All right, Indi­ana Jones. You can climb jun­gle vines and for­age for your own food. You can locate run­ning streams with sur­pris­ing accu­ra­cy and you train for triathlons in your free time, we get it. Unfor­tu­nate­ly, this puts you at high­er risk for alti­tude relat­ed issues—because you prob­a­bly think you’re too tough to be affect­ed by alti­tude sickness.

The truth is, it can hap­pen to any­one, at any time (grant­ed you are at a high enough alti­tude: gen­er­al­ly above 8,000 ft.). There are no real indi­ca­tors as to whether or not it will affect one per­son over anoth­er, it’s just one of those odd things. For­tu­nate­ly, it isn’t contagious.

So what is alti­tude sick­ness any­way? There are many forms of it, but the issues we are deal­ing with are 1. Oxy­gen and 2. Water. As you get high­er in alti­tude, air pres­sure decreas­es and you get less oxy­gen every time you take a lung­ful of air. This low­ered air pres­sure also caus­es water to evap­o­rate more quick­ly from your sys­tem, caus­ing dehydration. 

Signs & Effects of Alti­tude Sick­ness, or AMS (Acute Moun­tain Sickness)

  • Headache
  • Fatigue
  • Nau­sea
  • Con­fu­sion
  • Dif­fi­cul­ty walking
  • Gen­er­al­ly feel­ing real­ly, real­ly terrible
  • Hav­ing to uri­nate more frequently
  • Hyper­ven­ti­la­tion
  • Nose­bleed
  • Drowsi­ness
  • Height­ened pulse

These are fair­ly com­mon issues when trav­el­ing from sea lev­el to a high alti­tude at a rapid rate, but they can be fatal. So let’s go over a game plan to keep you safe next time you decide to adven­ture a lit­tle clos­er to the stars.

How to Deal with Alti­tude Sickness

1. Avoid Rapid Ascents
If pos­si­ble, sleep a night or two at an inter­me­di­ate alti­tude, say between 5,000 and 7,000 ft., before your expe­di­tion into alti­tudes above 8,000 ft. Once above 8,000 ft., avoid ascend­ing more than 1,000 ft. per day to camp. 

Climb­ing high­er each day is fine, but avoid sleep­ing high­er than 1,000 ft. as com­pared to the pre­vi­ous night.

2. Try Coca Leaves & Gingko Biloba
Although not always read­i­ly avail­able, these are nat­ur­al reme­dies that increase the rate of accli­ma­tion for some peo­ple. Fore­sight can be key.

3. Drink Plen­ty of Water
It’s just a fact—you get dehy­drat­ed faster at high­er alti­tudes. Not only are you exert­ing more ener­gy, but water vapor is also lost from the lungs at a high­er rate. With this in mind, alco­hol con­sump­tion should be avoid­ed entire­ly, as it will only dehy­drate your body further.

4. Med­icate
Ibupro­fen treats the symp­toms of nau­sea and headache some­times caused by alti­tude sick­ness, but the drug Diamox, or aceta­zo­lamide, decreas­es the time need­ed to accli­mate to high altitude.

5. Descend
If alti­tude is seri­ous­ly affect­ing you, the most effec­tive solu­tion is to descend to a low­er alti­tude imme­di­ate­ly. The end-stage of AMS is HACE, or High Alti­tude Cere­bral Ede­ma, which caus­es your brain to swell and stop work­ing prop­er­ly. HACE can be fatal if left untreated.

As with any intense phys­i­cal activ­i­ty, it is always best to con­sult your doc­tor before embark­ing on a trek at high alti­tude. Take your time, lis­ten to your body, and be pre­pared to turn around if necessary.

©istockphoto/swissmediavisionWill your adven­tures be tak­ing you into high-alti­tude envi­ron­ments this sum­mer? If so, be careful—and do your research. Alti­tude affects every­body dif­fer­ent­ly, and it’s impor­tant to under­stand what you’re get­ting into.

It’s Called “Atmos­pher­ic Pressure”
The first step? Stop say­ing that the air is thinner—because tech­ni­cal­ly, the air itself isn’t chang­ing as you climb high­er. The tro­pos­phere (which stretch­es from sea lev­el to rough­ly 65,000 feet) always con­tains 20% oxy­gen and near­ly 80% nitro­gen. What does change is the atmos­pher­ic pres­sure, which decreas­es as you ascend? At the sum­mit of Mount Ever­est, for exam­ple, the atmos­pher­ic pres­sure is less than 30% of the pres­sure at sea level.

You don’t need to go to the sum­mit of Mount Ever­est to feel changes in your body, though. Accord­ing to the med­ical def­i­n­i­tion, any­thing above 8,000 feet (or 2,440 meters) is con­sid­ered high alti­tude. It’s rare to have seri­ous issues below 12,000 feet, but it’s dif­fer­ent for every per­son every time. That’s one of the inter­est­ing things about alti­tude sick­ness: it can hap­pen to any­body, regard­less of age, phys­i­cal con­di­tion­ing, expe­ri­ence, or gen­der. All bod­ies are unique, and you’ll be most in tune with yours if you’re hon­est with your­self about what you feel.

Alti­tude Sickness
That said, most peo­ple will expe­ri­ence at least some symp­toms when trav­el­ing above 12,000 feet. Acute Moun­tain Sick­ness, or AMS, is the catch-all med­ical term for feel­ing shit­ty up high—and experts say it feels exact­ly like a right­eous hang­over. Symp­toms include dif­fi­cul­ty sleep­ing, fatigue, a mild to mod­er­ate headache, loss of appetite, nau­sea, an ele­vat­ed heart rate, and short­ness of breath. None of these symp­toms are life-threat­en­ing, but they are your body’s way of giv­ing you infor­ma­tion. Slow down, stay hydrat­ed, eat well, and rest as much as pos­si­ble. Take ibupro­fen or aceta­minophen. For most climbers, AMS is man­age­able and will resolve with prop­er acclimatization.

For some peo­ple, though, it gets worse. There are two pri­ma­ry con­cerns at alti­tude: HACE and HAPE. HACE, or high alti­tude cere­bral ede­ma, is a build-up of flu­id around the brain. Symp­toms include a per­sis­tent headache, atax­ia, and altered lev­el of con­scious­ness. HAPE, or high alti­tude pul­monary ede­ma, is a build-up of flu­id around the lungs. Symp­toms include a per­sis­tent cough, short­ness of breath, and pink phlegm. Both are every bit as seri­ous as they sound, and both dic­tate an imme­di­ate descent and med­ical attention.

How can you pre­vent alti­tude sick­ness? Don’t rush. Sched­ul­ing lots of time to accli­ma­tize are the best way to pre­vent issues. Be gen­tle with your body, and when in doubt, descend.

For more infor­ma­tion about how to stay safe in the moun­tains, check out Wilder­ness Med­i­cine by William W. Forgery, MD, and Alti­tude Ill­ness: Pre­ven­tion & Treat­ment by Stephen Bezruchka.