Altitude Sickness

2022-08-12 | Published By: Bold Himalaya

Altitude sickness is an illness due to the decreasing amount of oxygen at above sea level altitudes ranging usually about 3,500 meters that may range from a mild headache and weariness to a life-threatening build-up of fluid in the lungs or brain, and even fatality at moderate to high altitudes. Altitude sickness typically occurs when a person rapidly ascends to high altitudes, normally above 8,000 feet.
Mountain climbers are at risk of developing altitude sickness (also known as mountain sickness), which may be harmful or even more fatal if its onset is ignored. Altitude sickness is caused by gaining altitude too fast, which doesn’t allow the body to adjust to the atmosphere where low oxygen presents. It happens most often when people are not used to high altitudes and go quickly from lower altitudes to higher. For example, you may get a headache when you drive over a high mountain pass, hike to a higher altitude or arrive at a mountain resort. Altitude sickness can be dangerous so it is a smart move to take special care if you go high-altitude hiking or camping in the high Himalayas. Mild altitude sickness is common and even experts do not know who will get and who will not get Altitude sickness. Altitude sickness is also called Acute Mountain Sickness (AMS).

Types of altitude sickness

There are three types of altitude sickness:
Acute Mountain Sickness (AMS)

It is the mildest form of altitude sickness and it is very common among peak climbers or trekkers. It usually begins 12 to 24 hours after arriving at a higher altitude. They lessen in a day or two as your body adjusts. The symptoms can include:

  • Dizziness

  • Fatigue and loss of energy

  • Shortness of breath

  • Loss of appetite

  • Sleep problems

High-Altitude Pulmonary Edema (HAPE)

It is a buildup of fluid in the lungs that can be very dangerous and even life-threatening. This is the most common cause of death from altitude sickness. The symptoms of HAPE include:

  • Cyanosis is when your skins, nails, or whites of your eyes start to turn blue.

  • Confusion and irrational behavior

  • Shortness of breath even while resting

  • Extreme fatigue and weakness

  • Feeling like you’re suffocating at night

  • Persistent cough, bringing up white, watery fluid.

High altitude Cerebral Edema (HACE)

It is the most severe form of altitude sickness and happens when there’s fluid in the brain. It is too life-threatening, and you need to seek medical attention right away. The symptoms of HACE include:

  • Headache

  • Loss of coordination

  • Weakness

  • Disorientation, memory loss, hallucination

  • Psychotic behavior

  • Coma

Altitude sickness medication

Altitude sickness medication Altitude Sickness is common in travelers who enjoy traveling at higher altitudes. Mostly, the people who are on an adventurous trips like trekking and peak climbing. That’s why travelers should be well known for the medications for altitude sickness. The medicines for high altitude sickness include: 

  • Acetazolamide to prevent and treat high altitude sickness

  • Ibuprofen and paracetamol for headaches

  • Anti-sickness medicine, such as promethazine, for nausea.

Begin taking acetazolamide 1 to 2 days before you start to go up to high altitude and continue to take it while going up. You should still go up gradually and follow the prevention advice, including taking time for acclimatization, having regular rest days, and drinking plenty of water. If you get symptoms of altitude sickness while taking acetazolamide, rest or go down until you feel better before going up again. If you think you have altitude sickness then,

Stop and rest where you are

  • Do not go any higher for at least 24 to 48 hours

  • If you have a headache, take ibuprofen or paracetamol

  • If you feel sick, take an anti-sickness medicine such as promethazine

  • Make sure you are drinking enough water

  • Do not smoke, drink alcohol, or exercise

For Complication cases HAPE and HACE:

The symptoms of HAPE can start to appear a few days after arrival at a higher altitude. It can be fatal if it’s not treated immediately. It can be treated by the following:

  • Move down to a lower altitude immediately

  • Take nifedipine

  • Give bottled oxygen if available

Nifedipine is a medicine that helps to reduce chest tightness and make breathing easier. It’s also often part of an expedition’s medical supplies. You should go hospital as soon as possible for follow-up treatment. A person with HACE will often not realize they’re ill. HACE can develop quickly over a few hours. It can be fatal if it’s not treated immediately. It can be treated by:

  • Move down to a lower altitude immediately

  • Take dexamethasone  

  • Give bottled oxygen, if available

Dexamethasone is a steroid medicine that reduces swelling of the brain. It’s often carried by professional mountain climbers as part of their medical supplies. If you cannot go down immediately, dexamethasone can help relieve symptoms until it’s safe to do so. You should go to the hospital as soon as possible for follow-up treatment.

The ideas to be safe from Altitude sickness

The best way to be safe from altitude sickness is to ascend slowly once you are more than 3,000 meters above sea level. Advance for only 300 meters or less per day. Be sure to take an extra day of rest and acclimatization after completion of every 1,000 meters. 
Training (Meditation and breathing yoga)

To be in good physical condition while trekking at a higher altitude is always effective. If you are in good physical condition then you are more likely to catch altitude sickness, but if you are a regular gym guy and have proper physical fitness then you are less chance to catch altitude sickness. Before starting any of the adventurous trips in the high Himalayas, you should do training activities like hiking and walk at higher elevations.

You will be used to higher elevations which keep you away from the chance of altitude sickness. However, some people swear by doing yoga and meditation to deal with altitude sickness. Doing poses that turn you upside down make the blood rush to your brain. Pranayama or deep breathing exercise may also help with shortness of breath, bringing more air into your lungs. Practicing all types of different yoga or meditation techniques is a great way to improve your breathing. 

Proper acclimatization

Acclimatization is the best way to be safe from altitude sickness as it gives enough time for our bodies to adjust to the environment at higher altitudes. High altitudes and lower air pressure cause fluid to leak from the capillaries which can cause fluid build-up in both the lungs and the brain. Continuing to higher altitudes without proper acclimatization can lead to potentially serious, even life-threatening illnesses. To properly oxygenate the body, your breathing rate (even while at rest) has to increase. Therefore, you have to acclimatize properly during your climbing or trekking activities in the high Himalayas. Acclimatizing doesn’t mean you have to stay and take a rest, it means you can ascend slowly by avoiding more than 500 meters in a day. And take the rest of the extra days after every subsequent 1,000 meters climb. ·

Avoid smoking, alcohol, and caffeine

Alcohol smoking cigarettes and caffeine can make altitude sickness symptoms worse. With the consumption of cigarettes, alcohol, and caffeine, breathing becomes difficult because you are not taking in as much oxygen. Drinking alcohol, smoking cigarettes, and consumption of caffeine at high altitudes do however exaggerate and enhance the dehydration many feel when they increase their elevation. This can affect one’s physical and cognitive well-being, which may cause him or her unable to walk safely. That’s why it is better to avoid alcohol, smoking, and caffeine consumption to stay hydrated and stay away from altitude sickness. If you need to drink alcohol, you can wait for 24 to 48 hours so that your body can adjust to the environment. ·

Drink penalty of water

Staying hydrated is also very important in preventing altitude sickness. Altitude increases water losses from the lungs due to the cold and dry air. Drink enough water regularly during your climb at higher altitudes. The body’s requirement for fluids is very high at altitude; often exceeding 4 liters of water per day. Water increases the volume of blood to oxygenate. By drinking water or getting hydration, you can increase your blood oxygen levels to help you recover from altitude sickness faster.

Eat high-energy diet

Although high-fat foods are energy dense, fat is not tolerated well at altitude and can worsen the symptoms of Acute Mountain Sickness (AMS). Travelers at higher altitudes are highly recommended to consume food rich in carbohydrates as it is the preferred energy source at higher altitudes. Carbohydrate replaces depleted muscle glycogen, prevents the muscle from being used as energy, and requires less oxygen for metabolism. A high carbohydrate diet can reduce the onset and severity of Acute Mountain Sickness and improve physical performance. Besides this, protein food is also recommended as it carries a high amount of calories which is a source of energy as well. ·

Avoid hard exercise

To exercise at a high altitude means working in an environment with reduced atmospheric pressure. You should take precautions to avoid becoming sick or injured at altitude. At high altitudes, your body needs to work extra hard to take in the same amount of oxygen as you are accustomed to at sea level. Oxygen levels at higher altitudes (above 2,500 meters) are lower than they are at sea level, which will cause your breathing rate to increase and will cause you to become tired much more easily. Therefore, doing hard exercise at higher altitudes should be avoided to stay away from the risk of high altitude sickness. ·

Proper sleep

Altitude sickness usually gets worse at night when you are sleeping as many high-altitude climates are extreme and dangerous. It is a good idea to do a higher climb during the day and then return to a lower altitude to sleep, especially if you plan on climbing more than 1,000 feet in one day. Sleeping at altitude provides enough exposure to stimulating the production of new red blood cells, whilst allowing you to maintain training quality at sea level. Therefore it is good to have proper sleep at lower altitudes or return to a lower altitude to sleep where your body can adjust to the atmosphere as there can be a disturbance in sleep due to high air pressure and the presence of low oxygen in the higher altitudes.

Trek at your own pace

There is a saying slow and steady wins the race so that you can move slowly at higher altitudes by having proper rest. Your body needs about two to three days to adjust to the changes. Altitude sickness occurs if you ascend too high and too fast. Trek or climb as your body capacity as anyone even the people with good physical fitness can get the altitude sickness at higher altitudes. Above 3,000 meters most experts agree that you shouldn’t ascend more than around 300-500 meters in a day. You should allow an acclimatization day for every 1,000 meters of height gain and move slowly upward steadily at a consistent speed. ·

Consult with a doctor before starting the trek

Trekking trail with the Himalayas always goes to higher altitudes and there are no hospital facilities and health institutions for any unexpected incident to arise. If you are taking some particular medicine regularly, you should bring it with you. Moreover, it is better to consult with your doctor who has all the updates about your physical condition or he may have updated the medication list. Any regular medicine prescribed by your physician must be taken along with you for your Himalayan Trekking in Nepal. Concerning your safety, your doctor will recommend the best altitudes till you should trek that your physical condition can attempt.

High Altitude Sickness FAQ

Should I be worried about altitude sickness?
You shouldn’t be worried about altitude sickness as our expert guides will help you in all the possible ways. When the symptoms of altitude sickness are begun, then our well-experienced guide will provide you with first aid and medicine like Acetazolamide which is best to treat altitude sickness, ibuprofen, and paracetamol for headache, promethazine for nausea, and promethazine when you feel sick. If there is an emergency then the guide will suggest you descend faster or take you to the hospital in serious cases.

What increases the risk of altitude sickness?

The risk of altitude sickness increases when the climbers or trekkers ascend quickly at a higher altitude without giving proper rest to a body. A quick change in the air pressure and lack of amount of oxygen in air and people who have a prior history of high altitude sickness as well as people who have a medical problem that affects breathing increases the risk of altitude sickness for any travelers at higher altitudes. What causes altitude sickness? Altitude sickness is caused by low oxygen levels in the air at altitudes above about 2,500 meters. It occurs when the body has not had time to adjust to less oxygen.

Is there any medication to prevent altitude sickness?

Acetazolamide, or Diamox, is the standard medical prophylaxis agent for high altitude sickness. The medication is effective in preventing all types of altitude sickness which include: Acute Mountain Sickness (AMS), High Altitude Pulmonary Edema (HAPE), and High Altitude Cerebral Edema (HACE).

At what height does altitude sickness start?

Symptoms of altitude sickness usually develop between 6 to 24 hours after reaching altitudes more than 2,500 meters above sea level. Normally, the higher chance of altitude sickness starts after ascending 3,500 meters above sea level.

How do you fix altitude sickness?

To fix the high altitude sickness stop at the point where you feel altitude sickness if possible descend to lower the altitude, take enough rest, drink a penalty of water, and take soup high diet soups all these ideas help to fix altitude sickness  

What are the 3 stages of altitude sickness?

There are three stages of altitude sickness which are Acute (mild) or Mountain Sickness (AMS), High Altitude Pulmonary Edema (HAPE), and High Altitude Cerebral Edema (HACE). How do you get rid of altitude sickness? The best way to get rid of altitude sickness is to plan for a higher altitude. The following are the tips to get rid of altitude sickness; Avoid drinking alcohol, smoking, and tobacco consumption Drink twice as much water Acclimate before heading up Ascend slowly Talk to your doctor

What is the fastest way to adjust to high altitude?

You can adjust quickly and safely to high altitudes by following the following step: Drink lots of water Reduce your exercise Get enough sleep Limit your alcohol intake Protect yourself from the sun Eat enough calories Acclimatize after every 1,000 meters above an altitude of 2,500 meters

How long does it take to acclimate to high altitude?

Given time so that your body can adapt to the decrease in oxygen molecules at a specific altitude is known as acclimatization. It generally takes 1 to 3 days to acclimate properly at that altitude. What are the 3 stages of acclimatization to high altitude? The three stages of acclimatization to high altitude are The preparation stage, The ascent stage, and the descent stage.

What happens to your body at a high altitude?

You will likely feel nauseous and light-headed and you may vomit and have a headache. Different levels of altitude sickness have different symptoms: Symptoms of mild, short-term altitude sickness usually begin 12 to 24 hours after arriving at a high altitude.

What is the best medicine for altitude sickness?

The best medicine for altitude sickness is to move to a lower elevation as quickly and safely as possible. At the very least, do not go higher. If symptoms are mild, staying at your current elevation for a few days might be enough to improve the symptoms. It is better to take Acetazolamide before climbing or at higher altitudes.

Who should avoid high altitudes?

Heart patients who are never physically active shouldn’t start being active while at high altitudes. Evidence suggests that heart failure patients should avoid climbing more than 300 to 500 meters a day when in high-altitude locations since drastic elevation changes can worsen the symptoms. Besides this, people who live at low elevations should avoid high altitudes since their body isn’t used to higher altitudes and you have a greater risk for symptoms.