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Summit Like a Boss: 5 Tips On How to Prevent Altitude Sickness

By Olivia Pedersen

May 21, 2015

Summit Like a Boss: 5 Tips On How to Prevent Altitude Sickness

By Olivia Pedersen

May 21, 2015

As rad as trekking in the Himalayas may be, as glorifying as summiting white peaks is, as awesome as that selfie will look on social media to express your level of badassness to the world, it’s not going to be a reality unless the proper precautions are taken to ensure a successful trip.

Some might ask: what is considered to be high elevation?

Generally, high elevation is considered to start at 8,000 feet above sea level.

There is no way to predict how your body will react in high elevations or how it will acclimate to the altitude. On average, it takes anywhere from 3–5 days to acclimate to 8,000–9,000 feet. The only telling factor for knowing how your body will react to high elevations is previous experience. If you have been exposed to or lived in high elevations, you will probably have an easier time adjusting than a person who has never been at high elevation before.

Below are five guidelines that will help you acclimate with grace, prevent altitude sickness, and reduce the possibility of helicopter rides — we want none of those helicopters!

Slowly, Slowly

Take it nice and slow. Allot plenty of time for adjusting. By walking at a slow pace, you give your body time to adjust to the change in oxygen levels it is receiving. The number one way to ensure that you will have issues adjusting to elevation gain is by going too high, too fast. Acclimatizing is a constant thing if you are continuing to gain elevation — once you become acclimated at one elevation and then you go higher, your body will need to reacclimatize to the new altitude.

Stay Hydrated

Increased activity means more sweat, which tends to evaporate quickly at higher altitudes, so you may not realize the amount of water you’re losing. The higher the elevation, the faster and more deeply you breathe, so you lose water through respiration twice as fast as you would at sea level. With that in mind — drink water. Plenty of it. While trekking, I tried to drink around 5 liters of water from morning to night at 5 hours of walking a day. The catch 22 here is that it’s not just about consuming mass amounts of water. Even if you are in taking the proper amount of water, you could simultaneously be depleting your body’s blood sodium levels.

There is such a thing as overdosing on water. While drinking a lot of water to stay hydrated is good, drinking too much water without replenishing electrolytes can also cause health issues such as cramping, nausea, and, in extreme cases, death.

Electrolyte and mineral supplements are very effective in replenishing your body to healthy levels. I used Vega Sport for electrolyte supplements and Trace Mineral Drops for mineral replenishment.

View of white peaks
Lounging in the clouds

Walk High, Sleep Low

Above 9,000 feet, it is important to do an altitude-check hike. Once you get to your night’s stay, take a hike 1,000 feet or higher than you will be sleeping that night. This will help you sleep easier and avoid complications. Remember to keep track of how much elevation you are gaining in a day. It is dangerous to sleep more than 1,000 feet higher than you slept the previous night when you are above 10,000 feet.

To simplify it:

  • 1,000 feet of elevation gain = Walk High, Sleep Low (i.e., only sleep 1,000 feet higher than you did the previous night, with a climate hike check of +1000 feet)
  • After 3,000 feet of elevation gain = Rest day

Altitude Acclimation Medicine

Now for the big overlying question that every trekker asks themselves (hopefully) before heading out on a high elevation excursion.

“Do I or don’t I take altitude medication?”

It is important to ask yourself this question BEFORE leaving on your adventure, because it is a preventative care medication that needs to be started a few days before you are at high elevation. Some considerations when making your decision are: have I been to a high elevation before? What is my time frame? Will mild AMS symptoms freak me out and in reaction cause me to be unnecessarily paranoid? Do I even want to deal with mild AMS symptoms? Do I want to risk creating symptoms from taking the medication?

Once you've weighed your answers, consider talking to a doctor for more information. Here's a brief explanation on how it works:

Acetazolamide (Brand Name: Diamox)
It is used to decrease symptoms of Acute Mountain Sickness and speeds up the time that it takes for the body to acclimatize.

Recognize the Symptoms:

At 8,000 feet or higher, you need to be extra aware of how your body is doing, and make sure you are paying attention to symptoms.

Acute Mountain Sickness (AMS) is the most common altitude sickness and is resolved within 1-3 days. Symptoms include headache, fatigue, loss of appetite, nausea, and vomiting.

If you have early symptoms of AMS, listen to what your body is trying to tell you. Take a rest day, do NOT gain any more elevation, and drink lots of fluids but NO alcohol or other sedatives. When in doubt, or if you can tell symptoms are getting worse, descend, descend, descend!

If you don’t, your case of AMS may turn into HACE.

High-Altitude Cerebral Edema (HACE) is unresolved AMS, a condition when your brain is not receiving the oxygen it needs. Although rare, if you start to act like a lost, confused, drunk person you need to descend 1,000 feet immediately.

High-Altitude Pulmonary Edema (HAPE) can occur congruently with AMS and HACE or by itself. This is when your respiratory system is not getting the oxygen it needs. Initial symptoms include severe lack of breath during moderate activity; late symptoms include a severe lack of breath during no physical activity, a cough, and fatigue. In this case, descend immediately.

If you have late symptoms of HACE or HAPE descend immediately! HAPE and HACE can cause permanent damage to the body and, in severe cases, death.

For more info about AMS, HACE, or HAPE check out these reliable resources:

The Center for Disease Control

Mayo Clinic

In my experience, if you walk slowly, stay hydrated, and get a proper amount of rest days in (1 day per every 3,000 feet), then you should acclimatize just fine and summit that pearly white peak you’ve got your eye on without incident. If you have never been to 8,000-plus feet, I would suggest going to high elevation somewhere in a generally local proximity, and see how you do. That way, you can figure out how easily your body can or can’t adapt to high elevations before you spend a couple thousand dollars to fly to a foreign country and end up in a remote place in the Himalayas with worsening symptoms. But if you do get sick, just remember, descend, descend, descend!

Altitude explanation sign

Continue to Trekking the Himalayas: Episode 4

In regards to the Spring 2015 Nepal Earthquakes:

I am deeply grieved by the many deaths and injuries caused by the devastating earthquakes in Nepal. My prayers go out to those lost and to those that have lost friends and family close to them.

It is during tragedies like this that we must come together to help our brothers and sisters that are now at the mercy of the elements. While writing my narrative on trekking the Himalayas, my intention was to bring awareness and understanding to the astounding beauty that inherently lives in every aspect of Nepal. I invite you to join Revant Optics, through Doctors Without Borders or one of the many other reliable relief agencies in providing aid to the survivors and restoring that beauty.

Sincerely, Olivia

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