Altitude Sickness: A Complete Guide for Climbers and Travelers

Altitude Sickness

Reading time : 8 min

Outline

Introduction

What Is Altitude Sickness?

Altitude sickness, also called Acute Mountain Sickness (AMS), is a condition that occurs when your body struggles to adapt to the low oxygen levels at high altitudes. As you go higher, the air becomes thinner, meaning there is less oxygen available for your body to function properly. This condition typically affects people at altitudes above 2,500 meters (8,200 feet) and can be mild, moderate, or severe.

While some people may experience only mild symptoms, others may develop life-threatening complications if they continue to ascend without proper acclimatization. The risk of altitude sickness depends on how quickly you ascend, your overall health and fitness level, and your body’s ability to adapt to reduced oxygen levels.

What Causes Altitude Sickness?

The main cause of altitude sickness is rapid ascent to high elevations without giving the body enough time to adjust to the lower oxygen levels.

Here’s why altitude affects the body:

  • At sea level, oxygen levels are around 21%, and the air pressure is high enough to ensure oxygen is efficiently delivered to the body.
  • As altitude increases, air pressure decreases, making it harder for the lungs to absorb oxygen.
  • The body requires time to adjust, a process known as acclimatization. When it doesn’t get enough time, altitude sickness develops.

Key factors that increase the risk of altitude sickness:

  1. Ascending too fast – If you gain more than 300-500m (1,000-1,600 feet) per day above 3,000m (10,000 feet), you may develop symptoms.
  2. Starting at a high altitude – If you fly or drive directly to a high-altitude location without gradual exposure, the risk increases.
  3. Previous experience – Just because you didn’t get sick before doesn’t mean you won’t in the future; altitude sickness can happen to anyone.
  4. Dehydration and poor diet – Not drinking enough water or eating properly can make symptoms worse.
  5. Underlying health conditions – People with lung or heart conditions may be more sensitive to lower oxygen levels.

Types of Altitude Sickness

1. Acute Mountain Sickness (AMS) – Mild Altitude Sickness

This is the most common and least dangerous form of altitude sickness. Most people experience it when they ascend too quickly.

Symptoms of AMS:

  • Headache (often the first symptom)
  • Nausea or dizziness
  • Shortness of breath (especially during physical activity)
  • Loss of appetite
  • Fatigue or weakness
  • Trouble sleeping

Treatment for AMS:
🚨Rest at the same altitude for a day or two until symptoms disappear.
🚨Drink plenty of water and eat high-energy meals.
🚨Pain relievers (e.g., ibuprofen, aspirin) can help with headaches.
🚨Mild oxygen therapy may help but is not always necessary.

Consider taking Acetazolamide (Diamox) to speed up acclimatization (only under medical advice).

If symptoms worsen, do not ascend further—instead, descend to a lower altitude.

2. High-Altitude Pulmonary Edema (HAPE) – Fluid in the Lungs (Severe Altitude Sickness)

HAPE occurs when fluid leaks into the lungs, reducing the ability to breathe properly. It is one of the leading causes of altitude-related deaths if not treated quickly.

Symptoms of HAPE:

  • Extreme breathlessness, even when resting
  • Persistent cough (often producing pink or frothy sputum)
  • Chest tightness or pressure
  • Blue or pale lips and fingernails
  • Confusion and disorientation
  • Extreme fatigue and inability to move properly

Treatment for HAPE:
🚨 Immediate descent to a lower altitude (at least 1,000m / 3,300ft) is required.
🚨 Supplemental oxygen can help stabilize breathing.
🚨 Nifedipine (a prescription medication) may be used to reduce lung pressure.
🚨 In extreme cases, a portable hyperbaric chamber (Gamow Bag) may be used until evacuation is possible.

3. High-Altitude Cerebral Edema (HACE) – Swelling of the Brain (Severe Altitude Sickness)

HACE is a life-threatening condition where fluid collects in the brain, causing swelling and loss of brain function. It is rare but fatal if not treated immediately.

Symptoms of HACE:

  • Severe headache (worse than AMS)
  • Loss of coordination (difficulty walking or moving)
  • Extreme confusion or hallucinations
  • Slurred speech and inability to concentrate
  • Unconsciousness or coma

Treatment for HACE:
🚨 Immediate descent is the only cure—at least 1,000m (3,300ft) lower.
🚨 Dexamethasone (a steroid medication) can help reduce brain swelling.
🚨 Supplemental oxygen is necessary.
🚨 A portable hyperbaric chamber may help in emergencies.

Without proper treatment, HACE can be fatal within 24 hours.

How to Prevent Altitude Sickness

1. Acclimatization – Let Your Body Adjust

  • Follow the rule: Climb high, sleep low – This means ascending during the day but sleeping at a lower altitude.
  • If climbing above 3,000m (10,000ft), take rest days every 3-4 days.
  • If you feel sick, do not ascend further until symptoms improve.

2. Slow and Steady Ascent

  • Gain no more than 300-500m (1,000-1,600ft) per day above 3,000m (10,000ft).
  • If you need to ascend quickly, spend extra days at intermediate altitudes to adjust.

3. Stay Hydrated and Eat Well

  • Drink 3-4 liters of water per day to prevent dehydration.
  • Eat high-energy meals rich in carbohydrates for quick energy.
  • Avoid alcohol and tobacco, as they can slow acclimatization.

4. Use Preventive Medications

  • Acetazolamide (Diamox): Helps the body adjust faster but doesn’t cure altitude sickness.
  • Dexamethasone: A steroid used in emergencies to reduce severe symptoms.

Stay Safe at High Altitudes

Altitude sickness is a serious risk, but it is entirely preventable if you follow proper acclimatization and safety measures. If you experience any symptoms, stop ascending and listen to your body.

If you plan to climb Mount Kilimanjaro, Everest Base Camp, the Andes, or any other high-altitude region, always prepare well and follow expert advice to stay safe and enjoy your adventure!

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