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Travel Science: Beating Altitude Sickness While Traveling

by on August 1, 2012 · 17 comments

in Points Guy Pointers, TPG Contributors

TPG contributor Katharine Gammon is a science writer for publications including WIRED, Popular Science and Los Angeles Magazine. When she’s not jetting to international conferences to interview some of the world’s leading scientific minds, she’s globetrotting herself, exploring unique destinations including recent trips to New Zealand and Southeast Asia. Today she writes about the science of altitude sickness and how travelers can prevent it from ruining their vacation.

Mountain bikers at the Montage Deer Valley outside Park City, Utah, have to contend with high altitude.

Who doesn’t get a thrill climbing a mountain or enjoying a panoramic view from up high?  Unfortunately, the altitude may not give you such a thrill. “Basically altitude sickness feels like a really nasty hangover,” says Dr. Grant Lipman, a Clinical Assistant Professor of Surgery in the Division of Emergency Medicine at Stanford University. “People get severe headaches and vomiting to start, then an altered level of responsiveness, and a rapid heart rate with shortness of breath at rest as things get worse.”

Sounds pretty nasty. One of the issues with altitude sickness is that it’s difficult to predict who will be among the unlucky few that have a truly difficult time with altitude.

No specific factors – such as age, sex, or physical condition – correlate with susceptibility to altitude sickness. Some people get it and some people don’t, and some people are more susceptible than others. “The biggest predictor of altitude sickness is if you’ve gotten it previously,” says Lipman.

Most people can go up to 8,000 feet without any ill effects. However, more than 25 percent of people who travel to high elevations each year, often to hike, camp or ski, will suffer from this condition.

The underlying mechanisms are pretty straightforward: the concentration of oxygen at sea level is about 21%. As altitude increases, the number of oxygen molecules per breath is reduced. At 12,000 feet, there are roughly 40% fewer oxygen molecules per breath. In order to properly oxygenate the body, a person’s breathing rate is forced to increase, even at rest. In addition, for reasons not entirely understood, high altitude and lower air pressure causes fluid to leak from the capillaries, causing 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.

Planning a trip to Machu Picchu? Make sure you’re prepared for the altitude – it sits at nearly 8,000 feet above sea level.

Until now, climbers and travelers have had a few weapons available to combat altitude sickness. They could take dexamethasone and acetazolamide or Diamox, a prescription-only drug – but those drugs had side effects. Lipman thought that other anti-inflammatory medications could help, so he set up a study to test the effectiveness of ibuprofen in helping with altitude sickness.

In the study, 58 men and 28 women traveled to an area of the White Mountains northeast of Bishop, California. They spent the night at 4,100 feet and were given either 600 milligrams of ibuprofen or a placebo at 8:00 am before heading up the mountain to a staging area at 11,700 feet. There, they were given a second dose at 2:00 pm. Then they hiked about 3 miles up to 12,570 feet, where they received a third dose at 8:00 pm before spending the night on the mountain.

Of the 44 participants who received ibuprofen, 19 (43 percent) suffered symptoms of altitude sickness, whereas 29 of the 42 participants (69 percent) receiving placebo had symptoms, according to the study. In other words, ibuprofen reduced the incidence of the illness by 26 percent.

Lipman says that the drug may work by reducing swelling near the brain, which reduces headaches and may help acclimatize travelers to the new altitude. He suggests that people take 600 mg or three 200 mg ibuprofen tablets, like Advil or Motrin, several hours before climbing to a higher elevation. Then he says that climbers should take a day off the drug to allow the body to acclimatize.

However, he warns that the clinical trial didn’t test travelers visiting altitudes above 12,500 feet – base camp at Mount Everest, for example, lies at 17,598 feet. “Most people will adjust in 2-3 days to altitude, but you may not have that kind of time to move slowly on vacation. If you really start to feel sick, the best thing to do is descend to last elevation you felt well at,” he says, adding “there is always more oxygen downhill.”

Even the base camp for Mount Everest lies nearly 18,000 feet above sea level!

Though not overwhelming, Lipman’s findings could prove especially useful for recreationists who have week-long vacations planned at high altitudes. “You don’t want to feel horrible for 15 to 20 percent of your vacation,” Lipman said. He says there are additional things travelers can do to help their bodies adjust to high altitudes. “Stay hydrated – drink until your pee is clear – and avoid sleeping pills or alcohol, which can lower respiratory drive. And most of all, get out there and have fun.”

What about you? Have you suffered from altitude sickness? What happened and how did you get over it?

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  • Matthew Wilson

    As I have traveled across the world, I am a firm believer in probiotics. They keep me going! I have rarely been sick.

  • garkman

    Went to Cusco / Machu Picchu for last New Year’s and used acetazolamide…best choice I ever made – flew in to Cusco ON new year’s eve, was able to go out and have a blast that night, go on tours the next day w/o problems – whole week I was there never had any issues at all while most of the other people I ran into all had at least one very bad day.

  • Skyskers248

    Chewing a bit of coca leaf tea in Peru does wonders for acclimation to the Machu Picchu altitude. :)

  • Shorty

    Pretty hard to beat acetazolamide and sildenafil (Viagra). The acetazolamide shifts your oxygen dissociation from hemoglobin and the Viagra will reduce any cerebral edema that can contribute to your headache. As for probiotics like a previous poster mentioned, you may like them for your gut and that’s great, but they will do nothing when it comes to respiratory physiology.

  • Jetstream007

    ‘Beating altitude sickness (AS)’ is not really what this is about. AS is caused by a physiological change (decrease in pO2 (partial oxygen prssure) and total outside air pressure. Most symptoms are wellknow (headache etc). Taking some drugs to alliviate the symptoms might be all right, BUT, there is no change in the underlying factors! The (by far) most frequent symptoms (shortness of breath, headache) are not dangerous by themselves, but a warning sign.

    However, vomiting, coughing(! this is a bad symptom), any change in consiousness IS dangerous and means you have to act fast: go lower, the lower the better, right at that moment. In a small but significant number of people, AS can and will kill quickly (say in 24 hrs., think pulmonary oedema). Time matters….!

    Good info on: http://www.theuiaa.org/upload_area/files/1/UIAA_MedCom_Rec_No_9_Children_at_Altitude_2008_V1-1.pdf

  • Jetstream007

    This is the link for adults (other post was on kids…):

    http://www.jma-sangaku.or.jp/tozan/medical/document/01_4x4_health_rules.pdf

  • http://osnews.com David Adams

    I live at 7200 feet, in Park City, Utah. I have the opposite effect. When I go on vacation down to sea level I feel like Superman for a few days.

  • Josh_brooks

    I’ve fought this my whole life. No matter how good of shape I was in. Cusco can be a beast, Bolivia is much worse, and I had to do an emergency late night departure from Tibet (5000m). It’s a scary thing when your heart starts beating fast (all night), you get dizzy, and you can’t catch your breath. Altitude sickness is weird. Affects some people and others not at all. Some of the people I was with were getting drunk and fine, whereas I was a mess. Was pumping 4 liters of water a day, sleeping well, and taking ibiprofen. Didn’t help. Just be careful for those going to Tibet/Bhutan, etc. It can be a beast.

  • Miles Who’s Been Twice

    Machu Picchu (MP) is at 8000 ft., and that isn’t a problem. The issue is that most visitors start in Lima (sea level), then fly to Cuzco (approx 12,000 ft.) and spend a day or two there before dropping down to MP. Travelers suffer in Cuzco, not at MP.

    The solution is to spend that first night not in Cuzco, but down in the Sacred Valley (approx. 8000 ft.). Continue on down the Sacred Valley to visit MP. Then, with your body acclimated to 8000 ft., go back up to Cuzco for your visit to that interesting city.

    There are several interesting cities down in the Sacred Valley, including Pisac, Ollanta and Aguas Calientes / Machu Picchu City, and some very large Inca structures, so it’s not like you are wasting any time there.

  • RakSiam

    I had a hard time in Bhutan. Couldn’t do much exertion and was short of breath, sweating profusely when I did. Was bummed to not be able to climb to Tiger’s Nest. But I knew it just wasn’t going to happen. It was my first time at any real elevation.

  • Miles Who’s Been Twice

    As has been mentioned above, but worth repeating: Altitude sickness is no respecter of age, gender or physical fitness. Young persons in top physical condition are just about as likely to get it, or not get it, as physically-unfit seniors.

  • http://www.thefitworldtraveler.com/ Mike

    Acetazolamide or Diamox definitely does have side affects. It’s basically a diarrhetic and makes you urinate. Don’t take it during the evening hours. I hate it when I had to leave my warm cozy sleeping bag to step out into the cold and relieve myself.

    When I was on the Everest Bast camp trek, our guide has pills that were basically a combination of acetaminophen and ibruprohen it did wonders for a headache. I would recommend asking your doctor about taking a combination of these two pills before the trip. I was lucky that my group had two western trained doctors who I consulted before I took the said medicine from our guide.

    If anyone wants to learn more about the specifics about Everest Base Camp, I have a trip review on my blog:
    http://www.thefitworldtraveler.com/a-view-from-the-trail-the-everest-base-camp-trek-experience

  • smitty06

    I have recently found ibuprofen to be very helpful. I am very very altitude sensitive. I have gotten sick on poorly pressurized airplanes (just ask the poor flight attendants that have had to clean up after me).

  • Maury

    I have been to Everest Basecamp and I can vouch that Diamox does work. On the other hand, I climbed Pico de Orizaba in Mexico without Diamox and I got altitude sickness.

  • Dave Op

    In airplanes, what altitude are the cabins pressured to? If planes are pressured to say 8000 ft, and one does not have a problem, then would it follow that one won’t have the issue in same altitude places?

  • Vince Acosta

    Altitude sickeness is serious for me. You struggle for every breath. Dry air might give you nose bleeds. You feel tired and sleepy most of the day. Diamox does not work very well for me. It look me last May up to 1 week to get used to 9100 ft. in the Wet Mountain Valley in Colorado. I slept a lot and drank lots of fuids. I am glad I did not have a full agenda at first.

  • Pingback: Destination of the Week: Machu Picchu, Lima and Cuzco | The Points Guy

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