How to Prevent Altitude Sickness Naturally

04 Jan How to Prevent Altitude Sickness Naturally

If you plan on getting high (literally, I mean) on your next holiday, you’ll want some advice on how to prevent altitude sickness naturally. For sea level peeps like us, heading to the mountains means we need to think about the impact it might have on our health. And as anyone who’s had altitude sickness in the past can attest, it’s one that shouldn’t be ignored.

Because, without a doubt, the sites of Mexico City or the scenery of Machu Picchu and the Colorado Rockies just aren’t quite the same when you feel like rubbish. So let us share exactly what it is and some tips on how to prevent altitude sickness naturally on your next trip.

 

What is Altitude Sickness?

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Altitude sickness is our body’s response to reduced oxygen and changes in air pressure that typically occur at altitudes above 8,000 ft (2,400 m). If you gain altitude too quickly, your body doesn’t have enough time to adjust. This causes what is known as hypobaric hypoxia – simply, a lack of oxygen reaching the tissues of your body.

In severe cases, fluid can build up in the lungs or brain. These more severe altitude conditions are known as high altitude pulmonary edema (HAPE) or cerebral edema (HACE). In most cases the body will adapt, it’s just a matter of time. These adaptations are increased respiratory ventilation, heart rate and blood flow to the brain, alkalising of the blood and increasing intimal smooth muscle the in arteries over several days.

If you move too high too quickly or your body can’t make these changes fast enough, you will suffer symptoms of altitude sickness.

 

Symptoms of Altitude Sickness

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The symptoms of altitude sickness usually begin within six to 12 hours of arriving at altitudes above 8,000 ft (2,400 m). Often described as being similar to a hangover (a really bad hangover by the sounds of it) symptoms can include:
– headache
– fatigue / tiredness
– nausea / vomiting
– shortness of breath
– dizziness / feeling light-headed
– lack of appetite
– difficulty sleeping

These symptoms of altitude sickness are estimated to affect about 25% of people who live at a low altitude and sleep at an altitude above 8,000 ft (2,400 m). The number is closer to 50% once you reach 10,000 ft (3,000 m).

It’s also important to note that being young and fit does not reduce your risk and you could still experience symptoms of altitude sickness even if you haven’t been affected on previous climbs. I’ll also just point out that ladies seem to be less at risk than guys. No-one knows why but I think we can all agree it’s just another sign of our genetic advantage 😉

It’s also worth being aware of the more severe symptoms of high altitude pulmonary edema or cerebral edema (severe altitude sickness). If you experience any of these, forget the Gingko and get yourself straight to the emergency department, stat.
– breathlessness
– heart palpitations
– blue-tinged skin and nails due to lack of oxygen (cyanosis)
– frequent coughing because of fluid in the lungs
– sputum that is frothy or tinged pink with blood from damaged lung tissue
– inability to sit up or walk in a straight line.

 

How to Prevent Altitude Sickness Naturally

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So I think we can all agree that no-one wants altitude sickness. My days of hangovers on holidays are well and truly over and I definitely don’t want fluid build-up in my brain or lungs… Lucky for you, we’ve done the research (most of it first-hand), so you can learn how to prevent altitude sickness naturally. Here’s what you need to do:

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Take time to acclimatise.

If you read above about what altitude sickness is, you’ll understand why time is the most important factor in avoiding it. It is time that allows your body to adapt. This means you have to give yourself a few days to acclimatise.

If you are flying or driving directly to somewhere above 8,000 ft (2,400 m) (e.g. Cusco or La Paz) you’ll need to spend two or three days doing not much at all. This is even more important if you are traveling internationally on a long-haul flight and/or changing time zones. Your body needs time to get used to your new environment and sleeping patterns.

When we flew into Cusco (11,100 ft / 3,400 m) before hiking the Inca Trail in 2015, we arrived in the morning and spent the day relaxing in Cusco. The next day was spent mostly sitting on a bus at altitude and checking out the Sacred Valley. We then slept the night at Ollantaytambo near the start of the trail (9,200 ft / 2800 m) before beginning the hike the next morning. That gave us two full days before beginning any serious exercise and, on top of the other strategies listed below, we didn’t get any symptoms of altitude sickness at all.

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Don’t rush it.

Once you start hiking above 8,000 ft (2,400 m) you need to take it slow. The altitude, not the pace, that is. A good rule of thumb is to ascend no more than 1,000 ft / 300 m per 24 hours. It’s also suggested that you spend an extra day acclimatising for every 3,300 ft / 1000 m you climb.

These rules are really important when it comes to sleeping at altitude. Which brings us to the next tip…

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Climb high, sleep low.

The ‘climb high, sleep low’ philosophy is pretty simple. Even if you walk at altitudes above 300 m / 1,000 ft higher than the previous day, make sure you make your way down to the right altitude before sleeping.

Gentle walks to higher altitudes before descending to sleep are a common technique used on rest days during longer hikes – like the hike to Everest Base Camp. Which we never made, care of an earthquake in 2015… one day.

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Stay hydrated.

Staying hydrated is another important tactic to prevent altitude sickness naturally. Drinking water is key (even if you do not feel thirsty) for a few reasons:
> Humidity is lower at higher altitude. This means sweat evaporates faster and can cause you to misjudge how much water you are losing through physical exertion (no sweat, no effort, right? Wrong).
> You lose more water through respiration at high altitudes. Because of the lower oxygen levels, you breathe faster and more deeply, causing you to lose up to twice as much water through respiration compared to at sea level.
> Altitude has a diuretic effect  i.e. it makes you pee. Your kidneys play an important role in the body’s adaptation to altitude and in the process can cause you to lose more water through urination.

And while you’re keeping your fluids up, here’s a few to avoid:
– Alcohol. It’s a depressant and can slow your breathing rate and cause dehydration.
– Caffeine. Caffeinated drinks, like coffee and energy drinks, can also lead to dehydration.

When it comes to staying hydrated at altitude, it’s recommended to drink an extra 1 to 1.5 litres of water per day to what you would at sea level. The best way to test if you’ve had enough water is to check your urine. If it’s dark rather than light or clear, you are dehydrated and need to drink more.

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Eat. Mostly carbs.

What to eat at high altitude? Carbohydrates, is the simple answer. But you should keep it in balance, so make sure your main meals still contain some protein and healthy fats. But here’s a few reasons why skipping the Atkins diet at altitude is a good idea:
> Carbs require less oxygen for metabolism and digestion than fats and protein.
> At lower oxygen levels (e.g. at altitude) we use glucose (via glycolysis) for energy at a faster rate.
> Altitude affects our sense of taste, with most climbers preferring the taste of carbs rather than fats.

It’s also worth noting that altitude can trigger a lack of appetite, causing people to consume up to 40% less calories. So while you might lose your appetite at first, it’s vital to eat plenty of food, even if you are not hungry. After all, you burn more calories in cold, high altitude environments even at rest.

In terms of a rough macro split, we like to aim for 60-65% carbs, 20-25% protein and 15-20% fats when at altitude.

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Breathe Deeply.

For the yogis, this means practising pranayama. Slow deep breathing at high altitude has been shown to increase blood-oxygen levels and ventilation efficiency. To get the best effect, breathe in and out through your nose and take slow and long deep breaths until your stomach expands. The trick is to do this without breathing too slow and creating stress or tension.

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Use Ginkgo Biloba.

If you’re looking for an extra boost to prevent altitude sickness naturally but don’t like the idea of drugs or side effects, Ginkgo Biloba is for you. This natural supplement is a herbal extract from the leaves of the Ginkgo tree and has been used for thousands of years to treat a range of illnesses.

It has been scientifically studied for its beneficial effects on altitude sickness, with great success. This study and this study are both good examples. While some websites will say the evidence is inconclusive, it’s important to remember that the source and composition (read: quality) of the Ginkgo is important to it’s effectiveness for altitude sickness prevention. So go with a quality recommended brand, not the cheapest version you can find online.

It’s best to start taking the Ginkgo Biloba 4 – 5 days before reaching altitude and for the duration of your time at altitude. The recommended dose is 80 – 120 mg twice a day, morning and evening. Because it works by thinning the blood and increasing circulation, there are some contraindications for people on medicines that do similar things. As always, it’s best to check with your health practitioner during a pre-travel health consult.

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Chew Coca leaves with the locals.

As is often the case, the locals know best. And if you are traveling to Central or South America for a hike, you may wish to get on board with the local custom of chewing coca leaves. Be aware though that even one cup of coca tea can result in a positive cocaine drug test, apparently. So it’s best avoided by professional athletes and anyone who might be subjected to a drug test for work.

But for the rest of us, you can either chew the leaves or make tea. Perfect for cold mornings in the Andes. Yes, it’s 100% natural and coca has been shown scientifically to induce biochemical changes that enhance physical performance at high altitudes, including on treks to Everest Base Camp.

 

What about Altitude Sickness Medication Alternatives?

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Many travelers to high altitude will be prescribed the drug acetazolamide (Diamox) by their local doctor because of its ability to improve oxygenation of the blood. Unfortunately, as with most drugs, it comes with a list of common side-effects.

These side-effects include nausea, diarrhea, fatigue, frequent urination and fever. Which sound a lot like the kind of symptoms you’re trying to avoid on a multi-day hike. We were fortunate to have learnt how to prevent altitude sickness naturally before our first high mountain trek and so have never taken it ourselves. But we’ve been on hikes with people who have and the outcome wasn’t pretty for quite a few of them.

There is another drug, dexamethasone (Ozurdex), which has also been used to prevent altitude sickness, but with mixed results and its own list of side-effects that include ulcers, cataracts and depression. No thanks.

 

Altitude Sickness Treatment

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Prevention is obviously the best treatment. Once you’ve got altitude sickness, most of the methods here won’t do a good job at improving symptoms. While you should still follow the same tips, the best thing you can do is to descend.

Depending on the severity of symptoms, most people find that with an extra day or two at the same altitude, their body has time to adapt and they can resume activities. For anyone who experiences altitude sickness, wait up to 12 hours for symptom improvement at the same altitude. If symptoms don’t improve, descend at least 1,000 ft (300 m) and reassess your symptoms after 12 hours.

If you’re not able to descend because of symptoms or weather, treat with oxygen if available. Some places will also have portable hyperbaric chambers at rescue stations or carried by rescue workers that should lead to pretty rapid symptom improvement.