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As you journey to higher elevations, particularly mountainous regions, you'll encounter various environmental changes that can impact your well-being. These include cold temperatures, low humidity, increased sun exposure to UV radiation, decreased air pressure, and diminished oxygen levels. Altitude sickness arises as a response to the reduced air pressure and oxygen levels typically experienced at altitudes exceeding 8,000 feet. If you anticipate traveling to such heights, adhere to some simple strategies to prevent altitude sickness.
Guidelines
Strategies for Preventing Altitude Sickness
Gradual Ascent is Key. When venturing to high-altitude locales, it's crucial to ascend gradually. Your body requires approximately three to five days at altitudes above 8,000 feet to acclimatize before ascending further. To aid in this process, particularly in areas lacking altitude indicators, consider purchasing an altimeter or a watch equipped with an altitude meter to monitor your elevation. These items are available for purchase online or at outdoor gear retailers.
- It's essential to avoid certain behaviors. Do not exceed 9,000 feet in altitude in a single day. Avoid sleeping at an elevation 1,000 to 2,000 feet higher than the previous night. Allocate an extra day for acclimatization for every 3,300 feet gained.
Rest Up. Another effective approach to combat altitude sickness is to ensure you get ample rest. Travel, whether domestic or international, can disrupt regular sleep patterns, leading to fatigue and dehydration, thereby increasing the risk of altitude sickness. Before embarking on your ascent, allocate a day or two for rest to acclimatize to your new surroundings and sleep schedule, particularly for international travel.
- Furthermore, during your three to five-day adjustment period to the new altitude, prioritize rest for the initial days before engaging in exploratory activities.
Consider Prophylactic Medications. Prior to embarking on high-altitude journeys, it's advisable to obtain prophylactic medications. Schedule a consultation with your physician to acquire these medications before your departure. Provide your medical history and explain your plans for ascending to elevations exceeding 8,000 to 9,000 feet. If suitable, your doctor may prescribe acetazolamide.
- Acetazolamide is an FDA-approved medication for preventing and treating acute mountain sickness. It functions as a diuretic, increasing urine production, and enhances respiratory ventilation, facilitating greater oxygen exchange in the body.
- Follow the prescribed dosage of 125 mg twice daily, commencing one day before your trip and continuing for two days at your highest altitude.
Explore Dexamethasone. If acetazolamide is not recommended or if you have an allergy, alternative options exist. Dexamethasone, a steroid, has demonstrated efficacy in reducing the incidence and severity of acute mountain sickness.
- Administer as directed, typically 4 mg every 6 to 12 hours commencing the day prior to your journey and continuing until full acclimatization at your highest altitude.
- Additionally, consuming 600 mg of ibuprofen every 8 hours may aid in preventing acute mountain sickness.
- While Ginkgo biloba has been studied for altitude sickness treatment and prevention, its efficacy remains inconsistent, and it is not recommended for use.
Check Your Red Blood Cells (RBC). Before departure, it may be necessary to undergo testing for red blood cells (RBCs). Schedule a consultation with your doctor for this evaluation before your trip. If anemia or low RBC count is detected, your doctor may recommend addressing this issue before traveling, as RBCs are essential for oxygen transport to tissues and organs, critical for survival.
- Low RBC count can result from various factors, with iron deficiency being the most common. Deficiency in B vitamins can also contribute to low RBC levels. If deficient, your doctor may suggest iron or vitamin B supplements to correct the imbalance.
Stay Hydrated. Dehydration diminishes the body's ability to adapt to altitude changes. Consume two to three liters of water daily, starting the day before your journey. Carry an additional liter of water during ascent and drink as needed on descent.
- Avoid consuming alcohol, and refrain from doing so for the initial 48 hours of your trip. Alcohol acts as a depressant, slowing breathing rate and promoting dehydration.
- Similarly, avoid caffeinated beverages such as energy drinks and sodas, as caffeine can lead to muscle dehydration.
Consume Properly. Certain types of foods can prepare you for your journey and help prevent altitude sickness. High-carbohydrate diets, as shown in studies, can alleviate symptoms of acute mountain sickness, improve mood and performance, and enhance oxygen saturation in the blood during simulated high-altitude experiments. Carbohydrate-rich diets are believed to enhance energy balance. Incorporate a high-carbohydrate diet before and during acclimation periods.
- This may include pastas, breads, fruits, and potato-based meals.
- Avoid excessive salt intake, as it can lead to dehydration of body tissues. Look for foods and meals labeled as low-salt or no-salt-added at the grocery store.
- While physical endurance and conditioning may seem beneficial before mountain climbing, studies indicate no evidence that physical fitness guards against altitude sickness.
Identifying Symptoms
Familiarize Yourself with the Types. Altitude sickness encompasses three syndromes: acute mountain sickness, high altitude cerebral edema (HACE), and altitude pulmonary edema (HAPE).
- Acute mountain sickness results from decreased air pressure and oxygen levels.
- HACE represents a severe progression of acute mountain sickness, characterized by brain swelling and dilated brain vessel leakage.
- HAPE may occur independently or accompany HACE, or develop one to four days after ascending above 8,000 feet. It involves lung swelling due to fluid leakage caused by high pressure and blood vessel constriction in the lungs.
Recognize Acute Mountain Sickness. This condition is relatively common in certain regions, affecting 25% of travelers above 8,000 feet in Colorado, 50% in the Himalayas, and 85% in the Mount Everest region. Symptoms include headaches within two to 12 hours of altitude change, sleep disturbances, dizziness, fatigue, increased heart rate, shortness of breath during activity, and nausea or vomiting.
- Recognizable symptoms encompass headache within two to 12 hours of altitude change, sleep disturbances, dizziness, fatigue, increased heart rate, shortness of breath during activity, and nausea or vomiting.
Identify High Altitude Cerebral Edema (HACE). Initially, symptoms of HACE mirror those of acute mountain sickness. As the condition progresses, additional symptoms emerge, including ataxia (loss of coordination), altered mental state (such as drowsiness, confusion, changes in speech, memory, mobility, thoughts, and attention), loss of consciousness, or coma.
- Unlike acute mountain sickness, HACE is relatively rare, affecting only 0.1% to 4% of individuals.
Be vigilant for high altitude pulmonary edema (HAPE). This condition can manifest as an escalation of high altitude cerebral edema (HACE), presenting symptoms similar to acute mountain sickness and HACE. However, it can also occur independently. Look out for symptoms such as dyspnea (shortness of breath at rest), chest tightness and pain, wheezing during exhalation, increased breathing and heart rate, weakness, and coughing.
- You may also observe physical changes such as cyanosis, where the mouth and fingers turn darker or bluish in color.
- Similar to HACE, HAPE is relatively rare, occurring in only 0.1% to 4% of cases.
Address symptoms. Despite preventive measures, altitude sickness may still occur. In such cases, it's essential not to exacerbate the condition. For acute mountain sickness, wait for up to 12 hours for symptom improvement. Descend immediately by at least 1,000 feet if symptoms persist after 12 hours, or sooner if severe. Oxygen therapy can alleviate symptoms within a few hours if available. Reevaluate symptoms for improvement afterward.
- If experiencing signs of HACE or HAPE, descend immediately with minimal exertion to avoid worsening symptoms. Periodically reassess symptoms for improvement.
- If descent isn't feasible due to weather or other constraints, administer oxygen to increase pressure. Utilize portable hyperbaric chambers if available. If symptoms are manageable and respond to treatment, descent may not be necessary. Report incidents to rescue teams if communication is possible, providing location details and awaiting assistance.
Administer emergency medications. In emergencies, your doctor may prescribe certain medications. Acetazolamide or dexamethasone may be recommended for acute mountain sickness, and dexamethasone for HACE. Take the prescribed pills immediately with water.
- For HAPE, your doctor may prescribe non-FDA approved drugs for prophylaxis and treatment. Some studies suggest these drugs can reduce HAPE incidence if taken 24 hours before the trip. Options include nifedipine (Procardia), salmeterol (Serevent), and phosphodiesterase-5 inhibitors (tadalafil, sildenafil).
Dietary Recommendations
Foods That Aid in Altitude Sickness Prevention
Foods to Steer Clear of to Prevent Altitude SicknessUseful Advice
Key Warnings
- If you're experiencing symptoms of altitude sickness, avoid further ascent, especially for sleeping.
- Descend if your symptoms worsen or persist despite resting.
- If you have certain medical conditions, they may worsen at high altitudes. Consider a pre-trip evaluation by your healthcare provider for safety. These conditions include arrhythmias, severe COPD, congestive heart failure, coronary artery disease, hypertension, pulmonary hypertension, diabetes, and sickle cell disease. Additionally, be cautious if you're taking narcotic pain medications, as they can reduce respiration.
- Pregnant women should avoid sleeping at altitudes above 12,000 feet.
