NATURAL MEDICINE: The high altitude hangover

By on May 19, 2015

What is High Altitude Sickness?

For those visiting the lovely valley of Jackson Hole, or those of us who live here and explore the many mountain peaks, being aware of high altitude illness is vital. High altitude is defined as between 8,000 to 12,000 feet above sea level and it’s at this elevation that people often begin experiencing sickness. That’s not to say that you can’t experience this at lower elevations as well. Altitude illness has three major categories. The first is called acute mountain sickness. The second is high-altitude pulmonary edema. And the final is high-altitude cerebral edema. Symptoms of mountain sickness are often described as being like a “hangover” – with a headache, fatigue, nausea, decreased appetite and insomnia. High-altitude pulmonary edema is a condition where fluid builds up in the lungs and causes a person to cough, feel breathless with exertion and eventually feel breathless at rest. High-altitude cerebral edema is a condition where the brain swells with excess fluid. A victim may report feeling confused, lethargic, drowsy, and might have difficulty maintaining their balance. Acute mountain sickness is not considered life threatening, but is a precursor to developing the two more advanced conditions. Once a person develops those they need to descend immediately.

What happens at high altitude?

When traveling to high altitude, air pressure, humidity and temperature drop, while ultraviolet radiation increases. When exposed to these conditions, there is increased risk for hypoxia or low oxygen in the blood, and increased demands on the body for energy. The symptoms of high altitude illness result from this oxygen deprivation. Symptoms usually begin around 6 to 12 hours after arrival at high elevation.

What increases your risk?

Your susceptibility for developing high altitude illness is dependent on many factors. Your genes are largely responsible for your likelihood of developing high altitude sickness and how well you manage at high altitude. No amount of physical fitness can change this fact. There are no tests to help determine if you are more at risk for high-altitude sickness compared to anyone else. For the most part age does not affect high-altitude illness except for a slightly decreased risk in people over the age of 50. This may be due to the fact that younger people tend to “attack hike” and ascend at a faster than optimal rate. Other factors that influence high-altitude sickness are the rate of ascent, how high you plan to go, and how long you stay there. Faster ascent and longer trips at altitude may equate to more symptoms.

How to prevent High Altitude Illness?

Acclimatization, or a slower ascent, prevents acute mountain sickness while improving sleep, general well-being and exercise performance.

The Center for Disease Control has these recommendations for acclimatization:

The best way to prevent high-altitude illness is to ascend slowly. Don’t ascend from a lower altitude to above a 9,000 feet sleeping altitude in a single day.

After you are at an elevation of 9,000 feet or above, the next sleeping altitude should not be higher than 1,600 feet per day. Don’t continue to ascend to sleep at a higher elevation while experiencing symptoms.

Do only mild forms of exercise during the first 48 hours.

Avoid alcohol, a respiratory depressant, for the first 48 hours.

High altitude exposure for two nights or more within a month of a trip is helpful

A prescription of Diamox to speed up acclimatization is often considered but side effects such as drowsiness, lethargy, vision changes, numbness of the extremities and more are possible.

Naturopathic Prevention

Beyond following the CDC’s recommendations, here are a few naturopathic tips to prevent high-altitude illness:

Drink 8 to 32 ounces of water every hour depending on how much you are sweating, what the temperature is, and how hard you are breathing. The color of your urine indicates your hydration status; yellow urine is not a good sign of hydration; clear-colored urine is.

Include electrolytes in your water. This will optimize your absorption of water and aid you in maintaining important minerals like potassium and sodium in your body.

Eat — a lot. You use a lot more calories at elevation than you do at sea level. Eat a snack combo of carbohydrates, protein and fats every one to two hours or when you feel weak or fatigued

Avoid diuretics such as coffee or caffeinated tea. These will dehydrate you and increase the likelihood of developing altitude illness.

Take daily antioxidants such as Vitamin C and Vitamin E. They will reduce the effects of altitude sickness.

Take Ginkgo biloba. This flavonoid increases blood flow and oxygen to the brain.

Take Rhodiola or Ginseng. These herbs are known as adaptogens and help the body to endure stress.

Take ginger. Ginger helps with nausea and prevents vomiting which are common symptoms of acute mountain sickness.

Do deep breathing and pressure breathing exercises. Do slow and deep breathing while at altitude to increase the depth of your breath optimizing the oxygen intake. For pressure breathing, purse your lips while exhaling to force out carbon dioxide. This allows for easier oxygen exchange in your lungs.

Be aware while at elevation, and know the signs and symptoms of altitude illness. If you develop the “hangover-like” symptoms of AMS, you should consider descending. Rest for a period of time at the same elevation and descend if your symptoms persist or worsen. You can expect a full recovery in 1 to 2 days from these symptoms once you descend, rest and hydrate. If you develop the more severe symptoms of high-altitude cerebral edema or high-altitude pulmonary edema, immediately descend and seek medical attention.

Due to possible side effects of medications or supplements, and possible preexisting medical conditions, I would recommend consulting with a doctor before traveling to high altitude. With a bit of awareness you can prevent high-altitude illness and enjoy your trip to the mountains.

McKenzie Steiner, ND is a naturopathic physician with a family practice in Jackson Hole. Visit her on the Web at drmckenziesteiner.com.

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About Dr. McKenzie Steiner

One Comment

  1. Genius Envy

    May 23, 2015 at 2:51 pm

    One research-vetted strategy to prevent altitude sickness is ibuprofen. Google “ibuprofen + altitude sickness” for the protocol at the Stanford.edu web page. Their study showed a benefit with the first dose of ibuprofen taken just 6 hours before starting your ascent ( like bedtime, before starting your hike the next AM) My husband and I (young 60’s) followed the protocol for our horse packtrip to the Popo Agie part of the Winds. Since one can drive (after paying the Tribal fee) to Dickinson Park at 9,200 ft, you have ascended at a fast clip. And it’s plenty of uphill from that initial 9,200 ft. We never got altitude sickness. Always take ibuprofen with some food to protect your stomach.

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