Altitude Sickness...

FAQ and threads for those just starting to hike the Colorado 14ers.
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Re: Altitude Sickness...

Postby PolishPete » Fri Dec 16, 2011 9:26 am

Awesome TR, and great climb Ruben!
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Re: Altitude Sickness...

Postby [jon] » Sat Dec 17, 2011 11:01 pm

Theres been some good info posted, but just to repeat some of it because I think it's important - stay hydrated. Especially since you'll be skiing for 3 days before you hike. Skiing is a physical sport that can drain your fluids, electrolytes, and fuel reserves. So doing that for 3 days before you attempt to climb a 14er in the snow (which I imagine is more taxing than when there isnt snow) can really test your limits. You'll probably be a bit more slow, and sluggish, and not feeling 100%, but that might not have anything to do with the altitude. So be sure to take in plenty of water, electrolytes, and calories. And get plenty of sleep... not being well rested is a good way to drain your energy.

Sometimes I have gotten bad headaches on the way down a 14er. But for me I believe they're mostly from dehydration, and lack of electrolytes, as well as looking down at the ground for each foot step (I also end up with a sore neck from that). So be smart about food, and water and that will probably help you out the most.
The journey of a thousand miles starts with one foot step - Lao Tzu
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Re: Altitude Sickness...

Postby chrismjx » Sun Dec 18, 2011 3:14 pm

Elizabeth37 wrote:Fitness is part of it, but the Department of Defense wouldn’t be backing a study to develop a test for it if it was the only or main component. From what I’ve read genetics is a significant factor, which is what the study is looking at. I’ve done a bunch of marathons and an ironman too, so I’m in decent shape. I haven’t spent much time over 10K and once I hit about 13K I can’t turn my head without feeling like I’m going to pass out.

I agree, genetics must have quite a bit to do with it, because despite being winded from climbing 3 flights of stairs in Denver most days, I can hike, climb, snowboard etc. at high altitude (12k+) usually with no issues at all. Once, I thought maybe I was experiencing some early symptoms of HAPE on Mt. Bierstadt of all places, but they abated as soon as we started descending, probably by the time we hit 13k...
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Re: Altitude Sickness...

Postby uwe » Sun Dec 18, 2011 8:41 pm


Do not take diamox. It is a drug designed to alleviate altitude sickness at higher altitudes for folks doing multi-days in high altitude.
Not for a day on the mountain to avoid a headache. A couple of bayer aspirin to start and stay hydrated and fueled-up are key.

Three days of skiing will work your legs pretty good.
Then a climb. Like the ambition.

Proper gear, route knowledge, a climbing plan shared with family/friends including a expect me back by and if not call, 911 work. Weather (
CAIC, (, for avy reports.

Long distance running is a little counter intuitive to altitude climbing.
In LDR, you breath shallow. For altitude climbing you are trying to suck in every last O2 molecule available.
The other thing is you can make the wrong decision because of over-confidence tied to the endurance experience: "I can finish".
This could get in the way of safe climbing and good decisions.
Unlike running to exhaustion where you can typically call for a ride - I did this at mile 21 of the 1981 Atlanta Marathon - when you are at altitude in the wilderness, working to exhaustion to get to the top can kill you. You still have to come down. No one to call to pick you up until you get back to the TH. The aerobic from LDR will certainly help stamina, endurance, but you will still be sucking for air. Strength training - lunges, squats, calf raises, core and upper body strength building helps a lot if you are not already doing it.

Looking forward to seeing how you made out.
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Re: Altitude Sickness...

Postby gdthomas » Sun Dec 18, 2011 9:53 pm

This will be your first 14er. You may have no altitude problems or you may feel like crap. It's hard to say. Get in the best shape you can, hydrate while you are in Colorado, avoid alcohol, limit your caffeine intake, DON'T TAKE DRUGS (diamox, aspirin or otherwise), and eat as you would at home while you're here. In other words, don't make drastic changes searching for a magic formula to avoid altitude sickness. Skiing should help you adjust but you might consider skiing two days, resting on day three and climbing on the 4th day. Otherwise, you may be too tired after three straight days of skiing to complete a winter 14er climb.
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Re: Altitude Sickness...

Postby Wish I lived in CO » Mon Dec 19, 2011 6:01 am

I must rebut here regarding diamox, please do not take personally. As I expressed earlier, I agree whole heartedly with most that the first course should be to try climbing without it as you may do fine, or if not then descend if need be. Then the next time if need be you may want to consider acetazolomide (diamox) - of course consult your doctor as it is a prescription drug. Please see link with useful information regarding acclimating:

Quoting from the link the section on acetazolamide:

There is a lot of mythology about acetazolamide:
MYTH: acetazolamide hides symptoms
Acetazolamide accelerates acclimatization. As acclimatization occurs, symptoms resolve, directly reflecting improving health. Acetazolamide does not cover up anything - if you are still sick, you will still have symptoms. If you feel well, you are well.
MYTH: acetazolamide will prevent AMS from worsening during ascent
Acetazolamide DOES NOT PROTECT AGAINST WORSENING AMS WITH CONTINUED ASCENT. It does not change Golden Rule II. Plenty of people have developed HAPE and HACE who believed this myth.
MYTH: acetazolamide will prevent AMS during rapid ascent
This is actually not a myth, but rather a misused partial truth. Acetazolamide does lessen the risk of AMS, that's why we recommend it for people on forced ascents. This protection is not absolute, however, and it is foolish to believe that a rapid ascent on acetazolamide is without serious risk. Even on acetazolamide, it is still possible to ascend so rapidly that when illness strikes, it may be sudden, severe, and possibly fatal.
MYTH: If acetazolamide is stopped, symptoms will worsen
There is no rebound effect. If acetazolamide is stopped, acclimatization slows down to your own intrinsic rate. If AMS is still present, it will take somewhat longer to resolve; if not - well, you don't need to accelerate acclimatization if you ARE acclimatized. You won't become ill simply by stopping acetazolamide.

As indicated the drug like most has side effects, and I've experienced some of them. But the effects are not in anyway permanent and I don't feel I'm endangering my health either short or long term. Taking acetazolamide is not evil like taking LSD or something. It simply helps you acclimate (not mask) and makes the climb more enjoyable. I am not a purist and not out to set any records, just want to have fun climbing in the mountains and acetazolamide helps me to accomplish this.
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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Re: Altitude Sickness...

Postby climbing_rob » Mon Dec 19, 2011 7:40 am

The Diamox debate is never ending. My take on it, first merely an anecdote:

My Colorado climbing buddy of some years and a couple dozen 14ers, an accomplished marathoner, many time participant in the Pikes Peak Marathon, never an altitude sickness problem, moved to San Diego.

Next year, came back to CO to climb a 14er, acclimated a couple days, got puking sick on our 14er climb. Asked my advice, I said simply "Diamox, low dose (60mg twice a day)". Next year, he came back for the PPM, took low dose Diamox, zero problem!

I swear by the stuff, I use it for climbs > 20,000', never once had AMS. Would I have come down with AMS without taking it? Who knows. Why risk it for a multi-thousand dollar trip? A Diamox prescription costs about five bucks.

Diamox gets a bad rap because of the ridiculous 250mg twice a day dosage generally prescribed. This is the dose little old ladies take for their glaucoma, and docs, not knowing any better, prescribed the same for high altitude use. This dose generally creates annoying side effects. Take merely a fourth of that dose, and voila, faster acclimation to CO altitudes for sea level dwellers. Try some first at home to make sure you don't react to it. Its a Sulfa drug, and some claim allergies to such.

The bottom line: Diamox accelerates acclimatization. Why would you not take it coming from sea level for a limited time in CO?
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Re: Altitude Sickness...

Postby Colorado_Man » Sat Jan 14, 2012 12:28 pm

Well, there is no proven traits amongst people that will be affected by altitude. The biggest misconception is that you have to drive to the top of Everest to ever get altitude illness. This is certainly not true. I personally got some effects of AMS (acute mountain sickness) while going from Savannah Ga. (12ft) to Springer Mt Ga, just over 3,780 if I'm not mistaken. So this is something to take into consideration. As far as prophylactic measures, hydration is paramount. You may also get some benefit from taking low dose asprin for a week or so prior to your arrival. Now, as far as Diamox (acetazolamide) is concerned, this medication may in fact help. I am not going to recommend any dosages of any Rx drug on the internet, so you'd have to get an appropriate dosage from your family doctor. But remember, nothing will make up for proper acclimatization. But, you get the most benefit from sleeping at elevation where your body adjusts and increases the amount of oxygen carrying red blood cells necessary to perform at elevation. But all in all, enjoy your trip!
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Re: Altitude Sickness...

Postby Fred North » Sat Jan 14, 2012 9:17 pm

We live at about 450 feet. Most of our friends have never been sick on a climb but one who is incredibly fit can't get past 13,500 without getting terribly sick. It is an individual thing. Like an earlier post said, climb as high as you can and have a blast.
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Re: Altitude Sickness...

Postby bking14ers » Sun Jan 15, 2012 10:19 am

My nephew gets altitude sickness really bad, and he is very fit. Does Diamox work as good for very fit climbers? Has any fit climbers prone to AMS been cured of it by using Diamox? The dumb thing is, the closer we get to the summit the AMS goes away, and he becomes Super Man. On the way down it all comes back just as bad.
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Re: Altitude Sickness...

Postby SeracZack » Sun Jan 15, 2012 11:05 am

bking14ers wrote:My nephew gets altitude sickness really bad, and he is very fit. Does Diamox work as good for very fit climbers? Has any fit climbers prone to AMS been cured of it by using Diamox? The dumb thing is, the closer we get to the summit the AMS goes away, and he becomes Super Man. On the way down it all comes back just as bad.

That doesn't sound like AMS. AMS will get worse as you go up and will go away only with descending. I could be wrong, but that sounds like something else. But I am certainly no expert here.
Security is mostly a superstition. It does not exist in nature, nor do the children of men as a whole experience it. Avoiding danger is no safer in the long run than outright exposure. Life is either a daring adventure, or nothing.
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Re: Altitude Sickness...

Postby Jim Davies » Sun Jan 15, 2012 11:31 am

Very fit people are often more likely to get AMS, because they ascend too fast.
Climbing at altitude is like hitting your head against a brick wall — it's great when you stop. -- Chris Darwin

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