How to Prevent & Treat Altitude Sickness

Millions of people travel to high altitudes annually, especially in the Himalayas, Alps, Andes and North American Rocky Mountains. Traveling to a higher altitude without gradually acclimatizing often results in altitude sickness, and is most prevalent at 8,000 feet (2500m) or higher above sea level. My first experience with altitude sickness was on vacation to one of the world’s seven wonders, Machu Picchu. Getting to Machu Picchu requires transiting through Cusco, the old capital of the Incan empire, which is located at 11,200 feet (3400m) above sea level. Most persons arrive in Cusco by flight which gives the body zero time to acclimate naturally. This post covers what is altitude sickness, how to prevent it and natural + medical remedies to treat the condition.

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What’s Inside This Post

1. What Is Altitude Sickness?
2. How to Prevent Altitude Sickness
3. Natural Remedies for Altitude Sickness
4. Treatment + When to See a Doctor
5. My Experience With Altitude Sickness in Peru

What Is Altitude Sickness?

Altitude sickness, also called acute mountain sickness (AMS), is a condition which occurs after a person is rapidly exposed to high elevations. The partial pressure of oxygen gets less at higher altitudes which means that it is more difficult for oxygen to bind to haemoglobin, the oxygen-carrying molecule in the blood. Simply put, it is harder for your lungs to pick up oxygen at high elevations. The body can acclimate to this over time by making more haemoglobin and the lungs get specially adapted to pick up oxygen more easily. However, since most persons will find themselves in higher altitudes after a few hours with a quick flight instead of gradually over days or weeks, altitude sickness is pretty common.

The body responds to this sudden increase in altitude in different ways. Symptoms may include headaches, nausea, vomiting, fatigue, confusion, difficulty sleeping, and dizziness. Some persons compare altitude sickness to the feeling of a bad hangover. Shortness of breath may occur as your body takes more breaths to get enough oxygen. Age, fitness level or gender do not predict your chances of getting altitude sickness. Even the fittest of athletes may develop shortness of breath and see significant reduction in their abilities if placed at a higher altitude without time to adjust. However, you are more likely to develop altitude sickness the more rapid your change in elevation occurs, the higher up you go, if you have a high degree of activity at this new altitude without acclimating and of course, if you already had a prior episode of altitude sickness. Symptoms usually disappear within two to three days.

How to Prevent Altitude Sickness

As I mentioned previously, there is no way to predict who will develop altitude sickness. Therefore, we all should try to prevent it when traveling to higher elevations. The best way to prevent altitude sickness is to travel to altitudes above 2,500m slowly. This means to avoid flying directly into areas of higher elevations, and avoid climbing more than 300m to 500m per day if hiking. Also, try to have a rest day for every 600m to 900m ascended. However, sometimes we don’t have that luxury of time and must travel to higher altitudes quickly. Here are six tips to prevent altitude sickness:

1. Stay hydrated. Start drinking at least 2 litres of water daily for one week before traveling, and continue hydrating well during the trip.
2. Avoid drinking caffeine and alcohol. These substances predispose one to dehydration.
3. Avoid smoking. Your alveoli already have their own battles to fight with gaseous exchange.
4. Avoid strenuous exercise for the first 24 hours.
5. Eat a light but high-calorie diet. High carbohydrate and potassium intake (e.g. from ripe bananas) can be helpful.
6. Consider getting acetazolamide from your doctor. Acetazolamide (Diamox) is FDA-approved in the USA to prevent and treat altitude sickness, however the drug is not licensed for this use in the UK and several other countries. That being said, a general practitioner can still prescribe acetazolamide off-label in those countries for altitude sickness as it’s been proven effective. Start taking acetazolamide 1-2 days before traveling, and continue taking it for 2 days after landing at a higher elevation. Take it for longer if symptoms of altitude sickness develop. A natural alternative to acetazolamide is taking gingko biloba supplements instead. Gingko biloba was proven effective at decreasing altitude sickness in a 2007 Chilean study.

Natural Remedies for Altitude Sickness

People have inhabited mountain ranges above 2500m for centuries and have found their own natural remedies for preventing and treating altitude sickness. Here are five indigenous + natural remedies to include in your vacation at higher elevations:

1. Ginger and peppermint are both proven to reduce nausea. Suck on ginger lozenges or peppermint candy to prevent the nausea and vomiting of altitude sickness.
2. My favourite, coca Leaf. Coca is the plant from which the illicit drug cocaine is made, and is only legal in Peru and a few of its Andean neighbours. It does not cause addiction or the other negative effects of cocaine, however one cup of coca tea results in detectable concentrations of cocaine metabolites in the urine for several hours. Chew on the leaves or make a tea with them to reap the benefits.
3. Garlic and cloves. Garlic enhances blood flow and prevents nausea and dizziness. Cloves also help the body to utilize oxygen more efficiently. Both can be eaten raw while on the trail, or enjoy garlic soup to combat the effects of altitude sickness.

Treatment + When to See a Doctor

Despite natural remedies and your best efforts at prevention, you may still end up with mountain sickness. For the most part, this is self-limiting and resolves within two to three days of being at a higher elevation. Here are some over the counter medicines you can pack with you or purchase from the nearest pharmacy.

1. For headaches— Paracetamol (Tylenol/Panadol) and NSAIDs such as ibuprofen (Advil). Take as directed on the packet.
2. For nausea & vomiting— Dimenhydrinate (Gravol/Dramamine) and promethazine. Take as directed on the packet.

Combine these medicines with the aforementioned tips to get through your altitude sickness as quickly as possible. However, a small percentage of individuals may need medical assistance. If shortness of breath persists at rest and gets very severe, or a person becomes confused, has a headache not responding to painkillers or has decreased responsiveness, medical attention should be sought right away. Medical treatment for altitude sickness may include oxygen, hyperbaric treatment and medicines such as acetazolamide and dexamethasone. However, definitive treatment is for the affected person to be brought to a lower altitude. Symptoms resolve immediately upon return to a lower altitude.

My Experience With Altitude Sickness in Peru

My brush with altitude sickness was mild but frightening nonetheless. Upon arrival in Cusco, I immediately noticed that the air was thinner. I took long deep breaths to get enough oxygen and felt fine at rest, but had some shortness of breath while exploring Cusco on foot and once I had to go up any sort of incline. Usually I can climb at least 3 flights of stairs before becoming a bit winded but in Cusco I was winded by the first flight. I spent 24 hours in the city before leaving for Aguas Calientes by train to get to Machu Picchu. I felt fine walking around Aguas Calientes which is lower than Cusco at 6070 feet (2040m). However, my shortness of breath returned while hiking to Huayna Picchu, the highest point of Machu Picchu which is 8835 feet (2693m) above sea level. Ascending 2,000 feet in an hour and hiking steadily uphill on rough uneven stone steps was challenging for my poor lungs.

Returning to Cusco by train resulted in another sudden increase in altitude which made me nauseous and very short of breath, even at rest. This gave both my boyfriend and I a scare, and I couldn’t help but think about more sinister and life-threatening causes of shortness of breath like high altitude pulmonary edema (HAPE) or a pulmonary embolus. Both conditions would require hospital admission and rack up massive bills. The thought of having to explain my symptoms in a foreign language to a Peruvian doctor made me nervous, BUT thankfully my worst fears never materialized. Instead, I had an uneventful flight back to sea level in Lima and my symptoms disappeared. My alveoli were happy.

I prophylactically took Algic-P, a combination painkiller of aceclofenac (similar to Cataflam) and paracetamol (Panadol) to prevent getting a headache in the first place so perhaps that’s why I didn’t experience one. I took it before going out for a walk in Cusco at 11,200 feet above sea level, and again before hiking to Huayna Picchu. I didn’t want to wait for a headache to start then have to suffer before the tablets kicked in. I drank lots of coca tea at my hotel and train station, hydrated often and had a few ginger lozenges to prevent nausea. I also took a vitamin C tablet almost daily. Prevention is better than cure!

Wrap Up

Bookmark or pin this post for future skiing or mountain climbing trips. I’m sure it’ll come in handy. Look out for two more posts in my Peru series and catch up on previous posts you may have missed. Lastly, remember to subscribe for new adventures and check out my Amazon store.

‘Til next time.

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