Just talked to the pharmasist where I work, who claims the drug diamox helps with allitude sickness. Has anyone had experiance with this drug for any length of time? He said you have to start it right away before you start a major hike. Hiking 221 miles on the JMT will be a challenge for a person from Minnesota. Not many hills up here.

I took Diamox on a trek in Nepal after I started getting headaches at around 15,000 feet. We were above that height for two weeks, crossing three 18,000 foot passes, and I took Diamox all that time. I had some tingling in my hands and feet, which is apparently quite common, but no other side effects. The headaches went away.

With regard to the John Muir Trail it all depends at what height altitude starts to affect you. I've come straight from Britain - highest altitude 4,500 feet - and hiked in the High Sierra and the Colorado Rockies without any ill effects many times. The only time I've noticed any effect was when I went straight from Denver airport to Leadville at 10,000 feet and found it hard work getting up the stairs to my room. But two days later I felt fine on an ascent of Mount Elbert.

Coming from a low altitude doesn't necessarily mean you'll have problems with higher altitudes. Of course being sensible and not going too high too fast is wise. For the John Muir Trail starting in Yosemite and not pushing the first few days would probably be okay for acclimatisation.

Thanks for the info Chris. We are starting in Yosemite and heading south to Mt.Whitney.

Victoria,

I've heard Dr. Peter Hackett speak recently at the annual congress of the Society of Critical Care. He's dedicated his life to high altitude research. His website has some good info: http://altitudemedicine.org/

If you are willing to wade through the research their group has several pubs available in PDF you can read. See: http://altitudemedicine.org/publications.php

I found the article published in Emergency Medicine Clinics of North America, 2004 to be particular well done.

Brian

Vicky, my physician is into sports medication and outdoor adventures. He only recommends Advil. (He is okay with the 120 mg of Ginko Biloba.) He thinks it is important to recognize the symptoms of altitude sickness that survive Advil's treatment and to not avoid going higher when such occurs.

As you know I'm from MN too and starting in the Yosemite Valley and only doing 10 miles a day, you should have no problem whatsoever with altitude sickness that the OTC solutions provide.

In 2008 after doing the last 165 miles of the JMT I had no problems doing the hike to the summit of Whitney. In 2006 after doing 9 days of the High Sierra Trail but only one mountain pass (Kaweah Gap), I and my two hiking partners felt a little dizzy at Trailcrest Pass (which is 750 feet lower than the summit and is at the junction before going up to Whitney) and we did not do the Whitney summit. What this taught me is that the multitude of increasingly higher passes encountered on the JMT provide the necessary altitude adjustment.

If you do decide to take the Diamox, I would google "diamox altitude" and discuss your concerns with a sports medicine physician.

I was given some diamox while in the himalayas (you can also just buy it off the shelf at nearly any store in Nepal) and used it with great results. My girlfriend and I flew from Chengdu, China (elev. <1000ft) to Lhasa, Tibet (elev, 11,000ft). Gaining more than 10,000 ft in elevation in 2 hrs wasn't fun, but we were some of the few travelers we knew who didn't get pretty sick from the altitude. The only side effect was tingling hands and feet for a few minutes each day, but I think I've read that is a harmless side effect and not uncommon. It definitely helped us at the high passes on our trek.

I have a health condition that makes me particularly susceptible to altitude sickness. Diamox is standard operating procedure for anything over 7500 ft for me. It makes the difference between being able to enjoy skiing at 13,000 ft vs. being a sleep-deprived, vomiting, oatmeal-brained zombie at 10,000 ft.

The only side effect I've noticed is that its diuretic effect requires more fluid consumption and more potty breaks.

My dosage course begins 24 hours before reaching altitude to begin lowering blood pH and increasing respiration rate.

Edited by MikeMartin on 03/02/2009 19:37:24 MST.

I got a prescription before I went to Nepal. I took it at first. It made my fingers tingly. It is just a duiretic.

The leaders of our trip made us gain altitude very slowly. This was their trick to ensuring the best outcome for the trek. It worked to gain altitude slowly because I decided to stop taking the diamox to see if I really needed it. I was fine so I never took it again.

People routinely drive from LA (sea level) to climb Whitney, making the travel from sea level to 14,000 ft in about 24 hours. This is a recipe for altitude sickness and many of them do get symptoms.

Just coming from MN doesn't mean you'll be any more prone to altitude sickness than anybody else. You'll probably be able to acclimatize just fine, especially since you'll be walking over several days to the highest altitudes.

I used it on my last trip to Whitney in the summer of 2007. I used it on day #2 & #3 after going over Forrester Pass at 13,000 feet. After that I did not need it as I was acclimatized to the altitude. When I summited on day #5 I felt great and did not need the Diamox. For me i think the bottom line is acclimatization. If I had spent more time at ~10,000 feet i would not have needed it. Strange thing is that when I was a kid the altitude never bothered me.

Victoria,

I'll agree with what's already been said here but go into a little more explanation (disclaimer- I'm not a scientist or doctor). Barring some physical abnormality you'll be fine if you're hiking N-S. You're basically falling a small scale version of the old climber's maxim 'climb high, sleep low' which gives your body the appropriate setting to best cope with elevation gain in an efficient manner. It's common on the JMT to hike over the high passes during the day and camp at lower elevations. I'm not sure of the science behind this but I'd guess its similar to how your body reacts to a workout- tear down the muscle pushing by weight around, then allow it to recover, resulting in a stronger muscle- except with the oxygen delivery system that is your circulatory system.

The first day or two you might feel a bit more 'out of it' especially since you're going from around 4K to around 7K and its a steady climb out up from Happy Isles trail head to the Tuolumne area. Drink a lot of fluid. Prepare to be a little chilled & restless the first night or two. Most importantly, be aware of the signs of AMS and don't ignore them. If you feel ill for an extended period at over 8K feet, descend!

Oh, and enjoy one of the finest patches of dirt on the entire planet :)

I lived here in Nevada at 6500-7000ft for the first 10 years of my life, and i spent a lot of time above 10000ft on Mt Wheeler in that time. I moved to Iowa when i was 10 and lived there for 10 years, but visited Nevada for a week or so every year. I was an avid runner in Iowa, and twice i took friends with me to nevada. Both of my friends were runners of about the same ability as myself, but they had always lived in Iowa. They quickly noticed some of the symptoms of altitude sickness when we got here, even down at 6500ft. And when we hiked to the summit (13063ft) they were having serious problems and needed to take breaks quite often, whereas i was just pleasantly light headed, like a really intense runners high. So i wonder if there is part of us that is acclimated almost permanently, because im sure most of my blood was completely replaced by new blood in that year that i would spend in Iowa. Or maybe i just enjoy the light headedness. If anybody has any factual information on this, please share.

Also, no surprise here, but age has a huge influence on how one acclimates to thin air. Ive never seen anybody younger than 40 get sick here but ive seen 4 older persons (1m 3f) get so sick that they had to leave this valley entirely in search of a town at lower altitude. And they were just at 6500ft.

Its odd to me that somebody mentioned the fact that the scrips for altitude sickness are diuretics, meaning they make your blood thicker, and another post suggested advil, which i believe thins the blood. I doubt either of these has any influence on the amount of hemoglobin in the blood.....so, um....how does that work?

I recently asked my doctor about what I could take to help with altitude sickness. I experience headache, nausea and become lethargic at elevations above 8,000 feet. He said I should start taking iron tablets starting 1-month before and during my trip and stay well hydrated before and during.

That's interesting. Let us know how that works.

If you are a coffee drinker, don't try going without and
going to altitude, it can amplify any headaches.

Viagra also works-they sell it in China as a less expensive
alternate to Diamox (sp?) for altitude sickness.

Of course the best thing is to go down right away if
you feel real bad. Can be a medical emergency.

Pilots of unpressured airplane cabins are required to
wear oxygen above 8000 ft.

JJ-

Your doctor apparently believes you are anemic, and perhaps that is the case but it doesn't account for the headaches and nausea, just the lethargy. I would say many doctors have little or no experience with altitude sickness and so would not know about Diamox or other treatments. Georgia is not known for its 8000 ft (2400 m) peaks. ;-)

Acetazolamide (Diamox) actually works pretty well and there are some studies that show that Ginko biloba also works for many.

Although the mild form of altitude sickness (Acute Mountain Sickness) (headache, trouble sleeping, nausea, loss of appetite and swelling of face and hands) can occur as low at 6000 ft (1800 m), for most people it is over 8000 ft (2400 m). Usually due to rapid ascent to altitude. Going lower is the preferred treatment or going up slowly over several days may keep it from happening at all. Tylenol or ibuprofen for the headaches and rest may be enough for a mild case. Do not ascend until symptoms have resolved.

Severe altitude sickness is Life Threatening! Immediate Descent at least 3000 ft (1000 m) is recommended. Severe means headaches unrelieved with Tylenol or ibuprofen, vomiting, coordination problems, confusion, stupor, hallucinations, severe lethargy, seizures, coma, stroke like symptoms. You do not have to have all of the above symptoms to have severe AS. Diamox or ginko or rest WILL NOT fix this. You must take the person DOWN, NOW!

Although we mostly think of severe AS happening in the Himalayas and very high mountains, it can happen below 10,000 ft (3000 m) and does so be aware. If your hiking partner is complaining of a headache and getting confused it may not be those mushrooms he's been snacking on, it may be AS.

-Mark

Edited by markhurd on 03/21/2009 21:03:06 MDT.

Altitude doesnt really bother me like i said, i like the light headedness and thats the extent of it in my case. But when i first moved out here by mt wheeler i wanted to feel totally normal at 13000ft. So i hiked up and camped 3 days a week just below the tree line (about 11000ft, i think). To make this more effective, i ate a lot of parsley, which is very rich in iron, and on my trips i would pack a bunch as well. I cant say for sure that the Parsley made a huge difference, because it was probably mostly just the fact that i was sleeping at high altitude, but i had good results. Iron might also explain why women are more prone to altitude sickness, because their iron supply needs to be replenished fairly often, whereas a males iron stays pretty constant. When the amount of iron in the blood drops, so to does the amount of homoglobin. So in my opinion, iron is by far the healthiest and most natural way to acclimate to altitude, but it does take a little more time. Oh yea, and its toxic if you eat to much, and very hard to get out of your blood.

Stefan,

Acute Mountain Sickness (AMS) seems likely to be due to swelling of the brain with gain in altitude. It probably has nothing to do directly with the "amount of hemoglobin in the blood" or the amount of blood you have. Diamox is a diuretic as you note and works by decreasing the swelling. It also increases your respiration rate which tends to actually slow down at rest at higher altitudes, especially when sleeping. Some researches think that it is the amount of space you have in your head that makes the difference between whether you get AMS or not. If you have more room for your brain to swell without being compressed then you may not get symptoms. Some people are just more empty headed than others. ;-)

Also your experience has been that only people over 40 have this problem, but in generally this could happen to anyone, including children. So little ones with a headache, loss of appetite, and lethargy need to be evaluated, too. It's not just for old people.

Also, men and women are equally susceptible to getting AMS.

-Mark

Edited by markhurd on 03/21/2009 21:31:55 MDT.

That makes much more sense. I knew there was a logical explanation for my huge dome piece, now i can embrace my abnormality :). But thanks for that explanation Mark. This might also explain my suspicion of some kind of permanent acclimation to altitude. I wonder if the difference lies in a long term adaptation, or being born and raised at high altitude or if its simply genetic? Would the son of two sherpas who was raised at sea level get altitude sickness? I gotta find a bigger mountain :) thanks again.

when i was first trying out ultralight

had been really jonesing for a backpack & had to squeeze in a quick weekend trip, plus monday

left the house (sacramento - so sea level) much later saturday morning than planned, drove to trailhead (Rock Creek, so pretty high to start - around 9000ft) & started right in hiking, making much faster and easier time due to my new ultralight load. soon found myself pushing on, off trail, through steep, rocky & bouldery 'scape with a fair amount of snow in the shady areas. set up camp next to a lake a bit over 11000 ft - probably a very quick 8 miles in and about 1.5 off trail. didn't notice at first, but i was showing some signs as i set up camp, got water, made dinner, etc. but by the time dinner was done, i was obviously not thinking clearly, lacking coordination (more lacking than usual) & had to force myself to eat my meal. then the weakness and nausea was really starting to set in. so i jumped in bed, hoping rest after the meal would be enough. a couple hours into the night, though, and it was clear that i was still going downhill (figuratively), so i decided i'd better do so literally while i still had legs to stand on. had some uncomfortable discharges from various openings along the way down, but managed to drop about 1500 ft & was about to literally drop myself. jumped in bag & bivy right next to the trail so someone would find my body next morning worst case. was still feeling sick, but the 1500 ft seemed to tip the sand to start balancing out the right way, gradually.

slept like a stone.

woke up, looking forward to some hot tea and breakfast, then realized if i wanted it, i'd have to hike back up to where i'd left my stove and pot. feeling still a bit ill and quite a bit weak, just walked out last couple miles with tail between legs. my friend's son in law (they live in mammoth) followed my directions up, though, and came back with my pot & stove, refusing my offer of both or one of the found pieces of equipment in return for his effort.

now i always, always, always remember the rule i'd already made for myself: always sleep at least one night at high elevation before starting a high elevation trip. last couple longer trips i've actually done 2-3 nights camping around 9-10,000 ft before starting (one partway place that's good is campground at mt. rose - i also like to stop on the way to s. sierras & stealth camp off the road up on monitor pass).

This is a good thread, no one is arguing about who's right or wrong, good info and what works for some may not for others. One note on the Diamox, according to a doctor friend of mine some people are allergic to Diamox. She used Diamox when she climbed Kilimanjaro with no side effects, but he friend couldn't take it.

Mark- no I'm not anemic, my doctor suggested taking iron tabs for one month prior and during the trip then stop. You are exactly right, GA isn't known for high peaks, although I talked to a few hikers this week attempting a thru-hike on the AT, they made the first 30 miles sound like Everest. :D I think where I live is somewhere around 1060 ft.

Stefan- what you said is exactly what my doctor was referring to, keeping the hemoglobin at a more stable level. Even though I'm not anemic, I do know women's iron needs to be replenished more often than men.