How To Prevent And Treat Altitude Sickness

Altitude sickness, also sometimes referred to as mountain sickness, is caused by the drop in barometric pressure associated with high altitudes. It is not usually an issue for individuals who live at higher elevations, such as those in Peru, as their bodies adapt to the climate over time. But for those who are not accustomed to high altitudes, it can be debilitating. Symptoms of altitude sickness include trouble sleeping, nausea, vomiting, shortness of breath, loss of appetite, blue or pale skin, chest tightness, rapid heart rate, and headache. If left untreated, altitude sickness can even lead to life-threatening pulmonary or cerebral edema.

This article discusses a number of different prevention methods and treatment options to help individuals avoid or recover from altitude sickness.

Take Time To Acclimatize


To prevent altitude sickness, doctors advise patients to take time to acclimatize themselves to higher elevations. Altitude sickness is particularly common in hikers and skiers, and it occurs when patients climb to a higher elevation in a very short period. High-altitude areas have lower air pressure and lower oxygen levels than areas at lower elevations. When patients arrive at high elevations too quickly, the body does not have enough time to adjust to the reduced air pressure and oxygen at the new location. To compensate for the changes in air pressure and oxygen, the patient's breathing rate will naturally become faster in an attempt to increase blood oxygen levels. However, blood oxygen levels do not return to what they would be at lower elevations, and the body needs time to adjust to functioning with reduced oxygen. Most doctors suggest allowing a minimum of ten to fourteen days to adjust to high altitudes, and many patients need twenty days or more to fully adjust.

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No Alcohol Consumption


To prevent altitude sickness, patients are encouraged to avoid alcohol consumption. Alcohol can contribute to dehydration, and patients who are dehydrated may take longer to acclimatize to higher elevations. Patients should avoid wine, beer, and other alcoholic beverages. In addition to avoiding alcohol consumption, it is recommended that individuals who are visiting high-altitude areas try to drink at least three to four quarts of water each day. Sleeping pills, barbiturates, and tobacco should be avoided as well. If the patient has consumed alcohol at a high elevation, they should try to offset this by drinking water and by eating a diet that is at least seventy percent carbohydrates. The patient should also be aware of the potential symptoms of altitude sickness and understand most symptoms normally begin within twelve to twenty-four hours of arriving in a high-altitude area. Patients who notice sleep problems, low energy, shortness of breath, fatigue, and dizziness should consider being evaluated by a physician. This is particularly necessary if the symptoms continue for more than three days.

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Stop And Rest


If individuals feel any of the symptoms of altitude sickness coming on, the first thing they should do is stop and rest. If individuals are hiking or climbing, they should keep in mind the higher they climb, the worse symptoms will become. It may even be a good idea to return to a lower altitude until they feel better. More on this later. Individuals should also consider the slower they elevate, the better their body will be able to adjust to the altitude. They should keep to a slow to moderate pace, and be sure to stop and rest whenever they start to feel woozy. Everyone should consider taking periodic breaks even if they do not feel sick.

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Take Pain Relievers


In a 2012 trial published in the Annals of Emergency Medicine, ibuprofen was found to decrease the likelihood of altitude sickness. Eighty-six men and women spent the night at an elevation of 4,100 feet and were given either six hundred milligrams of ibuprofen or a placebo every six hours leading up to bedtime. The individuals taking pain relievers were twenty-six percent less likely to experience symptoms of altitude sickness. The majority of individuals have convenient access to ibuprofen or a similar drug, so this is an option for individuals who have the time to prepare for the trip and take pain relievers ahead of time. Eveyrone should, however, remember to consult a doctor before taking a new medication and always follow the directions on the packaging, unless otherwise specified by a doctor.

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Anti-Sickness And Nausea Medication


Anti-sickness and nausea medication, such as ondansetron or promethazine, may also help symptoms of altitude sickness. Promethazine is useful because it is something individuals can take after they start to feel sick and should help remedy the specific symptoms of nausea and vomiting. It is, however, vital to be aware of potential side effects, which are rare but include rapid breathing, rapid or irregular heartbeat, fever, increased sweating, loss of bladder control, muscle stiffness, pale skin, and weakness. Individuals should also avoid taking multiple anti-nausea and sickness medications at once, as they may have unexpected interactions. Patients must remember to always consult a doctor prior to taking a new medication.

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Drink More Water


When individuals feel sick, drinking more water can almost always help. It is important to stay hydrated when physically exerting oneself. In fact, dehydration can cause symptoms very similar to those of altitude sickness. If individuals experience nausea, headache, shortness of breath, or other associated symptoms, they should start to treat their symptoms by drinking more water. It is also important to note the body needs more water at high altitudes than usual. This is because the humidity drops and sweat evaporates faster. Individuals also lose water through the increased respiration associated with low barometric pressure. It is a good rule to gulp an extra liter or two of water at high altitudes.

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Acetazolamide is normally used to treat glaucoma, but because of how it works, it also happens to help prevent altitude sickness. If individuals know they are sensitive to drops in barometric pressure and they anticipate traveling to high altitudes, they may want to try taking acetazolamide starting two days before the trip and continue taking it for the duration of the trip. This medication can help prevent altitude sickness, but once symptoms have started, it might not reduce them. Patients will also need a recommendation from their doctor before implementing this method. To take advantage of this treatment method, individuals must plan ahead. As always when taking a medication, patients should be aware of its side effects, which include frequent urination and tingling feet.

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Return To A Lower Elevation


The main treatment for all stages of altitude sickness is to return to a lower elevation. This should be done as quickly as possible. For patients with mild altitude sickness, doctors recommend returning to an elevation that is one to two thousand feet lower. Most patients who are mildly ill start to feel better after twenty-four hours of being at a lower elevation, and symptoms often resolve completely within three days. Individuals with more serious cases of altitude sickness should be immediately moved to an elevation no higher than four thousand feet. These patients will need to see a doctor for an urgent assessment, and hospital treatment may be required.

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Dexamethasone is a corticosteroid that can be beneficial in the prevention and treatment of altitude sickness. When used for prevention, most patients take a two-milligram dose by mouth every six hours, and some doctors could recommend taking a four-milligram dose every twelve hours. Military personnel and search and rescue team members who regularly work at altitudes of more than eleven thousand feet may be advised to take four milligrams every six hours. To reduce the risk of adrenal suppression and glucocorticoid toxicity, patients should not use this medicine for more than ten days. When dexamethasone is being used to treat altitude sickness, patients are typically given a four-milligram dose every six hours, and this dose might be administered intravenously. Potential side effects associated with dexamethasone include weight gain, mood changes, vision changes, dizziness, bloating, and nausea. Some patients might notice an elevated heart rate, headaches, anxiety, and irritability. Individuals who take this medication should let their doctor know about any side effects they experience. It may be possible to lower the dose of dexamethasone or switch to a new medication to reduce side effects.

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Supplemental Oxygen


Supplemental oxygen may be necessary for patients who need to be hospitalized as a result of altitude sickness. It is delivered through a mask that covers the mouth and nose, and it could also be given through a nasal cannula placed in the patient's nostrils. Individuals hiking at high altitudes might choose to carry supplemental oxygen tanks with them to prevent symptoms of altitude sickness during their climb. Patients with chronic obstructive pulmonary disease or other breathing problems may need to take supplemental oxygen with them on airplane flights, and they could require additional oxygen at home if they live in high-altitude areas. Individuals who believe they may need portable oxygen at higher elevations should check with a doctor first. They will want to know about the details of the patient's planned activities and will check the patient's blood oxygen levels. The doctor might need to listen to the patient's lungs with a stethoscope to identify potential breathing issues. If the doctor feels supplemental oxygen would benefit the patient, they will prescribe the appropriate product. While recreational oxygen canisters are available without a prescription, these may not be suitable for every individual, and patients should always consult a medical professional before purchasing any oxygen product.


    HealthPrep Staff