Altitude Sickness Prevention and Remedies for High Altitude Hikes
Whether you are hiking in the Rocky Mountains of Colorado or the high peaks of the Himalaya, altitude sickness is a real concern. Many people don’t realize that even a car ride at high altitude can cause altitude sickness. Although there is no sure-fire way to prevent altitude sickness, and the only real altitude sickness remedy is to descend to lower elevations, there are several steps you can take to help prevent altitude sickness. Here are a few tips for high altitude hikers and climbers to stay healthy in higher elevations.
NOTE: I am in no way, shape, or form a medical professional. If you have medical concerns, always consult a medical professional such as a doctor before engaging in high altitude activities. Below is simply my advice from my experience in high altitude terrain and things that have worked for me. However, this post is in no way responsible for your safety outside. Use good judgment, talk with a health professional, and be safe out there.
What is Altitude Sickness?
Altitude Sickness, sometimes referred to as Acute Mountain Sickness with more aggressive symptoms, refers to the negative side effects of being at high altitude. Typically, symptoms of AMS or altitude sickness show up when someone ascends up in elevation too quickly. There are a wide range of symptoms and if left untreated, it can lead to more serious illnesses such as HAPE or HACE.
The unique thing about altitude sickness is that no one really knows how it happens, why it happens or when it will happen. Someone who has had altitude sickness before isn’t any more or less likely to get it again. Some people may only show one or two symptoms, while others may experience violent symptoms that lead to more dangerous illnesses.
Take me for example, I’ve had serious cases of AMS twice and I live a mile above sea level. Both times it showed up in different ways. The first was while I was spending a few days in Breckenridge (9,600 feet). Symptoms showed up quickly and worsened to the point of vomiting and an inability to sleep. The second time I got AMS was during my trip to Nepal. This time, despite doing everything I could to ascend slowly, the symptoms set in over the course of a few days, finally escalating on my way back down from the summit of Gokyo Ri (17,575 feet). In both instances, descending to a lower elevation provided the only relief for my symptoms.
What are the Symptoms of Altitude Sickness?
Most people experience mild symptoms of altitude sickness once they are above 8,000 feet. Primary symptoms include:
- Headache (also a sign of dehydration)
- Loss of appetite, nausea, vomiting or excessive farting (oh yeah, it’s a thing).
- Fatigue. Including dizziness, lightheadedness, insomnia or a “pins and needles” sensation in the body
- Shortness of breath
- Persistent, rapid pulse
Mild symptoms are typical above 8,000 feet and almost expected above 10,000 feet. Most of the time you embark on a high altitude hike, feel a few mild symptoms of altitude sickness, then descend back down to lower elevations. However, sometimes the symptoms linger or worsen, especially with prolonged exposure to higher altitudes. If left untreated, these symptoms certain can worsen and lead to more serious illnesses like HAPE and HACE. The best thing you can do if you are experiencing more severe symptoms is to descend to a lower elevation and seek medical attention. Period.
What are HAPE and HACE?
High Altitude Pulmonary Edema or HAPE and High Altitude Cerebral Edema or HACE are two deadly forms of altitude sickness. These two illnesses cause fluid build-up in the brain (HACE) or lungs (HAPE) and both can lead to death. Not much is understood about HAPE and HACE other than the onset is fast and often caused by ascending too quickly or enduring prolonged exposure at altitudes above 6,000 m (19,685 ft). In rare instances, both conditions can come about at lower altitudes, which is why it is essential to ascending slowly on high altitude hikes.
Should I Take Altitude Sickness Medication?
I get asked about medication for high altitude a lot. Many people share opposing views on taking altitude sickness medication and to be honest with you, I am on the fence. There is a pill called Diamox or Acetazolamide that is available via prescription only. Diamox is used for different diseases, but one of its side effects is it helps prevent altitude sickness. Many travel doctors prescribe Diamox for trips to Peru, the Andes, the Himalaya, and other high-altitude hiking and trekking areas.
You may be thinking, great! I can just take a pill and not have to worry. Stop. That isn’t necessarily true. Diamox only alleviates symptoms of altitude sickness, it isn’t guaranteed to actually prevent altitude sickness, AMS or the development of more severe symptoms. The thought is that you could have a more severe form of AMS and not know it because you are taking medication to alleviate symptoms. Furthermore, Diamox is a diuretic, meaning it causes you to pee…excessively. This means your body is losing precious hydration at a greater rate, requiring you to drink a lot more water to stay properly hydrated. If you don’t hydrate properly, you can actually cause altitude sickness.
Diamox is commonly taken for trekkers and mountaineers alike at high altitude. The choice is ultimately up to you, but be aware that it is not an altitude sickness remedy.
How High is High Altitude Hiking?
Alright so how high is too high? Again, that depends. Most people experience mild symptoms of altitude at around 10,000 feet, but people also feel the effects of altitude at much lower elevations. The Death Zone, or above 8,000 meters (26,247 feet) is the elevation in which there is not enough oxygen for humans to breathe. Therefore, altitude sickness can virtually happen at any higher elevation.
A good rule of thumb is to be prepared to encounter the effects of altitude above 8,000 feet (2,438 meters). This is especially true if you do not live at a higher elevation. Altitude should not prevent you from going on a hike or having an adventure. Keep in mind that most people experience mild symptoms that tend to disappear after they have properly acclimatized. However, understanding that there are dangers associated with high altitude is an important part of staying safe while hiking in the mountains.
Tips for Preventing Altitude Sickness and Altitude Sickness Remedies
There are several steps you can take to acclimatize safely at altitude. Acclimatization refers to allowing your body the time it needs to adjust to higher altitudes. Remember, you can do all of these things, but the only altitude sickness remedy is to descend to a lower elevation. Taking steps to prevent altitude sickness certainly helps with proper acclimatization, but it will not guarantee that you will not get altitude sickness or AMS.
When in Doubt Descend
I will put myself on repeat here: the only real altitude sickness remedy is to descend to lower elevations. This may not be what you want to hear when you’ve come a long way for an epic ski vacation only to have your plans ruined by getting altitude sickness (been there). However, if your symptoms do not improve or worsen in the coming hours or days, you need to get lower. It isn’t a bad thing to have to descend. It happens to everyone at some point in their high altitude hiking career. Professional mountaineers to the casual weekend warrior are all susceptible to altitude sickness. It happens. It’s okay. What is important is that you listen to your body and head to lower altitudes.
If you are caught out hiking and discover you have altitude sickness, sometimes this means the only way down is by the power of your own two feet. This happened to me in the Himalaya. I walked for 12 hours to get to a lower, safer elevation where I began to feel better. Once I descended around 2,000 vertical feet, I felt tremendously better, and I used that as motivation to keep going.
Headed to the Himalaya? Check out these resources:
- How to Train for Everest Base Camp
- Trekking Tips for Nepal
- Why (and How) You Should Hire a Local Guide in Nepal
The 1,500 Foot Rule
In order to give yourself the best chance at preventing altitude sickness, stick to the 1,500-foot rule and only ascend 1,500 vertical feet in one day. This helps tremendously when tackling a tough trekking objective such as Everest Base Camp or Mount Kilimanjaro. Ascending quickly is the leading cause of altitude sickness. If you are on a high altitude hike or trek, plan out your route so you only ascend a maximum of 1,500 feet in a day.
Plan a Rest Day
Ascending too quickly is actually easier to do than you think. Let’s say you’re coming from Denver up to the Rocky Mountains to hike a 14er. Well, you’ll be starting your day at 5,280 feet and topping out at over 14,000 feet. With such a giant gap in elevation, it’s nearly impossible to follow the 1,500-foot rule. So what do you do? First, build in a rest day. It’s completely unrealistic to expect to arrive from sea level, sleep one night, then bust a move on a 14er and not get altitude sickness. Build in a day in Denver and head to the foothills on a hike, then sleep lower in Denver. Or, opt to stay in a mountain town. After a few low-key days, tackle your big high altitude hiking objective. Building in a rest day is an excellent way to prevent altitude sickness, as it lets your body adjust to the thin, dry air.
Your guide to Colorado’s best mountain climbs, hikes and more:
- Amazing 13ers right near Denver
- Incredible free camp spots near Denver
- The ultimate list of amazing hikes near Denver
- Colorado’s 14er bucket list (coming soon)
- Colorado’s best fall hikes you’ve never heard of
Hydrate, Hydrate, then Re-Hydrate
So you’re probably familiar with dehydration and the importance of drinking water during physical activity. However, the air at altitude cannot carry as much moisture, meaning your body dehydrates faster. Therefore, you’ll want to drink more water than normal. Consider hydrating a day or two in advance of a big, high-altitude hike. Bring plenty of water or a filter on your hike so you can keep hydrated. A big component of altitude sickness prevention revolves around proper hydration. Drink a minimum of two liters a day. If you get bored of water, consider using powdered Gatorade, Nuun tablets, or some other type of electrolyte-based drink additive to help encourage you to drink.
Go for Garlic the Natural Remedy for Altitude Sickness
Garlic is not only tasty, but it helps promote blood flow, which gives much-needed oxygen to your organs. The result from increased garlic consumption helps prevent altitude sickness. So bring some granulated garlic on your high-altitude trekking trip, order up the garlic soup at a teahouse, or simply add it to your meals while you vacay at altitude. So bring on the garlicky-goodness!
Hike High, Sleep Low
This is an age-old, high-altitude mountaineering trick that certainly helps, even at lower elevations. The concept is simple. Hike higher than you sleep. Say you set up camp in a valley and plan to hike the pass the next morning. Well, take a stroll several hundred feet higher, admire the view, and sleep low. What this does is give your body a taste for higher elevations, but allowing you to recover at lower ones.
Mountaineer much? Check out these guides:
- Tips for your first mountain climb
- What to pack for a mountain climb
- Letting go of summit fever
- How to push past your fear of heights
Keep Off the Caffeine and the Bottle
On the ascent, be sure to avoid caffeine and alcohol. These two ingredients spell disaster for proper altitude sickness prevention. Both dehydrate you and cause your body to go into overdrive. Save the celebrations for after your high altitude hike, and stick to herbal tea in the mornings.
Now you’re armed with some altitude sickness prevention know-how and even a few AMS remedies to help you out. High altitude hiking, climbing, and camping offer a unique chance to see some of the world’s most beautiful landscapes. Just be sure to properly acclimatize before heading on your big, high-altitude adventure.