Altitude Sickness is a Jerk

Daniel Winder wrote:The bad thing about Diamox is that you can't drink beer while you're taking it. It does work well though. Other than that, hydrate well, climb high, and sleep low.

well fuck that then...i am out. what is mountaineering without beer afterwards?

My magic formula for climbing at 13 or 14 has been to sleep a night at 8,000 or 9,000, then sleep a night at around 11,200, then climb and come back down to 11,200. (I live at about 6,000.)

And each day I drink at least 4 liters of water. With electrolyte powder in a couple of them. And eat a ton of salty snacks.

Works for me. I used to be plagued with altitude sickness.

Stich wrote: But not to the point of hyponatremia, right? Seriously, don't try chugging a whole gallon of water at one sitting. And keep up with salt intake.

Ya that's not what i said and is def a bad idea... gallons before and during is what i said.. I chug liters of water and beer, when sitting.

FrankPS wrote: A lot of people only have three or four days for the trip and want to go to altitude. So there isn't time for a long acclimation schedule. Spending the night at the trailhead helps, as does anything you can do to acclimate. I have been using Diamox for years for my short trips and have never dropped, forgotten, lost or run out of the pills.

I second the use of Diamox for lowlanders taking a climbing vacation to altitude. One problem I have run into is getting a prescription before a trip though. A lot of doctors (at least in the East) don't seem to be aware of this application of the drug. The last time I got one I brought in some references to show to the doctor.

Emil Briggs wrote:I second the use of Diamox for lowlanders taking a climbing vacation to altitude. One problem I have run into is getting a prescription before a trip though. A lot of doctors (at least in the East) don't seem to be aware of this application of the drug. The last time I got one I brought in some references to show to the doctor.

Bringing some copies of articles could not hurt. Acclimatization helped by Acetazolaide / Diamox is a well-known "off label" use, and has been studied for about fifty years.

But notifying your doctor several weeks in advance and giving them time to research it for themselves might be even better.
I've read some people are allergic to acetazolamide (also it does have side-effects), so it's not for everybody.

Since I live much near sea-level and have substantial problems with Acute Mountain Sickness above 2500 meters / 8000ft, I've used acetazolamide / Diamox to help for many trips with climbing below 4500 meters / 14900 ft.

low CO2 breathing:
Recently another advance-prep method I've tried (in addition to acetazolamide) for better performance the first day or two up high is ...
breathing air at sea-level with most of the CO2 removed (by piping it through a canister of "soda lime"). Doing intervals of that for some minutes a day during two to four days in advance, seems to help me significantly (like I slept soundly easily at Refuge Cosmiques after arriving from sea-level that morning).

Key problem is that breathing low CO2 works by actually inducing symptoms of AMS. So it's uncomfortable (and I assume dangerous if overdo it) and it takes time away from other things.
Taking Diamox tablets is so much easier.

Ken

kenr wrote: Bringing some copies of articles could not hurt. Acclimatization helped by Acetazolaide / Diamox is a well-known "off label" use, and has been studied for about fifty years. low CO2 breathing: Since I live much near sea-level and have substantial problems with Acute Mountain Sickness above 2500 meters / 8000ft, I've used acetazolamide / Diamox to help for many trips. Recently another advance-prep method I've supplemented with for better performance the first day or two is breathing air at sea-level with most of the CO2 removed (by piping it through a canister of "soda lime"). Doing intervals of that for some minutes a day during two to four days in advance, seems to help me significantly (like I slept soundly easily at Refuge Cosmiques after arriving from sea-level that morning). Key problem is that breathing low CO2 works by actually inducing symptoms of AMS. So it's uncomfortable (and I assume dangerous if overdo it) and it takes time away from other things. Taking Diamox is so much easier. Ken

How much water do you drink in the three days leading up to your trip to altitude? Have you ever tried coming up with a H20 schedule prior to your departure? I find this critical to success on my high alt trips.

Morgan Patterson wrote: How much water do you drink in the three days leading up to your trip to altitude? Have you ever tried coming up with a H20 schedule prior to your departure? I find this critical to success on my high alt trips.

Since acetazolamide / Diamox is a diuretic one of the main side effects is extra urination. So it's natural to drink more water to replace it. But I don't measure that or monitor it, and I've done just fine.

I have had problems with hyponatremia from over-hydration in non-altitude performance situations, so now I've gotten wary of over-hydration generally.

One of the main conclusions from scientific studies of hydration (non-altitude) that have come out in the last five years is that extra drinking generally helps little and sometimes harms a lot. For people living in modern industrial societies, the new wisdom is: "Way more people have died from drinking too much water than from too little."

Ken

The days leading up to 14er bagging I generally try to drink water until I pee clear. That's the only plan. Keep it clear and if it's not then keep drinking. I end up drinking a lot and peeing a lot but I don't get altitude sickness.

If your long term goal is to perform better at altitude then doping on diamox or procardia will hinder that process. Your body needs to train and learn how to use it's own physiological mechanism to adapt to altitude and you do this by practice, practice, and more practice. Unless you want to be dependent on doping every time you come to altitude. Kenr just admitted to this scenario, "I've used acetazolamide / Diamox to help for MANY trips with climbing below 4500 meters / 14900 ft." Heavy exertion while on diamox can cause electrolyte imbalances, potassium depletion, cramps, nausea, vomiting and life threatening conditions.

Check out the books Man, Mountains and Oxygen and Training for Alpinism .

one of the things to note is if you're drinking large amounts of water try to add in some salts -- diluted gatorade so you dont start using your body's salts to piss out the excess urine and wind up depleted

Taylor-B. wrote:If your long term goal is to perform better at altitude then doping on diamox ...

"Doping" is usually thought to mean using drugs (e.g. EPO) or transfusion techniques to increase the ability to transport oxygen to the muscles. Used successfully by many bicycle racers.

But taking Diamox / acetazolamide has nothing to do with that - (nor does my supplementary trick of breathing reduced-CO2 air). Diamox is about helping your body to adjust how it regulates the acidity (pH) of blood and the exchange between CO2 in the air and carbonic acid in the blood. Diamox does nothing to increase hemoglobin or build red blood cells - (nor does the low-CO2 breathing trick).

My understanding is that all that my techniques do is speed up my body to acquire the ability to manage pH and carbonic acid balance at altitudes below 14500 feet / 4800 meters -- so that my climbing during the first few days at altitude is not hindered by AMS symptoms. My muscles still have to make the moves and lift my body-weight using roughly the same red blood cells and hemoglobin I had at sea-level.

I could achieve the same ability to manage pH and carbonic acid balance by just waiting several days up at altitude. But the days in my trip are limited, and Diamox is cheap (and soda lime canisters and tubing for low-CO2 intervals are cheap), it seems obvious to me that getting more days of non-AMS-hindered climbing per trip is well worth it.

Once I have achieved the ability in the first few days, I stop taking acetazolamide tablets. After that I perform several days of climbing without the supposed "aid" of diamox and without ever using any "doping" strategy.

I'm not seeing why I'd want to make it my "long-term goal" to do without diamox or low-CO2 breathing when preparing for future trips.

Ken

kenr wrote: "Doping" is usually thought to mean using drugs (e.g. EPO) or transfusion techniques to increase the ability to transport oxygen to the muscles. Used successfully by many bicycle racers. But taking Diamox / acetazolamide has nothing to do with that - (nor does my supplementary trick of breathing reduced-CO2 air). Diamox is about helping your body to adjust how it regulates the acidity (pH) of blood and the exchange between CO2 in the air and carbonic acid in the blood. Diamox does nothing to increase hemoglobin or build red blood cells - (nor does the low-CO2 breathing trick). My understanding is that all that my techniques do is speed up my body to acquire the ability to manage pH and carbonic acid balance at altitudes below 14500 feet / 4800 meters -- so that my climbing during the first few days at altitude is not hindered by AMS symptoms. My muscles still have to make the moves and lift my body-weight using roughly the same red blood cells and hemoglobin I had at sea-level. I could achieve the same ability to manage pH and carbonic acid balance by just waiting several days up at altitude. But the days in my trip are limited, and Diamox is cheap (and soda lime canisters and tubing for low-CO2 intervals are cheap), it seems obvious to me that getting more days of non-AMS-hindered climbing per trip is well worth it. Once I have achieved the ability in the first few days, I stop taking acetazolamide tablets. After that I perform several days of climbing without the supposed "aid" of diamox and without ever using any "doping" strategy. I'm not seeing why I'd want to make it my "long-term goal" to do without diamox or low-CO2 breathing when preparing for future trips. Ken

You don't need to justify it -- it's mountaineering -- not a competitive sport. There is no cheating. Do what you wanna do. But let's be honest about what's going on: you are using drugs to enhance your performance. No different than using steroids so you can bench more or run faster or whatever.

Ryan Watts wrote:you are using drugs to enhance your performance. No different than using steroids so you can bench more or run faster or whatever.

Taking acetazolamide is using a drug to combat a sickness - (Like maybe re-read the first post of this thread). It's called Acute Mountain Sickness (AMS). The sickness has symptoms, which are listed in books and some websites.

Like other sicknesses, some people get it and some people don't. Some people have worse symptoms than other people.

Telling climbers to "be honest" about taking acetazolamide / diamox for a couple of days before and after they arrive at 9000 ft altitude is like telling climbers to "be honest" about taking a decongestant because they've got sneezing, stuffy nose, and headache from allergy to pollen from spring flowers blooming near the cliff.
In both cases, the only thing taking the drug does is enable somebody to enjoy climbing without feeling symptoms of sickness.

Taking acetazolamide is not remotely like taking steroids to increase muscular strength, or taking EPO to increase oxygen-carrying capacity of blood - (both of which work as well at sea-level as they do at altitude). Not being able to bench-press 250 lb is not a sickness. Not being able to place in the top three in a bicycle race is not a sickness.

(Anyway, when I use my "low CO2 breathing" method for advance preparation, I'm not taking any drug at all.)

kenr wrote: Taking acetazolamide is using a drug to combat a sickness - (Like maybe re-read the first post of this thread). It's called Acute Mountain Sickness (AMS). The sickness has symptoms, which are listed in books and some websites. Like other sicknesses, some people get it and some people don't. Some people have worse symptoms than other people. Telling climbers to "be honest" about taking acetazolamide / diamox for a couple of days before and after they arrive at 9000 ft altitude is like telling climbers to "be honest" about taking a decongestant because they've got sneezing, stuffy nose, and headache from allergy to pollen from spring flowers blooming near the cliff. In both cases, the only thing taking the drug does is enable somebody to enjoy climbing without feeling symptoms of sickness. Taking acetazolamide is not remotely like taking steroids to increase muscular strength, or taking EPO to increase oxygen-carrying capacity of blood - (both of which work as well at sea-level as they do at altitude). Not being able to bench-press 250 lb is not a sickness. Not being able to place in the top three in a bicycle race is not a sickness. (Anyway, when I use my "low CO2 breathing" method for advance preparation, I'm not taking any drug at all.)

Lol -- but not being able to climb at 14k without acclimatizing properly *is* a sickness?

If you think that you taking diamox to climb at altitude is the same as a cancer patient taking meds for a debilitating illness, idk what to tell you. It is clearly not the same.

To be clear I don't think there's anything wrong with diamox or anything else you feel like you want to take. Do whatever you want -- it's a personal choice.

Hydration, coco leaves, rest, Diamox.
Altitude sickness is unpredictable... And little is known in terms of susceptiblity.
Getting lower is the best cure... Managing symptoms and watching out for HAPE and HACE at altitude... Carry some Dex Just in case!

A relatively recent pertinent document by the current big wigs in altitude research: wemjournal.org/article/S108…

We moved from Denver to Leadville when I was 13 and pudgy; my mom was 47 and in horrible physical condition. A friend of hers, an RN, suggested we take iron to build up red blood cells to carry more oxygen. The nurse suggested a week, so we took it for a month (a typical my-mom move). We never had problems: literally ran all over town without gasping.

Some folks can't take iron for a variety of reasons. But it sure worked for us. Since you can buy it w/o prescription, and it's cheap anyway, might be worth a try. It'll address issues that hydration won't.

And yeah, altitude headaches are the only ones I know that are worse than (my) migraines. A migraine you can medicate; altitude headaches have only one remedy.

I've had AMS a few times. The keys I've found to reducing it are making sure to drink plenty of water with electrolyte/carbs mix added (I like Hammer HEED) and taking aspirin. But AMS is triggered differently person to person and sometimes it is unpredictable. I hiked Mt. Elbert and had zero issues and less than a week later on Mt. Whitney I had the worst case I've ever had and felt like total s**t. Sleeping at the trailhead if it's around 10,000' the night before can help a lot if you can get a good nights sleep there.

Buy a pulse oximeter, $25. It will tell you how much oxygen is in your blood, and give you a measurement of how acclimatized your are. As you ascend altitude, your body has to catch up to the best it can do for that elevation.

The oximeter is lightweight and it will help you tell how you're faring along the way. Take your readings and keep a log, and soon you'll know when you're in the clear or headed into hot water.

Here's an example, at sea level, oximeter registers 98% saturation, get in car, rocket to 10k, e.g. drive up Haleakalā, and it's down to 85%, and then creeps back up near 95%. Of course, it won't ever get to the sea level saturation at altitude and that's just the nature of the beast.

more info...

Interesting genome characteristic and possible mechanisms.

Extinct Humans Passed High-Altitude Gene to Tibetans

Surprisingly, does not seem to associate with high altitude cultures in S.America.