Altitude Sickness

Altitude sickness groups the disorders related to stays in areas of high altitude above sea level. The tolerance of travelers to heights is variable and there is no evidence to predict individual risk.

Symptoms can appear from 2,500 meters of altitude. At 3,000 meters, 30% of travelers may have symptoms and at 4,000 meters it can affect 65-70%. Every year there are at least 7 altitude-related deaths among the 50,000 travelers going to Nepal.

Altitude sickness can be temporary as long as the ascent is stopped as soon as symptoms appear. After a rest and an adequate supply of water and carbohydrates and, as long as the symptoms have disappeared, you can continue to move forward. If they do not disappear, you must descend to lower altitudes until they disappear.

Table of Contents

What is altitude sickness?

Atmospheric pressure decreases the higher you are. Put more simply, the density of the air varies depending on the height. This means that in the same breath of air on a beach or on a peak of, for example, 6,000 meters above sea level (masl), your lungs will transmit a very different amount of oxygen to the blood. Without enough oxygen, your body begins to suffer from hypoxia and, with it, the first symptoms of altitude sickness, soroche, pointing or puna appear.

Causes of altitude sickness

Altitude sickness is due to the fact that the amount of oxygen in the atmosphere decreases with altitude; Thus, each breath we take contains less oxygen, with which less and less oxygen reaches the blood and therefore our tissues. Symptoms appear when the body does not adapt to such low levels of oxygen and cannot function properly.

Altitude Sickness Symptoms

The altitude sickness symptoms are:

Stabbing headache
Loss of appetite, nausea, and vomiting.
Major fatigue.
Weakness.
Dizziness.
Sleep disorders (drowsiness or insomnia).
General state “drunk” accompanied by vertigo.

Altitude sickness symptoms can appear 6-12 hours after reaching high altitudes (sometimes they can be delayed up to 24 hours later).

The severity of the disorder depends on:
The height reached.
The speed with which it is possible to reach the level.
The physical activity carried out at that height.
Altitude sickness symptoms usually disappear when descending to lower levels.

What normal changes occur with altitude that should not be confused with altitude sickness?

All people experience normal physiological changes with altitude that should not be confused with altitude sickness. Among them are:

Increase in the rate and / or depth of breathing (hyperventilation).
Shortness of breath during exercise.
Change of breathing pattern when sleeping.
Frequent waking during the night.
Increased urine production.

Altitude Sickness Treatment

Early diagnosis is important. Acute mountain sickness is easier to treat in the early stages.

The main altitude sickness treatment for all forms of acute mountain sickness is to descend (descend) to a lower altitude as quickly and safely as possible. You should not continue ascending if you have symptoms.

Extra oxygen should be given if available.
People with severe acute mountain sickness may require hospitalization.

An altitude sickness medication called acetazolamide (Diamox) may be given to help you breathe better. It can also help decrease symptoms. This medicine can make you urinate more often. When taking this medicine, be sure to drink plenty of fluids and not drink alcohol. This altitude sickness medication works best when taken before reaching a great height.

If you have fluid in your lungs (pulmonary edema), treatment may include:

Oxygen
An antihypertensive medicine called nifedipine
Beta-agonist inhalers to open the airways
In severe cases, a respirator
A medicine to increase blood flow to the lungs called a phosphodiesterase inhibitor (such as sildenafil)
Portable hyperbaric chambers allow hikers to simulate conditions at lower altitudes without actually moving from the mountain location. These devices are very useful in case bad weather or other factors make it impossible to descend the mountain.

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Altitude Sickness Medication

The general pharmacological altitude sickness treatment is carried out with acetazolamide or dexamethasone. These drugs can also be used in conjunction with any of the above measures. Dexamethasone is also the basis for the specific treatment of altitude cerebral edema (RCT). In the specific treatment of altitude pulmonary edema (EPA), in addition to dexamethasone, nifedipine or sildenafil are also used.

Inhalation of nitric oxide, in patients suffering from high-altitude pulmonary edema, significantly lowers systolic pulmonary artery pressure, increases oxygen saturation, and is accompanied by a more uniform lung perfusion demonstrated by scintigraphy. However, in subjects not prone to altitude pulmonary edema, the decrease in pulmonary arterial pressure is less and oxygenation worsens.

Morphine, in addition to inducing respiratory depression, can be dangerous at altitude.

How to Prevent Altitude Sickness?

The main way to prevent altitude sickness is acclimatization, that is, the progressive ascent to adapt slowly to the hypoxia of altitude. Even so, you have to know that no matter how much an acclimatization schedule is followed, it is possible that symptoms of altitude sickness occur. A rule that the International Union of Mountaineering Associations (UIAA) points out is that the maximum daily altitude increase is 500 meters once 3,000 meters above sea level are reached, taking a day off without ascending every 3 or 4 days.

A good way to prevent altitude sickness is to stay hydrated by drinking at least 4 to 5 liters of water a day and to maintain a varied diet rich in carbohydrates. It is advisable to avoid alcohol and tobacco and very large meals.

Another golden rule to prevent altitude sickness is to rest. Sleep at least 8 hours and do not try to exert yourself physically.

In the event that you are going to travel to countries where people tend to suffer from altitude sickness, it doesn’t hurt that you go to the doctor to tell you if you can take any medicine to prevent soroche. Do not self-medicate, consult your doctor, especially if you have any allergies.

A natural remedy that populations such as Peruvians have used for centuries are coca leaves. You can take them in mate (in tea) during breakfast or dinner, in candies or directly by chewing them or leaving them on one side of the mouth until it secretes all its juice.

There is a saying that goes: “Drink before you’re thirsty, eat before you’re hungry, bundle up before you’re cold, and rest before exhaustion.” Follow it strictly to prevent altitude sickness.

Keys to preventing acute mountain sickness include:

Climb the mountain gradually. Climbing gradually is the most important factor in the prevention of acute mountain sickness.
Stopping for a day or two to rest every 2000 feet (600 meters) of ascent when above 8000 feet (2400 meters).
Sleep at a lower altitude when possible.
Make sure you have the ability to get off fast, if necessary.
Learn how to recognize the first symptoms of mountain sickness.
If you are going to be traveling above 9840 feet (3000 meters), you must carry enough oxygen for several days.
If you plan a quick ascent or a high ascent, ask your provider for medications that might help.
If you are at risk for a low red blood cell count (anemia), ask your provider if the trip is safe. Also ask if an iron supplement is appropriate for you. Anemia lowers the amount of oxygen in the blood. This makes you prone to mountain sickness.

When climbing:

Do not drink alcohol
Don’t drink a lot of fluids
Eat regular meals that are rich in carbohydrates
You should avoid high altitudes if you have heart or lung disease.