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From my personal anecdotal experience, I've seen first-hand some horror stories with altitude sickness. I will always tell people now to acclimatise, drink fluids, and follow the local tricks like chewing coca leaves in Bolivia. However, as far as I'm aware, the only "cure" for it is still to come down to a lower altitude (or pressure chamber).

For the most part, it doesn't matter how fit or healthy you are - it is seemingly random who it affects, and you can be fine one time and terrible the next.

I've been lucky myself to only ever get a little dizzy, out of breath and have headaches, and that's in several trips over 4000m.

What do you use to avoid altitude sickness, or have you seen methods which serve to delay the effects, avoid symptoms or generally get through it OK?

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Since I have suffered minimising altitude sickness while traveling I would say it is quite on topic. +1 –  andra Dec 20 '11 at 5:24
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We have lots of past on-topic questions about malaria, dengue, and "Is it safe to drink the water in X?" Common health issues likely to be faced by a traveler are totally on topic IMO. If it helps your outlook on this question, altitude sickness is relevant to simply flying on a plane, since planes in some remoter parts of the world are not pressurized and may be flying at altitudes sufficient to bring on sickness. –  Jonathan Van Matre Dec 20 '11 at 13:35

6 Answers 6

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I travel & trek regularly between 3000-5000+ meters , and I find altitude sickness highly predictable : practically everyone I've seen sick have been outside safety guidelines . First night between 2000-3000, third night still below 4000 , and max 500 meters higher in sleeping altitude for every night ...end of all major problems.

Diamox not only works, it is recommended for direct flights to 3000+ locations like Cusco, Lhasa, Leh etc.--see he guidelines from CDC or ISMM. I don't like the side effects, but the cure is definitely better than the disease , and I didn't hesitate to use it for example on the road to Lhasa when it became necessary. Like all medications there are a few who can't take this, so discuss this with a doctor.

Water does not work, beyond avoiding dehydration headaches, think around one liter extra per day. Altitude sickness is edema, i.e. excess of fluids in the tissues, and you won't prevent this by pushing in more fluids in to the system. In fact you can cause the exact same symptoms by binging on water. More on this here.

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altitude sickness is only in part predictable. Different persons react quite differently to the same situation. Heart patients, those on blood pressure medication, people with respiratory problems (even minor ones they may not know they have) are all far more likely to suffer symptoms than others, but it's not limited to them. But yes, go up slow, go down slow (a problem of course when flying to high altitude airports from the lowlands, which is why the aircraft pressurisation is adjusted to provide some relief on those flights). –  jwenting Jan 18 '12 at 6:55
    
The one single factor that is most important is the rate of ascent , as in the guidelines . In every group that goes outside guidelines you´ll see different degrees of altitude sickness , in every group that stays within you are very unlikely to see any major symtoms. Just being on BP medication puts you in a risk group : a wild generalisation. Asthmatics generally do very well at altitude , a fair number employed in building the railway to Lhasa and it turned out well. Going down fast (like 5000+ passes on Ladakhi roads) is a non-problem , actually recommended before you get develop AMS. –  vistet Jan 19 '12 at 11:06

The best thing you can do is acclimatization. This means you should adjust your body gradually to the height. This can be done for example by increasing the height you're staying from day to day. Another very important fact that is widely used by mountaineers is that you should always sleeps some meters below the highest point of the day. So for example you reach the height of 4000 meter where you plan to spend the night. Before going to sleep you should if possible gain another 200 - 300 meters, spend some time there, then go down and sleep at 4000 meters.

A lot of mountaineers also use Acetazolamid (Diamox) which can be taken preventive. But it's use is discussed controversialy because it has a lot of side effects.

Additionally to that you should drink a lot, but no alcohol and you should also take care of you're nutrition. It is very important that you force yourself do not use a lot of power. (this is particularly important when climbing a high mountain. You have to force yourself to walk slowly enough). If you feel slight symptoms it isn't necessary to do anything, but if it gets worse you should go down to lower altitudes as soon as possible. If it is really bad, you should immediately seek medical help, because it can kill you.

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AFAIK (I'm not a doctor), Diamox is not for preventive usage but to treat symptoms of altitude sickness while you are going down. There is Coca in homeopathic doses however that may be helpful for preventive. –  dolmen Dec 20 '11 at 20:12
    
Yes, but afaik some climbers misuse it as a preventive medicine. –  RoflcoptrException Jan 12 '12 at 23:07
    
If you search for acetazolamide in Google Scholar, you'll find that its preventive use was known already in the 1960s. There are lots of false rumors around, mainly because altitude sickness is an obscure subject with not too many experts. My take is that you generally don't need any preventive medication. On the other hand, if you intend to do something stupid or otherwise believe that you are a special case, go see a doctor. Not just any doctor (they are probably almost as ignorant as everyone else), but someone who actually knows something about high altitude medicine. –  Jouni Sirén Dec 15 '13 at 8:52

First of all DON'T listen to tour operators. I made this mistake when I went to San Pedro di Atacama (Chile). On the first day I bought a tour to >6000 m. I suffered a severe form of altitude sickness. Afterwards I could judge on the pictures taken that the scenery was breathtaking. While at location I only felt miserable. I needed 2 days to recover, which was a waste of time. I did miss quite some other things to do while there. While there I talked to other travelers and they told me that it was plain stupidity to go on the advice of tour operators. They don't think in terms of returning customers. As usual there are good ones that suffer from the bad ones here, but since then I prefer to listen to peers.

In the same week I also went to the geysers which also were at high altitude. Then I took the advise to drink liters of "mate di coca" which is sold at every bar there. Don't worry, although this tea is made from the same ground material as cocaine, you need tons of these leaves, to make cocaine. It could also be, that my body got adjusted to the altitude in the days after the first altitude sickness, but I enjoyed my trip to geysers to the fullest.

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I suppose that were not coming from Bolivia's altiplano (~4000m) when you came to San Pedro. However even from there you could have encountered altitude sickness. –  dolmen Dec 20 '11 at 20:17
    
What did the tour operators tell you? –  Mark Mayo Mar 14 '12 at 22:21

I think Mark already mentioned most things you can do in his question.

There is also some medication you can try. In Bolivia this stuff was pretty cheap (as was most other medication) and I assume it is readily available in places where it is needed.

I also like to emphasise his point about the randomness of mountain sickness, just because you are fine in one place, doesn't mean you are safe up to that altitude.

I went up to 5500 meters and spent months in places over 3500 meters without any problems, but then one time at about 4200m I experienced some symptoms. In that case the medication helped.

Also I met locals in Ecuador who lived all their life over 3000m and got pretty sick by going up to 4500m.

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There is plenty of high altitude to be had in the great indoors as well as the great outdoors. When I taught a course in Colorado Springs, I was astonished at how thirsty I was. I always have a bottle or two of juice or water a day when teaching (standing and talking is actually thirsty work), but I drank both of them by morning coffee break. I replaced them, and drank both by lunch, and so on. Eventually I commented to my students how I could not understand why I was so thirsty. They said they assumed I had been told to drink that much, and that it was in fact the best way to prevent altitude sickness. I didn't have any ill effects (other than raising some eyebrows when I submitted my expenses) and would recommend drinking many litres a day more liquid than you would at your own altitude.

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I would guess the low humidity had more to do with this than the altitude. –  Nate Eldredge Dec 20 '11 at 16:46
    
Strong altitude sickness usually occurs above 3000m. Colorado Springs is much lower (1839m). –  dolmen Dec 20 '11 at 20:21

Since no one has said the obvious yet, I'll go ahead. The best way to avoid or minimize altitude sickness is to avoid high altitudes. Thank you, I'm here all week.

I did actually want to add one other traveler-related piece of advice on this topic. Don't go scuba diving within the unrecommended time before flying on a plane. Here is a link to PADI's recommendations: http://www.padi.com/rdp/erdp/General_Rules_using_the_eRDP.htm PADI is the world's foremost organization on scuba diving. Although I have heard some dive instructors make more conservative (longer time) recommendations. Certainly the argument is made here http://answers.yahoo.com/question/index?qid=20071130220055AAIdoa9 that this general recommendation is just that: general. Better advice might be to follow your particular guide's advice and always go with a reputable guide if you're not comfortable on your own. If you are comfortable on your own, you shouldn't need this advice! ;) Airplanes usually pressurize the cabin equal to the atmospheric pressure at 8,000 ft. http://www.who.int/ith/mode_of_travel/cab/en/

And to bolster/undermine what other have said:

I live at 5,000 ft and travel and stay at altitudes above 8,000 ft every 6 mos or so. Not enough to get "permanently" acclimated to the higher altitude though. My relatives from about 1,000 ft come to visit here (5,000 ft) and can definitely get altitude sickness. DRINK WATER. I've gotten to the point where I can tell I'm getting a high-altitude headache because I haven't had enough water at the higher altitude. I don't agree with those who say it can be bad for you. It is really hard to over-hydrate. It happens but so, so rarely, you'd have to be really trying to do it. The thirst mechanism is very weak. Usually if you've waited to drink long enough to be thirsty, you've waited too long.

Diamox made me pee a lot, but worked for me climbing Mt. Kilimanjaro.

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Altitude sickness @ 1500 meters would be near miracolous : I've never seen anything notable near 2000 meters as a regular guest in the Himalyas over two decades , and the International Society for Mountain Medicine , ismm.org , also dismisses the idea : "Practically speaking, however, we generally don't worry much about elevations below about 2500 m (8000 ft) since altitude illness rarely occurs lower than this." binging on water is a well known way to produce cerebral edema , there are documented deaths at both low altitude ( like Boston Marathon ) and high altitude. –  vistet Apr 15 at 20:02

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