Altitude Sickness

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Wish I lived in CO
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Re: Altitude Sickness

Post by Wish I lived in CO » Tue Jun 02, 2015 7:49 am

martinleroux wrote:More than you probably want to know:

Identifying the lowest effective dose of acetazolamide [Diamox] for the prophylaxis of acute mountain sickness: systematic review and meta-analysis
British Medical Journal, 2012
http://www.ncbi.nlm.nih.gov/pmc/article ... .e6779.pdf

"This systematic review and meta-analysis summarises the current evidence on the efficacy of acetazolamide 250 mg, 500 mg, and 750 mg daily in the prevention of acute mountain sickness. A systematic search of relevant published and unpublished literature identified 11 [randomised, placebo-controlled] trials for inclusion in the review. The results showed that at all three doses acetazolamide was efficacious in preventing acute mountain sickness above 3000 m. Acetazolamide 250 mg was the lowest effective dose for which there was evidence for this indication".
The last sentence of 250 mg (per day) lowest effective dosage - I've found this to be true over the last several years. This is half the dosage of what is normally prescribed. It enables me to go from sea level to 14K in less than 24 hours and do well, yet with lesser / manageable side effects than the full dosage. I've tried the same without any dosage and it was a difficult experience. I now live at 5K and will have to see (on an easier peak) if I still need to dope up.
I look up to the mountains - does my help come from there? My help comes from the Lord, who made heaven and earth! Psalm 121:1-2
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jwendling
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Re: Altitude Sickness

Post by jwendling » Wed Jun 03, 2015 9:35 am

The last sentence of 250 mg (per day) lowest effective dosage - I've found this to be true over the last several years. This is half the dosage of what is normally prescribed. It enables me to go from sea level to 14K in less than 24 hours and do well, yet with lesser / manageable side effects than the full dosage. I've tried the same without any dosage and it was a difficult experience.
Yep. For me too. Coming from flat land and with limited time available I don't want to "lose" too many days waiting for my body to acclimatize. My first trip out--although successful in my mind--was difficult at best. The following years I've started a half dose of diamox a few days before the first 14er. World of difference. I cut a 250 mg in half and take one half in the morning and one in the evening.....with lots of water all day. My wife did the same last year (her first) and climbed LaPlata with no difficulties. We camp at 9,600 which helps also, I'm sure.

We have the same plan this year for July in the Sawatch/Sangres
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Re: Altitude Sickness

Post by palikona44 » Fri Sep 13, 2019 3:17 pm

Hi,
I wanted to bump this good post and describe my experience on Mt Spaulding yesterday and get some feedback if possible.

I’ve been hiking CO 14ers for 15 years (have done most of the class 1 and 2s) but haven’t been above 13,500’ in two years, until yesterday. I went up for an “easy” hike up Mt Spaulding from Summit Lake and was planning on heading over to Mt Evans, which I’ve hiked 5 times. I took it really slow, took deep breathes, was well fed and hydrated with water w/ a Nuun tablet, and felt good until about 13,500’. Once on the summit of Spaulding (13,850’), I sat down and took a rest. I started feeling nauseous and a bit shaky. No headache at that point. After eating my sandwich, I decided to bail on Evans at that point and began to descend, knowing this was my best solution. I had mild nausea and the beginnings of a headache all the way down that got a touch better once I got to the car. I drove down to Idaho Springs and felt somewhat ok again, albeit tired and kind of “off”. During the ride down, I ate an apple, energy bar and continued to hydrate. Through the rest of the day, I ate and drank water normally, but felt drained and had a slight headache, for which I took Advil.

A little background: I used to have no problem with altitude when in my 30s. Now I’m 45 and the last few times I’ve been that high, the same thing has happened. Yesterday was sort of a test to see if anything has changed. My fitness has dropped off since my 30s but I still hike about once a week at lower altitudes (10-12k) and bike 10-15 miles a week, and in the winter ski once a week between 10-13k). I’ve always gotten fairly winded when doing things at high altitude and I attribute it to having a slightly elevated hemoglobin level. I think this means my cells don’t deliver oxygen as efficiently.

During the winter, I don’t feel the altitude during the day but afterwards usually have a headache if I ski 5-6 hard hours. This I attribute to dehydration and I’ve been working at that.

So I wonder if yesterday was a result of: not as good fitness as in my past, elevated hemoglobin, and/or not enough recent exposure to higher altitudes.

Should I try what is recommended in this thread: 600g of Advil, 2-3 times a day when hiking that high? Is that safe? Seems like a lot.

Any thoughts are very much appreciated!
Last edited by palikona44 on Fri Sep 13, 2019 3:24 pm, edited 1 time in total.
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Re: Altitude Sickness

Post by mtree » Fri Sep 13, 2019 3:23 pm

I'm not a doctor nor do I play one on TV.
I'd start with a physical and have your blood pressure and heart/circulatory system checked out, ECG, etc. and maybe a stress test. Then go from there. Don't make assumptions on something like this. Go see the pros.
- I didn't say it was your fault. I said I was blaming you.
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Re: Altitude Sickness

Post by palikona44 » Fri Sep 13, 2019 3:25 pm

mtree wrote:
Fri Sep 13, 2019 3:23 pm
I'm not a doctor nor do I play one on TV.
I'd start with a physical and have your blood pressure and heart/circulatory system checked out, ECG, etc. and maybe a stress test. Then go from there. Don't make assumptions on something like this. Go see the pros.
I have. Everything checks out great.
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MichelleLW
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Re: Altitude Sickness

Post by MichelleLW » Fri Sep 13, 2019 3:35 pm

palikona44 wrote:
Fri Sep 13, 2019 3:17 pm
So I wonder if yesterday was a result of: not as good fitness as in my past, elevated hemoglobin, and/or not enough recent exposure to higher altitudes.
Could certainly be any of the above, I certainly notice particularly when I don't have enough recent exposure to altitude. However, another cause that could be worth exploring, particularly if you have not had altitude issues in the past, is hypothyroidism. Last year, I began experiencing altitude sickness like clockwork every single time I went about 13,000 and most of the time above 12,000, with a couple experiences while skiing. I was born and raised in CO, and prior to that had done 20+ 14ers, multiple 13ers and regularly skied multiple times per year, all of which with no symptoms whatsoever of altitude sickness. Thanks to the recommendation of a friend, I got my thyroid levels tested. They came back in the subclinical range, but deteriorated over the year (while still technically remaining subclinical), until I was put on Synthroid in the fall. I have not experienced altitude sickness since. I have no real idea why this caused altitude sickness, but it was a little bit like magic once I got the medication level correct. I hadn't noticed any other symptoms beyond the altitude sickness, but once I went on the medication I realized that my energy levels had been quite low - which I had just attributed to being out of shape!
Last edited by MichelleLW on Fri Sep 13, 2019 4:31 pm, edited 1 time in total.
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Re: Altitude Sickness

Post by shelly+ » Fri Sep 13, 2019 3:40 pm

palikona44 wrote:
Fri Sep 13, 2019 3:17 pm
not enough recent exposure to higher altitudes.
not enough recent exposure to higher altitudes. just try consistent exposure to altitude over time (weeks or even months).
left to my own devices.
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mtree
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Re: Altitude Sickness

Post by mtree » Fri Sep 13, 2019 3:43 pm

At least you got the basics out of the way.
I think 600g of Advil 2 or 3 times a day would kill you!!!
Other than that, I got nothing. Good luck figuring it out.
- I didn't say it was your fault. I said I was blaming you.
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Re: Altitude Sickness

Post by palikona44 » Fri Sep 13, 2019 3:58 pm

mtree wrote:
Fri Sep 13, 2019 3:43 pm
At least you got the basics out of the way.
I think 600g of Advil 2 or 3 times a day would kill you!!!
Other than that, I got nothing. Good luck figuring it out.
I misread :)

Is 400g a day, once a week ok? Yes, right?
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Re: Altitude Sickness

Post by Stratosfearsome » Fri Sep 13, 2019 4:43 pm

palikona44 wrote:
Fri Sep 13, 2019 3:58 pm

I misread :)

Is 400g a day, once a week ok? Yes, right?
Surely you mean 400mg? Milligrams. 400g is 400 grams, or one thousand times that amount, which almost half a kilo of Advil. This is definitely a question for your doctor, not an internet forum. :)
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Re: Altitude Sickness

Post by Bill G » Fri Sep 13, 2019 5:06 pm

So, like 5 pounds of Advil a day. Now how many calories is that? Rather than a Camelback I think you'll need a 50 gallon drum of water to wash it all down.

Now that would be an impressive summit picture. Just remember pack it in, pack it out.
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Re: Altitude Sickness

Post by palikona44 » Fri Sep 13, 2019 6:05 pm

](*,) yes 400 mg!!

Or my original question: is 600mg twice a day for a climb ok to combat altitude sickness?
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