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Autoimmune diseases affect over 24 million Americans, with thyroid disease responsible for about 20 million cases.¹ Autoimmune thyroid diseases can be underdiagnosed and many people may not know that they are affected. Do not let that scare you!¹ Look no further to learn about autoimmune thyroid diseases, risk factors, and the importance of early diagnoses.

What are autoimmune thyroid diseases?^1-3

Our immune systems are largely responsible for protecting us from infection, toxins, and other foreign substances. Autoimmune diseases like rheumatoid arthritis and lupus occur when the immune system begins to attack your body because it thinks your own cells are intruders and do not belong. The auto-antibodies produced cause inflammation and damage your body’s tissues, organs, and hormone production. When this occurs at the level of the thyroid, a butterfly-shaped gland at your neck, it can cause several effects to increase or decrease thyroid hormones. The thyroid’s job is to regulate your mood, metabolism, temperature, heart rate, breathing, and growth. The two chief autoimmune thyroid diseases include Hashimoto’s thyroiditis and Graves’ disease. Medical professionals and scientists are unsure why exactly these conditions occur, but they believe a dysfunctional immune system is a key cause. 

Hashimoto’s thyroiditis causes hypothyroidism or a decrease in thyroid hormone production. With Hashimoto’s thyroiditis, your body thinks your thyroid cells are foreign invaders. The immune system sends thyroid peroxidase antibodies (TPOAb) to attack your thyroid with the goal of weakening and killing the ‘foreign invaders.’ If you develop Hashimoto’s thyroiditis, you may experience the following signs and symptoms: enlarged thyroid or goiter, weight gain, muscle pain, depression, hair loss, brittle nails, constipation, swollen face, and cold sensitivity. 

Graves’ disease results in hyperthyroidism or an increase in thyroid hormone production. In Graves’ disease, the body spontaneously attacks itself and produces an antibody known as thyrotropin receptor antibody (TRAb) that stimulates thyroid hormone production. This results in an excess of thyroid hormones and inflammation of the thyroid. Common signs and symptoms include insomnia, anxiety, weight loss, goiter, irregular menstrual cycle, rapid heartbeat, frequent bowel movements, bulging eyes, fatigue, and heat sensitivity or increased sweating. 

It is important to note that these symptoms develop slowly over time, so talk with your doctor or pharmacist if you experience them. Your doctor may decide to run thyroid hormone and antibody blood tests, and inspect your thyroid to determine if you have an autoimmune thyroid disease.

Risk Factors for Autoimmune Thyroid Diseases^2-8

1. Autoimmune disease – If you have a current autoimmune disease like Type 1 diabetes, this increases your risk of having an autoimmune thyroid disease. This is the primary risk factor because if your immune system is already not functioning properly, then it may cause other organs and glands to malfunction. Therefore, it is important that you regularly visit your doctor to check your thyroid gland functioning and know the symptoms. 

2. Sex – Females are more likely to develop autoimmune thyroid diseases than males as it occurs in one out of eight females. They are more likely to develop after pregnancy or menopause due to hormonal imbalances like with estrogen, the main female sex hormone. A thyroid disorder can cause irregular periods or menopause symptoms like hot flashes and mood swings, so contact your doctor or pharmacist if you experience these symptoms. Yet, males with low testosterone levels, the main male sex hormone, have a higher risk of autoimmune thyroid diseases too.

3. Age – Although Hashimoto’s thyroiditis and Graves’ disease can occur at any age, they are most commonly developed between the early 40s and 60s. This is because the body undergoes many changes as we continue to age which can affect our hormone levels and regulation processes. Sadly, these conditions may be harder to diagnose as we age because of a lack or overlap of symptoms between the conditions. 

4. Chronic stress – As the amount of chronic stress you are under over a long period of time increases, you have a higher chance of developing a thyroid disorder. Examples of chronic stress include job loss, death of a loved one, marriage, depression, anxiety, and financial instability. The increase in cortisol or the body’s stress hormone inhibits the production of thyroid hormones which can lead to Hashimoto’s thyroiditis. Even infections can affect your thyroid functioning. Increased stress can lead to reactivation of viruses that may have been inactive in your body like Epstein-Barr virus or mononucleosis. This is why it is crucial that you manage your stress with activities like mediation or walking and visit your doctor regularly.

5. Food sensitivity – Food sensitivities like with gluten and inflammatory foods such as processed foods increase inflammation and antibody production in your body. This can lead to thyroid dysfunction if your thyroid is attacked. Gluten is one of the most common food sensitivities and affects about 15% of the United States population. It is a protein found in wheat, barely, rye, and oats that make up common foods such as pasta, beer, and bread. If you have a food insensitivity and eat that food, the food tricks your body into thinking that it is harmful. This causes your body to make antibodies and become inflamed to fight it off that can lower your thyroid’s hormone production. Removing these foods from your diet may improve your thyroid functioning.

6. Toxins or radiation – Exposure to toxins like pesticides, excess contrast dyes like iodine from x-rays, mercury, and radiation can cause your thyroid to release minimal thyroid hormones. This leads to poor metabolism, fatigue, and weight gain that are signs of Hashimoto’s thyroiditis. Minimizing your exposure to these harmful chemicals may benefit your overall energy, development, and body process regulations. 

7. Heredity – Unfortunately, we cannot change our family history or genes, but this may play a role in autoimmune thyroid disease. If someone in your family like your sister, grandfather, or mother has Hashimoto’s thyroiditis or Graves’ disease, then you have a higher chance of developing the condition.

Heart Disease in Autoimmune Thyroid Diseases^2,3

By not regularly taking your thyroid medication, modifying your risk factors, or having an undiagnosed autoimmune thyroid disease, you may increase your risk of developing serious health problems. These include myxedema coma and thyroid storm that were discussed in last week’s article. Additionally, a common issue that both conditions can cause is heart disease. Heart disease is the leading cause of death in the United States, so it is vital you take steps to lower your risk. With Hashimoto’s thyroiditis, your low-density lipoprotein (LDL) or bad cholesterol blood levels may increase since the body’s metabolism ability is low. This can cause your heart to work harder to pump blood throughout the body as the walls of your arteries become clogged, causing heart failure. Graves’ disease can also lead to heart failure and irregular heart rhythms because an overactive thyroid increases your heart rate. As the blood is pumped at a faster rate, it can damage your arteries and distort your heart’s shape or functional ability.

Be sure your doctor knows your medical history and risk factors to determine if you should be tested for autoimmune thyroid disease. Hashimoto’s thyroiditis and Graves’ disease can be simply treated with an appropriate thyroid therapy to regulate thyroid hormone production, but they require lifelong treatment and follow-up. Fortunately, these medications can help you continue to live your life and perform your day-to-day activities!

References: 

1. Milas K. Risk factors of Hashimoto’s Thyroiditis. Endocrineweb website. https://www.endocrineweb.com/conditions/hashimotos-thyroiditis/risk-factors-hashimotos-thyroiditis. Accessed August 1, 2021. 
2. Hashimoto’s disease. Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/hashimotos-disease/symptoms-causes/syc-20351855. Accessed August 1, 2021. 
3. Graves’ disease. Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/graves-disease/symptoms-causes/syc-20356240. Accessed August 1, 2021. 
4. Seed S. What is autoimmune thyroiditis? WebMD website. https://www.webmd.com/women/whatis-autoimmune-thyroiditis. Accessed August 1, 2021. 
5. Grunewald J. Why do thyroid disorders affect women more often than men? Experience Life website. https://experiencelife.lifetime.life/article/why-do-thyroid-disorders-affect-women-more-often-than-men/. Accessed August 1, 2021. 
6. Older patients and thyroid disease. American Thyroid Association website. https://www.thyroid.org/thyroid-disease-older-patient/. Accessed August 1, 2021. 
7. Klimenko E. Functional medicine approach to autoimmune thyroid disease. Dr. Klimenko website. https://www.drelenaklimenko.com/autoimmune-thyroid-disease/. Accessed August 1, 2021.
8. Hyman M. A 7-step plan to boost your low thyroid and metabolism. Dr. Hyman website. https://drhyman.com/blog/2010/05/20/a-7-step-plan-to-boost-your-low-thyroid-and-metabolis/#close. Accessed August 1, 2021.

Thyroid disease affects all ages and can be present at birth, inherited, medication-induced, related to a past thyroid or inflammatory condition like lupus or Type 1 diabetes, or develop over time like after menopause. Additionally, females are about seven times more likely to have thyroid disease than males.¹ An imbalanced thyroid may have a large effect on your overall mental, physical, and emotional health, but it can be restored with natural and chemical thyroid medications.

What is the thyroid gland?^1,2

The thyroid, a butterfly-shaped gland in the front of the neck, plays a crucial role in regulating the body’s growth, development, and metabolism or creating energy from food. It releases chemical signals or hormones called T3 (triiodothyronine) and T4 (thyroxine). T3 is the active form of thyroid hormone produced from T4 to help with your body’s functioning. T3 and T4 are released into the bloodstream to control weight, body temperature, breathing, and energy. Hormonal release by the thyroid is ultimately controlled by the pituitary gland, a bean-shaped gland located below the brain. The pituitary gland releases thyroid stimulating hormone (TSH) to increase T3 and T4 when it senses levels are low. Hormonal feedback to the pituitary gland plays a role in how many hormones need to be released by the thyroid. However, an improper thyroid functioning can greatly affect your body’s processes. Releasing too much thyroid hormone is known as hyperthyroidism while releasing too little thyroid hormone is called hypothyroidism. 

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 Types of Thyroid Diseases^1-4

When too much thyroid hormone is released, this is known as hyperthyroidism. This means that the body will use energy too fast, causing you to feel tired, lose weight, and intolerant to heat. Graves’ disease, an autoimmune disease where the body suddenly attacks itself and produces an antibody like TSH, is a common cause of hyperthyroidism. When the thyroid is attacked, excess thyroid hormones are released and the thyroid swells due to the antibodies. Rarely, thyroid cancer or abnormal growth of the thyroid and hormone production leads to thyroid disease. 

The opposite of hyperthyroidism is hypothyroidism. Too little release of thyroid hormone causes you to feel tired, gain weight, and affect your sensitivity to coldness. It can be caused by removal of the thyroid; excess hyperthyroidism treatment; too much iodine from contrast dyes for x-rays; amiodarone, a heart rate-controlling medication; and lithium, a mood disorder medication.

Thyroiditis results when the thyroid gland is inflamed or swollen, leading to an increase or decrease in thyroid hormone release. It is characterized by the following three phases: thyrotoxic, hypothyroid, and euthyroid. After the thyroid swells and over produces thyroid hormones in the thyrotoxic phase, there becomes a low supply of thyroid hormones to release or the hypothyroid phase. The hypothyroid phase is longer-lasting and can be permanent. Once the thyroid has recovered and hormone levels are normal, this is known as the euthyroid phase. 

Hashimoto’s thyroiditis is an inherited and autoimmune disease where the body thinks the thyroid cells are harmful invaders. This causes the body to attack, damage, and kill your thyroid cells to end hormone production. The causes of Hashimoto’s thyroiditis are unclear, but it is likely related to a family history of thyroid or autoimmune diseases, excess iodine or radiation, and sex hormones since it is more common in females.

Thyroid Disease Symptoms²

An irregular thyroid gland includes a wide range of symptoms from difficulty breathing to hair loss. Yet, it can be difficult to diagnose since the symptoms appear in many other conditions. Hyperthyroidism and hypothyroidism are the two most common thyroid diseases that best categorize the symptoms of disease. Symptoms of excess thyroid hormones or hyperthyroidism include a rapid heartbeat, sweating, bulging eyes or exophthalmos, difficulty sleeping, nervousness, irritability, weight loss, muscle weakness, frequent bowel movements, heat sensitivity, and irregular menstrual periods. The symptoms of a lack of thyroid hormones or hypothyroidism can mostly be thought of as the opposite of hyperthyroidism. Hypothyroidism symptoms include a slow heart rate, hair loss, fatigue, constipation, depression, dry skin, hoarseness, cold sensitivity, and frequent or heavy menstrual periods. Yet, both conditions can result in an enlarged thyroid or goiter due to an imbalance of thyroid hormones.

Thyroid Disease Diagnosis^2,5,6

Diagnosing thyroid disease is done through measuring your symptoms and blood levels of T3, T4, and TSH. If TSH is found to be abnormal, your doctor may assess your blood levels of T3 and T4. A normal TSH level is between 0.4 and 4.0 mIU/L, total T4 is between 5 and 11 mcg/dL, and total T3 is between 100 and 200 ng/dL. Normally when T3 and T4 are low, more TSH is produced to stimulate the thyroid to make more hormones. In the case of hypothyroidism, T3 and T4 are low while TSH is high because the thyroid is abnormally inactive. When excess T3 and T4 are in the blood, they feedback to the pituitary gland to decrease the amount of TSH. If you have hyperthyroidism, T3 and T4 are elevated while TSH is low. This is because the thyroid is overproducing hormones by itself regardless of TSH level regulation. 

Thyroid antibodies like thyroglobulin (TG) antibodies can be measured in your blood to determine if you have an autoimmune condition like Graves’ disease or Hashimoto’s thyroiditis.

An imaging procedure like an ultrasound can also be used to view the thyroid gland. After applying a gel and probe to the area, high frequency sound waves are transmitted to show the size of the thyroid. If you are experiencing any of the symptoms or think your thyroid is swollen, you can simply check your thyroid in the comfort of your home. First, locate your thyroid that is above your collarbone or under your Adam’s apple. Then, drink a cup of water while tilting your head back. Look at your thyroid in the mirror as you swallow to see if you notice any lumps. If you notice any lumps, reach out to your doctor for further evaluation.

Thyroid Disease Treatments^5,6

Treatments for thyroid disease have the common goal to either manage symptoms like lowering heart rate or affect the amount of hormones based on hormone levels. Hypothyroidism, Hashimoto’s thyroiditis, and the hypothyroid phase of thyroiditis are mainly treated with levothyroxine, a chemical thyroid hormone to restore your low T3 and T4 levels. If you prefer more natural treatments, medications with pig thyroid gland extracts are available. Furthermore, some dietary supplements you may already be taking like omega-3 fatty acids, zinc glycinate, Withania somnifera, tyrosine, selenium, and vitamins A, D, and E can assist with having a balanced thyroid.

Hyperthyroidism is treated with medications to stop excess thyroid hormone production. Since radioactive iodine can damage your thyroid, leading to hypothyroidism, it can surprisingly be used to treat hyperthyroidism. A more irreversible option to decrease hormone production includes a thyroidectomy or removal of the thyroid, but this requires lifelong thyroid hormone treatment. Since the thyrotoxic phase of thyroiditis is typically short-lived, medications to manage symptoms like rapid heart rate, anxiety, sweating, and inflammation are used.

These conditions are treatable, but therapy is likely lifelong and may change based on your thyroid hormone levels and symptoms. By following an appropriate treatment plan, you will be able to live a normal, healthy life with a controlled thyroid. 

Thyroid Disease Complications^5,6

By not taking your medication as prescribed or left untreated, you are at risk for serious complications. If hypothyroidism is not treated, your metabolism slows down and puts you at risk for myxedema coma. This is a medical emergency and can leave you with hypothermia and altered mental status. If hyperthyroidism is not treated, your metabolism is overactive and could lead to thyroid storm. Because of excess thyroid hormones without regulation to keep levels within a normal range, your heart rate, blood pressure, and temperature increases to risky levels. Thyroid storm can lead to fever, psychosis, delirium, and dehydration. 

For more information and support, visit the American Thyroid Association (ATA) and Centers for Disease Control and Prevention (CDC) websites or talk with your doctor or pharmacist today. 

References: 

1. Thyroid cancer. Centers for Disease Control and Prevention website. https://www.cdc.gov/cancer/thyroid/index.htm. Accessed July 26, 2021.
2. Thyroid disease. Cleveland Clinic website. https://my.clevelandclinic.org/health/diseases/8541-thyroid-disease. Accessed July 26, 2021.
3. Hypothyroidism (underactive thyroid). Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284. Accessed July 26, 2021.
4. Picture of the thyroid. WebMD website. https://www.webmd.com/women/picture-of-the-thyroid. Accessed July 26, 2021.
5. Jonklaas J, Bianco AC, Bauer AJ, et al. Guidelines for the treatment of hypothyroidism: Prepared by the American Thyroid Association task force on thyroid hormone replacement. Thyroid. 2014; 24(12): 1670-1751. http://doi.org/10.1089/thy.2014.0028.
6. Ross DS, Burch HB, Cooper DS, et al. 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid. 2016; 26(10): 1343-1421. http://doi.org/10.1089/thy.2016.0029. 

1. Get enough sleep

Sleep and immunity are closely related. Inadequate or poor-quality sleep is linked to a higher susceptibility to illness. Adults need seven to eight hours of sleep each night.

Having good sleep hygiene is important to ensuring a good quality sleep.

• Set a sleep schedule and follow a nightly routine.
• Turn off the lights.
• Limit noise and distractions. Turn off your phone or put it on “Do Not Disturb.”
• Limit the use of your phone for the 2 hours before you plan to go to bed. Your phone emits a blue light that tells your body to suppress melatonin. Melatonin is an important sleep hormone that helps your body regulate its sleep patterns. See if you phone has a nighttime color setting to decrease the blue light emissions.
• Set a cool yet comfortable temperature. The ideal bedroom temperature is between 66^◦F and 68^◦F

Still having issues falling asleep? Consider these supplements to help you fall asleep.

• Best Rest
  • Take one to two capsules 30 to 60 minutes before bedtime

• Supports a healthy sleep cycle by encouraging an easy transition to sleep and a restful night’s sleep
  • This supplement contains passionflower, chamomile, lemon balm and hops which have been clinically shown to naturally calm and relax the central nervous system
• Melatonin
  • Take one capsule 30 to 60 minutes before bedtime

• Melatonin is a naturally occurring hormone that helps promote sleep. This sustained release formulation releases melatonin gradually to help promote extended sleep support

• Eat a healthy and balanced diet

Healthy foods help provide your body with the vitamins, nutrients, and minerals it needs to stay strong.  Eating high quality whole foods like whole grains, nuts, and fresh fruits and vegetables helps nourish your body. These foods are high in antioxidants and nutrients like vitamin C which may help in preventing the common cold. Healthy fats like olive oil and the omega-3 found in salmon also help your body by supporting heart health and reducing inflammation that can suppress your immune system.

Interested in boosting your immune system further? Try these supplements:

• O.N.E. Omega
  • Take one capsule daily with a meal
  • A powerful omega-3 fatty acid formula for cardiovascular, joint, skin and cognitive health

• Vitamin C
  • Take one tablet 1-2 times daily

• Vitamin C offers broad physiological support, including musculoskeletal, cardiovascular, neurocognitive, cellular, and immune health
  • One tablet contains the same amount of vitamin C found in eight oranges

• Exercise Regularly

 Moderate exercise can give your immune system the boost it needs to stay healthy. Being active is also associated with many physical and mental health benefits.

Aim for 150 minutes of moderate exercise weekly or about 30 minutes daily five days a week. Moderate exercise includes brisk walking/jogging, bicycling, and swimming.

• Stay Hydrated

Hydration may not protect you from germs and viruses directly like washing your hands or using hand sanitizer but it is very important in overall health. Dehydration can affect your mood, digestion as well as heart and kidney function. When you are dehydrated these systems do not work well and therefore lower your bodies ability to fight infection. It is recommended that you drink 64oz or ½ a gallon of water daily.

• Minimize Stress

Long-term stress is harmful to the immune system where short-term stress can be productive as it prepares your body to deal with challenges. However, finding the balance can sometimes be difficult. A few signs that you maybe more stressed than you realize are, hitting a wall in the afternoon, afternoon sugar cravings, feeling tired immediately upon waking, weight gain without a change in eating or exercise habits, a short temper, or dull emotions. (For more information on stress, check out our Adrenal blog) Finding ways to manage your stress is the key to good immune health. Ways to manage stress include meditation, exercise, yoga, adequate sleep, and mindfulness. If your stress is unmanageable, talk to your doctor, pharmacist, counselor, or therapist.

Still struggling with stress? Consider this supplement:

• Energy Xtra
  • One capsule once daily
  • Contains herbal blends to help promote energy, enhance stamina and help the body adapt and cope with occasional stress

• Don’t Smoke

Smoking, including vaping harms the overall immune system and can make it more difficult for your body to fight off infections.

• Supplement Appropriately

There is no FDA approved evidence to support the use of any supplements to treat or prevent COVID-19. However, studies do indicate that some supplements may help boost your bodies general immunity. Have more questions about supplements? Contact us and we will be happy to review your medications and make supplement recommendations.

• Vitamin D
  • Do not begin a Vitamin D supplement greater than 2,000 IU daily without first consulting a health care provider.
  • Take one capsule once daily
  • Vitamin D naturally supports calcium absorption and retention within the bones to promote optimal bone health
  • Vitamin D also has shown evidence of enhancing immunity.

• Zinc
  • Take one capsule once daily with a meal
  • Zinc is designed to support your bodies natural defense system as well as enhance digestion and metabolism of important vitamins, minerals, carbohydrates, and other essential nutrients

• O.N.E Multivitamin
  • Take one capsule once daily with a meal
  • Provides vitamins, minerals, and other essential nutrients to provide a comprehensive once-daily multivitamin.

• B Complex
  • Take one capsule 1-2 times daily
  • Offers a comprehensive blend of B vitamins designed to support cellular, cardiovascular, neurological, and psychological health

References:

1. Sleep & Immunity: Can a lack of sleep make you sick? (2020, November 19). Retrieved February 19, 2021, from https://www.sleepfoundation.org/physical-health/how-sleep-affects-immunity
2. What is sleep hygiene? (2020, August 14). Retrieved February 19, 2021, from https://www.sleepfoundation.org/sleep-hygiene
3. Daily nutritional supplements: Pure encapsulations®. (n.d.). Retrieved February 19, 2021, from https://www.pureencapsulations.com/
4. E;, H. (n.d.). Vitamin C for preventing and treating the common cold. Retrieved February 19, 2021, from https://pubmed.ncbi.nlm.nih.gov/23440782/
5. R;, S. (n.d.). Exercise and the regulation of immune functions. Retrieved February 19, 2021, from https://pubmed.ncbi.nlm.nih.gov/26477922/
6. Nieman, D., Henson, D., Austin, M., & Sha, W. (2011, September 01). Upper respiratory tract infection is reduced in physically fit and active adults. Retrieved February 19, 2021, from https://bjsm.bmj.com/content/45/12/987.abstract?sid=e6594508-3aaa-4c61-99ba-4ea138580947
7. Popkin, B., D’Anci, K., & Rosenberg, I. (2010, August). Water, hydration, and health. Retrieved February 19, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908954/
8. FS;, D. (n.d.). Effects of stress on immune function: The good, the bad, and the beautiful. Retrieved February 19, 2021, from https://pubmed.ncbi.nlm.nih.gov/24798553/
9. Smoking and Overall Health. (n.d.). Retrieved February 19, 2021, from www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/pdfs/fs_smoking_overall_health_508.pdf
10. In the News: Coronavirus and “alternative” treatments. (n.d.). Retrieved February 19, 2021, from https://www.nccih.nih.gov/health/in-the-news-coronavirus-and-alternative-treatments
11. Aranow C. Vitamin D and the immune system. J Investig Med. 2011;59(6):881-886. doi:10.2310/JIM.0b013e31821b8755

For the past year, we have been faced with unprecedented times caused by the COVID-19 pandemic. As of December 2020, we are starting to see the light at the end of the tunnel as vaccines become available.

What are mRNA vaccines?

Traditional vaccines work by using a weakened/inactivate portion of the virus to help our body develop immunity. The COVID-19 mRNA (messenger ribonucleic acid) vaccines contain instructions on how to make a harmless “spike protein” that are unique to the COVID-19 virus.  Our bodies then recognize the protein should not be there and build antibodies that remember how to fight the virus if we become infected with it in the future. 

Will the COVID-19 vaccine alter my DNA?

No. The COVID-19 vaccine is a mRNA vaccine that does not change or interact with your DNA in any way.

What vaccines are available?

There are currently two COVID-19 vaccines (Pfizer and Moderna) that have been approved by the Food and Drug Administration (FDA). There are 3 other vaccines (AstraZeneca, Janssen, Novavax) currently undergoing Phase 3 clinical trials that could become available once they receive FDA approval.

How many doses of the vaccine do I have to get?

Both Pfizer and Moderna vaccines require two doses spaced 21-28 days apart.

Can I get the COVID-19 vaccine if I have had COVID-19?

The CDC recommends that people who have had COVID-19 still get the COVID-19 vaccine. Since re-infection with COVID-19 is possible, getting the vaccine can still help protect you. However, you should not receive the vaccine if you have a current infection with COVID-19, you should wait until you are no longer symptomatic before receiving the vaccine.

Is the COVID-19 vaccine safe?

The FDA, Centers for Disease Control and Prevention (CDC) and Advisory Committee on Immunization Practices have all been actively involved in the vaccine evaluation process and have deemed the two current COVID-19 vaccines safe.

Can the COVID-19 vaccine make me sick with COVID-19?

No. None of the COVID-19 vaccines contain the live virus that cause COVID-19.

If I get the COVID-19 Vaccine, will I test positive for COVID-19 on a viral test?

No. None of the vaccines currently available for COVID-19 cause you to test positive on a viral test. Getting the vaccine allows your body to develop antibodies against COVID-19 so it is possible to test positive on an antibody test.

How long will the vaccine protect me?

At this time, it is unknown how long protection from the vaccine or from having COVID-19 (natural immunity) will last. More research is needed to know how long the immunity from the COVID-19 vaccine or natural immunity lasts and if a booster dose will be required.

What are the benefits of getting vaccinated?

Both vaccines currently available have shown approximately 95% efficacy 7-14 days after the second dose of the vaccine is received.

Can I get other vaccines along with my COVID-19 vaccine?

The CDC recommends that you do not receive any other vaccines within 14 days of the COVID-19 vaccine.

If I get the COVID-19 vaccine, do I still have to wear a mask?

Yes. Both vaccines currently available are 95% effective meaning that 1 out of every 20 people who have received the vaccine may not have full protection from the vaccine. It is also unknown if you could still be a carrier (have no symptoms) and spread the virus after vaccination. This is why until we know more, you should continue to wear masks and social distance.

How is the vaccine being distributed in North Carolina?

In North Carolina, vaccine distribution is being completed in groups. Availability of the vaccine worldwide is limited, so please be patient. Everyone who wants a vaccine will be able to receive a vaccine, it is just going to take time to get everyone vaccinated since demand is currently higher than the supply.  

• Group 1
  • Health care workers
  • Long-term care staff and residents
• Group 2
  • Older adults (65+)
• Group 3
  • Frontline Essential Workers
    • First responders (firefighters and police officers), correction officers, food and agricultural workers, U.S. postal service workers, manufacturing workers, grocery store workers, public transit workers, and those in the education sector (teachers, support staff and childcare workers)
• Group 4
  • Adults at high risk for exposure and increased risk of severe illness
    • Anyone 16-64 with high-risk medical conditions that increase the risk of severe disease from COVID-19
    • Anyone incarcerated or living in other close group living situations
    • Essential workers not yet vaccinated
      • Workers in transportation and logistics, water and wastewater, food service, shelter and housing (construction), finance (bank tellers), information technology and communications, energy, legal, media, public safety and public health workers
• Group 5
  • All persons 16 and older

What should you do while you’re waiting for the COVID-19 vaccine?

Continue to wear your mask over your nose and mouth, social distance at least 6 feet from others that do not live in your household whenever possible, wash your hands often and stay home if you are sick.

What should I expect once I get the vaccine?

The most common side effect from the vaccine is arm soreness/tenderness. Other symptoms include fatigue, low-grade fever, body aches and mild headaches that last one to three days. Side effects are seen more frequent after the second dose. These mild symptoms are your bodies way of telling you that your immune system is responding to the vaccine and producing antibodies to the COVID-19 virus. Meaning if your body sees the virus again it already has antibodies and knows how to respond, either preventing infection or making your infection less severe.

References:

1. COVID-19 vaccines. (n.d.). Retrieved February 19, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html
2. COVID-19 vaccine: What you need to know. (n.d.). Retrieved February 19, 2021, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/covid-19-vaccine-what-you-need-to-know
3. Find your spot to take your shot. (n.d.). Retrieved February 19, 2021, from https://covid19.ncdhhs.gov/vaccines/find-your-spot-take-your-shot

What is the Coronavirus?

Coronavirus is a virus that attacks the respiratory tract and causes a flu-like illness. There are many different coronaviruses but the one we are going to focus on today is the 2019 novel coronavirus also known as SARS-CoV-2 or COVID-19. The abbreviated name (COVID-19) can be broken down into its individual parts; “CO” standing for Corona, “VI” standing for virus and “D” standing for disease. This new coronavirus was first identified in December of 2019 hence the “-19” and originated from Wuhan, China.

How does COVID-19 spread?

The coronavirus is a respiratory virus that is spread by droplets or through direct contact. The virus can be spread by people who have COVID-19 but are asymptomatic, meaning they have no symptoms.

What can you do to protect yourself?

Hand washing is one of the best ways to protect yourself from getting sick. Wash your hands with soap and water for at least 20 seconds often throughout the day especially after blowing your nose, coughing/sneezing, going to the bathroom and before eating or preparing food. If soap and water are not available, use an alcohol-based hand sanitizer. Another way to protect yourself and others is to stay home if you are sick. It is also important to cover your nose and mouth if you cough or sneeze. Wearing a mask that covers your nose and mouth in public settings when not around people that live in your household when social distancing is not attainable. Wearing a mask in public settings provides an extra layer of protection against respiratory droplets. Social distancing or staying at least six feet away from others is important since people can have no symptoms and still spread the virus.

What are the symptoms of COVID-19?

Symptoms may appear 2-14 days after an exposure to the virus

• Cough
• Fever or Chills
• Shortness of breath or difficulty breathing
• Muscle or body aches
• Sore throat
• New loss of taste or smell
• Diarrhea
• Headache
• New fatigue
• Nausea or vomiting

If you have trouble breathing, persistent pain or pressure in the chest, new confusion, inability to wake or stay awake or bluish lips or face, seek emergency medical care immediately.

How is COVID-19 diagnosed?

Diagnosis can be difficult because in some cases COVID-19 may appear similar to the flu or other respiratory illnesses. A laboratory test (nasal swab) is used to confirm the diagnosis of COVID-19.

If you test positive for COVID-19, stay home, take care of yourself by staying hydrated and getting plenty of rest. Stay in contact with your doctor and be sure to seek emergency medical attention if you have trouble breathing or emergency warning signs. Stay away from others as much as possible and tell your close contacts that they may have been exposed to COVID-19. An infected person can spread COVID-19 starting 48 hours or 2 days before they become symptomatic or test positive.

If you test negative for COVID-19, you are probably not infected at the time your sample was collected. However, this does not mean that you will not get sick. You could test negative if the sample was collected early in your infection and then test positive later in your infection. If you develop symptoms later, you might need to be re-tested to determine if you are infected with the virus.

How is COVID-19 treated?

As of now, there is no specific treatments for COVID-19. People who become sick with COVID-19 are treated with supportive measures to treat the symptoms.

What should I do if I have had close contact with someone who has been diagnosed with COVID-19?

The best thing to do if you have been in contact with someone diagnosed with COVID-19 is to stay home for 14 days. Be alert for symptoms associated with COVID -19 and stay away from others whenever possible until your quarantine period is complete.

What individuals are at an increased risk for severe illness if infected with COVID-19?

Severe illness means that a person with COVID-19 may require hospitalization, intensive care, or a ventilator to help them breathe.

• Older adults
  • Anyone 65 years of age or older
  • The greatest risk is among those aged 85 and older
• People of all ages with certain underlying medical conditions
  • Cancer
  • Chronic kidney disease
  • Chronic lung diseases
    • Chronic obstructive pulmonary disease (COPD)
    • Cystic fibrosis
    • Pulmonary fibrosis
  • Dementia
  • Down syndrome
  • Heart conditions
    • Heart failure
    • Coronary artery disease
    • Cardiomyopathies
    • Pulmonary hypertension
  • Immunocompromised (weakened immune system)
    • Solid organ transplant
    • Bone or blood transplant
    • HIV
    • Use of corticosteroids or other immune weakening drugs
  • Liver Disease
  • Moderate to severe asthma
  • Obesity and severe obesity
    • BMI >30kg/m²
  • Sickle cell disease
  • Smoking
  • Type 2 diabetes mellitus
• Pregnant women

Is there anything I can do to decrease my risk of severe disease?

There are many ways to help strengthen your immune system. Read our blog on “Seven Ways to Help Strengthen your Immune System’ to give your immune system a boost.

References:

1. Coronavirus (covid-19) frequently asked questions. (n.d.). Retrieved February 19, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/faq.html
2. Sauer, L. (n.d.). What is Coronavirus? Retrieved February 19, 2021, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus

Diabetes is a metabolic disease, caused by no or too little insulin production that affects millions of Americans. As food is broken down by the intestines, glucose or sugar is released into the blood. In response, insulin is released from the pancreas to help move glucose into your cells. Extra glucose is stored within the liver, muscles, and fat cells. The more glucose in your blood, the more insulin the pancreas produces. In type 1 diabetes, the pancreas is no longer able to produce insulin, therefore glucose freely floats within the blood. In type 2 diabetes, either the pancreas is unable to produce enough insulin to control glucose levels or the body becomes less sensitive to the insulin produced.¹

As of February 2020, 11.3% of North Carolina adults have been diagnosed with diabetes, with approximately 250,000 more individuals undiagnosed.²

Types of Diabetes^1,3

Type 1 diabetes mellitus, formerly known as “insulin-dependent diabetes” or “childhood-onset diabetes” is caused by an autoimmune or viral destruction of the pancreatic beta-cells (the cells responsible for making insulin), typically caused by a genetic or environmental factor. This means that the pancreas is unable to produce any insulin. Beta-cell destruction can occur at different rates, affecting both adults and children and accounts for 5 to 10% of diabetes.

Type 2 diabetes mellitus accounts for 90 to 95% of diabetes and is caused by poor insulin production, rather than complete absence of insulin with type 1, or poor insulin response (insulin resistance). The exact reason this occurs is unknown, but being overweight, physically inactive, and making poor diet choices are key factors.

Individuals diagnosed with prediabetes are those that have blood glucose levels higher than normal, but not high enough to be considered “diabetic.” Prediabetes greatly increases your risk for both diabetes and cardiovascular disease and is typically seen in obese people with high cholesterol and high blood pressure.

Gestational diabetes is high blood sugar during pregnancy, in women without a history of diabetes. Uncontrolled gestational diabetes can lead to an extra large baby, a higher chance of C-section, or preeclampsia (high blood pressure during pregnancy). Women are routinely screened between weeks 24 and 28 of pregnancy to rule out diabetes.

Diabetes insipidus is a rare inherited disorder, affecting 1 in every 25,000 individuals, that causes the kidneys to produce large amounts of dilute and odorless urine. Typically the kidneys make 1 to 2 quarts of urine per day. With diabetes insipidus, the kidneys can produce 3 to 20 quarts daily. Diabetes insipidus is similar to diabetes mellitus because both cause polyuria or excessive urination, however patients with diabetes insipidus do not have trouble producing insulin and have normal blood glucose levels.

Diabetes Symptoms⁴

Each individual diagnosed with diabetes may experience different symptoms, however the three main indicators of high blood glucose are polyuria (frequent urination), polydipsia (excessive thirst), and polyphagia (excessive hunger). Other symptoms may include blurry vision, numbness or tingling in hands or feet, and slugginess or fatigue.

Diabetes Diagnosis⁵

The A1c or hemoglobin A1c (HbA1c) test measures the amount of sugar attached to  hemoglobin, a protein found in red blood cells that moves oxygen throughout the body. The higher your blood glucose, the more red blood cells become covered in sugar. A1c estimates your average blood glucose over 2 to 3 months and is measured with blood work or using a fingerstick A1c test. A normal A1c is less than 5.7%. Prediabetes is an A1c between 5.7 and 6.4%. Diabetes is diagnosed with an A1c greater than or equal to 6.5%.

The fasting plasma glucose (FPG) test determines the blood glucose level after not eating or drinking (except water) within at least 8 hours of testing, usually done first thing in the morning. Typically, blood glucose levels would be low if you are fasting since glucose comes from food breakdown. If you have diabetes, however, these levels may be high. A normal FPG is less than 100. Prediabetes is a FPG between 100 and 125. Diabetes is diagnosed with a FPG greater than or equal to 126. Testing blood glucose at any time is considered a random plasma glucose, which can also be used to diagnose diabetes.

The oral glucose tolerance test (OGTT) shows how well your body processes sugars by measuring your blood glucose before and 2 hours after drinking a sweet drink. This test is commonly used in pregnant women to help rule out gestational diabetes. A normal OGTT would be a blood glucose of less than 140, prediabetes 140 to 199, and diabetes greater than 200.

Diabetes Risk Factors⁶

Since type 1 diabetes is caused by an autoimmune reaction, risk factors for type 1 diabetes are not well understood. Known risk factors for type 1 diabetes, include a family history, since there may be a genetic link, and age. Type 1 diabetes can develop at any age, but there is a greater chance during childhood and early adulthood.

Risk factors for type 2 diabetes include a diagnosis of prediabetes, older age (45 years and older), obesity, and a sedentary or non-active lifestyle. Type 2 diabetes may also have a genetic link, increasing the risk for individuals whose parents or siblings have type 2 diabetes. African Americans, Hispanic/Latio Americans, American Indians, and Alaskan natives are typically at a higher risk.

Diabetes Complications⁷

Overtime, diabetes can cause complications throughout the body including the heart, blood vessels, nerves, eyes, and kidneys. High blood sugar, alongside high cholesterol, can clog blood vessels making it difficult for the heart to pump blood. This causes high blood pressure, which increases your risk of heart attack or stroke. High blood sugar can also damage nerves leading to neuropathies or a tingling, burning, or numbness in hands and feet. Diabetes increases risk for cataracts or glaucoma and if poorly controlled, blindness. Diabetes may also lead to irreversible kidney damage, requiring dialysis or kidney transplant.

Diabetes Treatment^8,9

Because in type 1 diabetes the pancreas is unable to make any insulin, the primary treatment for these individuals is insulin.

Treatment of type 2 diabetes is much more complex, with countless oral and injectable treatments, and typically depends on what works best for each individual. Oral medications work by increasing the amount of insulin released by the pancreas, decreasing glucose production, decreasing glucose absorption, increasing elimination of glucose, or improving the body’s response to insulin to lower blood sugar. Injectable medications work by increasing the amount of time you stay feeling full after eating, to help promote weight loss and by increasing insulin production. For patients with poorly controlled type 2 diabetes, insulin may also be used. 

Gestational diabetes can often be controlled by eating healthy foods and exercising regularly, however some women may need insulin to lower their blood sugar.

Hypoglycemia Symptoms and Treatment¹⁰

Hypoglycemia or low blood sugar can be caused by certain diabetes medications, including insulin, or skipping a meal, and can cause seizures, unconsciousness, or even death, if left untreated. Blood sugar is considered low if less than 70 mg/dL, however symptoms may appear at higher values in some patients. Symptoms of low blood sugar may include sweating, shaking, hunger, or fatigue. When treating low blood sugar, we use the “15-15 Rule” — 15 grams of carbohydrates and recheck blood sugar after 15 minutes. It is important to consume simple sugars because your body absorbs these quickly and helps raise your blood sugar the fastest. This includes things like half a glass of orange juice or soda or 5 pieces of hard candy. There are also glucose tablets that can be purchased over-the-counter to help treat low blood sugar. You should inform your healthcare provider if you experience low blood sugars often.

Diabetes Prevention¹¹

Lifestyle changes are especially important for preventing or treating type 2 diabetes. Losing 5 to 10% of your body weight can lower your risk of developing diabetes by about 50%. The American Heart Association (AHA) encourages individuals with diabetes to exercise regularly and eat healthy. Adults need at least 150 minutes of moderate-intensity physical activity per week, with both aerobic and strength training exercises. Dietary changes may include portion control and limiting added sugars, fatty meats, saturated fats, sodium, cholesterol, and alcohol. A proper diabetic diet is rich in high-fiber whole grains, like oatmeal or brown rice, non-fried fish at least twice weekly, lean meats like skinless chicken or turkey, and fruits and vegetables. The AHA also promotes smoking cessation. Individuals with diabetes that smoke are three times as likely to die of cardiovascular death versus non-smokers and have a more difficult time controlling their blood sugar.

For more information and support, visit the American Diabetes Association (ADA) and Centers for Disease Control and Prevention (CDC) websites or talk with your doctor or pharmacist today.

By CaraBeth Harrison, PharmD, PGY1 Resident

References:

1. American Diabetes Association. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes. Diabetes Care [Internet]. 2020 [cited 2021 Jan 25]; 43(Suppl. 1): S14-S31. Available from: https://care.diabetesjournals.org/content/43/Supplement_1/S14.full-text.pdf.
2.  The Burden of Diabetes in North Carolina [Internet]. Arlington (VA): American Diabetes Association. 2020 Feb [cited 2021 Jan 25]. Available from: http://main.diabetes.org/dorg/docs/state-fact-sheets/ADV_2020_State_Fact_sheets_NC.pdf.
3. Diabetes Insipidus [Internet]. Rochester (MN): Mayo Clinic. 2019 Feb 16 [cited 2021 Jan 25]. Available from: https://www.mayoclinic.org/diseases-conditions/diabetes-insipidus/symptoms-causes/syc-20351269.

4. Diabetes Symptoms [Internet]. Atlanta (GA): Centers for Disease Control and Prevention. [cited 2021 Jan 25]. Available from: https://www.cdc.gov/diabetes/basics/symptoms.html.

5. Diagnosis [Internet]. Arlington (VA): American Diabetes Association. [cited 2021 Jan 25]. Available from: https://www.diabetes.org/a1c/diagnosis.
6. Diabetes Risk Factors [Internet]. Atlanta (GA): Centers for Disease Control and Prevention. 2020 Mar 24 [cited 2021 Jan 25]. Available from: cdc.gov/diabetes/basics/risk-factors.html.

7. Type 2 Diabetes [Internet]. Rochester (MN): Mayo Clinic. 2021 Jan 20 [cited 2021 Jan 25]. Available from: https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193.

8. Basina M and Watson S. Everything You Need to Know About Diabetes [Internet]. Healthline; 2018 Oct 4 [updated 2020 Feb 26; cited 2021 Jan 25]. Available from: https://www.healthline.com/health/diabetes.
9. Gestational [Internet]. Atlanta (GA): Centers for Disease Control and Prevention. 2020 Jul 14 [cited 2021 Jan 25]. Available from: https://www.cdc.gov/pregnancy/diabetes-gestational.html.

10. Blood Sugar Testing and Control: Hypoglycemia (Low Blood Sugar) [Internet]. Arlington (VA): American Diabetes Association. [cited 2021 Jan 25]. Available from: https://www.diabetes.org/healthy-living/medication-treatments/blood-glucose-testing-and-control/hypoglycemia.
11.  Living Healthy with Diabetes. Dallas (TX): American Heart Association. 2020 Mar 12 [cited 2021 Jan 25]. Available from: https://www.heart.org/en/health-topics/diabetes/prevention–treatment-of-diabetes/living-healthy-with-diabetes.

Let me introduce you to Mary. She wanted to try CBD for sleep, she got so much more than better sleep.

First we have to understand a little about what quality Cannabidiol (CBD) is.

You can’t just go by the milligrams (mg) on the label.

Mary had tried CBD before, but not from a pharmacy. She said she was on 1500 mg of CBD, what she didn’t know was CBD labeling is not consistant across all companies. Some companies report the amount of CBD and some report the amount of CBD oil. Whats the difference? CBD is the active cannabinoid that so many people know and love. CBD oil on the other hand can include all kinds of other cannabinoids and the carrier oil. That means there is a big difference between the two. CBD oil might only contain 30% of the reported CBD.

Always verify before you buy.

Mary had heard things about contaminants in CBD and she was worried about lead the most. Each CBD product you buy must have a certificate of analysis to verify that it contains the stated amount of CBD, the expected amount of THC (either <0.3% or none), no pesticides, heavy metals, or other contaminants. That’s why she went to a pharmacy for her CBD products. She wanted the best and she knew her pharmacist never compromised on quality.

What form of CBD to use?

Once again her pharmacist was happy to help. Together they decided on a Full Spectrum Sublingual oil. Whats that? Full Spectrum means that in addition to CBD and other cannabinoids and terpenes, this oil also contains some THC (<0.3%). A broad spectrum oil contains only CBD and other cannabinoids and possibly very small trace amounts of THC. An Isolate contains only CBD.

How much CBD to take?

Now that Mary had her CBD she had to find her dose. CBD supports your natural endocannabinoid system, which means your body will respond to different amounts of CBD than someone else. Mary started taking 10 mg of active CBD, which is where many people start. She took it for a week and decided it was helping her at that dose, but wanted to see if it could be even better. She went up to 20 mg. Now she was sleeping better and getting better quality sleep. She tried going up to 25 mg a week later and discovered she didn’t feel as good as she did on the 20 mg, so she went back to 20 mg. Mary did what she needed to, she listend to her body and adjusted her dose to suit her needs. Keep in mind that CBD effects everyone differently and it is always best to start low and go slow.

What happened to Mary?

Mary went into the pharmacy after about 3 months to pick up another bottle of her CBD. She called her pharmacist over and told him that she had jogged down the stairs last week.

Her pharmacist was confused and said, “That’s great, I’m glad you were able to get some exercise.”

Mary smiled, “You don’t understand, I used to take the stairs one at a time, sideways, while holding the hand rail. This CBD has changed my life and helped with my arthritis that I’ve had for years.”

Her pharmacist smiled, “That’s amazing. I am so glad to hear that CBD has helped you so much. Do you mind if I tell others your story?”

Mary smiled, “Please do, everyone should get the chance at this kind of relief.” Stories like Mary’s are why Josefs pharmacists only recommend the best CBD.

FDA Disclaimer: These products are not for use or to be sold to persons under the age of 18. This product should be used only as directed on the label. It should not be used if you are pregnant, trying to become pregnant, or nursing. Consult with a medical professional before using if you have a serious medical condition or are taking any prescription medication. A medical professional’s advice should be sought before using this or any other supplement or dietary product. These products and statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease.  By using this site and purchasing products, you agree to follow all Terms and Conditions found on this site.

Copied verbatim from NCPA.org > Current Link

ALEXANDRIA, Va. (Oct. 20, 2020) – Jonathan Harward, pharmacy manager at Josefs Pharmacy in Raleigh, N.C., was honored as the recipient of the 2020 National Preceptor of the Year Award by the National Community Pharmacists Association Foundation as part of NCPA’s Annual Convention, which was held virtually. Harward, who is originally from Carthage, N.C. and now lives in Holly Springs, has precepted pharmacy students with Josefs Pharmacy since 2015.

Harward attended Campbell University, completing his undergraduate studies and graduating with his Doctor of Pharmacy degree in 2013. He completed a PGY-1 Community Pharmacy Residency with Kerr Drug and Campbell University.

In nominating him for this award, Dr. D. Byron May, professor and chairman of the Department of Pharmacy Practice at the Campbell University College of Pharmacy and Health Sciences, writes that Harward “understands that students have different learning styles and he cares enough to ascertain how each student learns best in order to maximize their learning experience.” May says Harward knows the importance of individualizing students’ experiences and prioritizes involving them in all aspects of his pharmacy practice. Students say Harward was a mentor to them long after their experiential training ended, giving testament to his compassion and dedication to their personal and professional development.

Harward’s commitment to pharmacy professionalism extends beyond precepting future pharmacists, carrying into his work at Josefs Pharmacy, where he is dedicated to his patients and his community. He has worked to develop and implement a medication synchronization program seeking to promote comprehensive medication reviews, immunizations and assessments in patients with HIV, HCV and rheumatoid arthritis. He worked to develop the ScriptAbility program through which visually impaired patients (using special technology) can hear instructions printed on their medication vial. He also holds immunization clinics at nearby businesses and places of worship for those who are uninsured, and shares his knowledge in presentations to various educational sessions throughout the community.

Harward is involved with efforts to transform community-based pharmacies, working with CPESN® USA and Flip the Pharmacy. These initiatives, among other things, aim to improve medication adherence and lower overall cost of care. Harward is currently seeing patients with hypertension through Flip the Pharmacy with plans to expand this coming year.

Harward says, “It is a privilege to be able to mentor and show students the great services that independent pharmacies have to offer our patients, while sharing with them the challenges we face from pharmacy benefit managers who attempt to undermine our work.” He thanks Dr. May in addition to Dr. Katie Trotta, Dr. Taylor McDaniel, and Dr. Tina Thornhill at Campbell University for nominating him for this award. Harward also thanks Finny and Blessy Joseph, the owners of Josefs Pharmacy, for allowing him to have students in the business.

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The NCPA Foundation is a nonprofit 501(c)(3) organization established in 1953 to honor the previous incarnation of NCPA, the National Association of Retail Druggists (NARD) Executive Secretary John W. Dargavel. Contributions to the foundation are tax-deductible as charitable donations to the extent permitted under federal tax law. The NCPA Foundation supports the growth of independent community pharmacy through scholarships to pharmacy students, critical research/programs to improve the success of independent pharmacy and patient care, community service programs, and financial aid to community pharmacy owners for their recovery in the event of disaster or other adverse circumstances. For more information, go to www.ncpafoundation.org.

Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing over 21,000 pharmacies that employ approximately 250,000 individuals nationwide. Community pharmacies are rooted in the communities where they are located and are among America’s most accessible health care providers. To learn more, visit www.ncpa.org.NCPA