certain blood disorders.  These types of conditions require medical treatment often to thin the blood in order to lower your risk of stroke.  There are several risk factors though that you can treat or control, many just through diet and exercise alone. Steps to treat or modify your risk factors: 1. Get Active Healthy adults should engage in moderate- to vigorous-intensity physical activity for 40 minutes total per day on 3 to 4 days each week. 2. Control Cholesterol Incorporate more physical activity and a diet lower in saturated and trans-saturated fats to lower your cholesterol.  If necessary take a statin-cholesterol lowering medication. 3. Eat Better The Mediterranean diet is recommended for everyone.  This diet is high in nuts, fish, fruits, and vegetables and is lower in sodium. 4. Manage Blood Pressure Normal blood pressure is considered less than 120/80.  There are many things that can affect blood pressure.  If you know you have high blood pressure the new recommendations encourage you to check your blood pressure at home. 5. Lose Weight Did you know that a modest weight loss of 10 pounds can lower blood pressure by ~5 mm Hg? 6. Reduce Blood Sugar Excess sugar consumption can not only lead to weight gain, but long-term can lead to serious complications.  Protect your heart, eyes, nerves, and kidneys by cutting down on the amount of refined sugar you consume (such as that found in soda, pastries, candy, white bread, and pasta). 7. Stop Smoking! Discuss any medication changes with your doctor In patients with multiple risk factors that are at high risk of having a stroke or heart attack a daily Aspirin (75 -100 mg) may be beneficial.  Aspirin is not recommended for all people to reduce their risk of stroke or heart attack.  Aspirin increases the risk of bleeding, and in many people with few risk factors and at low risk of a stroke this risk of bleeding is too great to support daily preventative Aspirin use.  Talk to your doctor or Tria Pharmacist and take steps today to know your risks! For more information on identifying and treating your modifiable risk factors go to the American Heart Association’s Power to End Stroke website for their Life Check tool at http://powertoendstroke.org/mylifecheck/main.html. #AmericanHeartAssociation #AmericanStrokeAssociation #strokeprevention

In recognition of National Diabetes Education Week, we are sharing some important information about this disease state that affects nearly 23.6 million Americans. What is Diabetes? Diabetes is associated with high levels of sugar in the blood There are two classifications of diabetes Type I – your body doesn’t produce insulin Type 2 – your body doesn’t use insulin properly or is resistant to the effects of insulin Type 2 diabetes is much more prevalent and is typically diagnosed as an adult Diabetes increases your risk of heart disease, kidney failure and blindness What are some of the risk factors for diabetes? Obesity Age > 45 Physical inactivity High carbohydrate diet What can people do to prevent diabetes? Increase physical activity – at least 150 minutes/week of moderate-intense aerobic exercise Well-balanced diet Limit alcohol consumption Maintain a healthy weight Screening for diabetes should begin for all adults at the age of 45 unless they have pre-existing risk factors such as obesity.  If risk factors exist, screening should begin after the age of 18. Diabetes is a treatable condition, but early identification and treatment is important to prevent serious complications.  If you have not been tested for diabetes, talk to your physician to see if screening is appropriate for you. #Diabetes #Diabetescare

Stroke is a disease that affects the arteries leading to and within the brain. It is the number 4 cause of death and a leading cause of disability in the United States. In honor of World Stroke Day, Tria Health wants to remind you of these important signs of a stroke. Visit the American Heart Association for more information about warning signs and symptoms. #AmericanHeartAssociation #StrokeAwareness #strokeprevention #WorldStrokeDay

It is estimated that 1 in 8 women will be diagnosed with breast cancer in their lifetime. As Breast Cancer Awareness month, October acts as an important reminder to have an early detection plan and encourage others to do the same. The Susan G. Komen organization teaches the following messages for breast self-awareness: 1. Know your risk. Talk to both sides of your family to learn about your family health history Talk to your health care provider about your personal risk of breast cancer 2. Get screened. Talk with your health care provider about which screening tests are right for you if you are at a higher risk Have a mammogram every year starting at age 40 if you are at average risk Have a clinical breast exam at least every three years starting at age 20, and every hear starting at age 40 Sign up for your screening reminder at komen.org/reminder 3. Know what is normal for you and see your health care provider if you notice any of these breast changes: Lump, hard knot or thickening inside the breast or underarm area Swelling, warmth, redness or darkening of the breast Change in the size or shape of the breast Dimpling or puckering of the skin Itchy, scaly sore or rash on the nipple Pulling in of your nipple or other parts of the breast Nipple discharge that starts suddenly New pain in one spot that doesn’t go away 4. Make healthy life choices. Maintain a healthy weight Add exercise to your routine Limit alcohol intake Limit menopausal hormone therapy (postmenopausal hormone use) Breastfeed, if you can #BreastCancerAwareness #October #ThinkPink

As experts in medications, pharmacists provide important guidance to patients and physicians to promote safe, effective and affordable medication use. Tria Health believes pharmacists are an integral part of every patient’s health care team.  This month we celebrate our talented pharmacy team and encourage our community to “Know Your Pharmacists, Know Your Medicine.” 8 Important Questions to Ask Your Pharmacist: What is this medication used for? How should I use this medication? What should I do if I miss a dose? When will the medicine begin to work? How will I know if the medicine is working? What side effects should I watch for? Is there anything I should avoid while taking this medication? How should I store this medication? #AskyourPharmacist #MedicationSafety #NationalPharmacyMonth

Football season and tailgating parties have started! Here are a few “skinny” recipes to help save some calories during the fun Fall festivities. 1. Crock Pot 3 Bean Turkey Chili 2. Mexican Slow Cooked Pork Carnitas 3. Skinny Buffalo Chicken Dip (Recipes are courtesy of http://www.skinnytaste.com/) #Fallfestivities #Footballseason #healthyrecipes

We get it… I In collaboration with our partners who have used both disease management and Tria Health’s medication therapy management services, we concluded 3 reasons why MTM is the smarter choice: Engaging the At-risk Population.  Tria Health’s average engagement is 45% of the at-risk population. We save clients an average of $1,543 per engaged member. Treating the Patient vs. Treating the Condition.  Tria Health pharmacists work with patients to ensure their medications are effectively treating all of their conditions. Traditional disease management programs focus on treating a specific condition. Reporting Outcomes.  Tria Health’s reporting is comprehensive and easy to understand. We drive both preventative and clinical outcomes; and provide the numbers to prove it. For more information about Tria Health, visit www.triahealth.com.