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14er newbie - frequent urination while hiking, AMS??

FAQ and threads for those just starting to hike the Colorado 14ers.

Re: 14er newbie - frequent urination while hiking, AMS??

Postby Somewhat of a Prick » Tue Sep 18, 2012 8:54 pm

summerspirit wrote:
Somewhat of a prick wrote:I pee all the time on 14'ers because I'm drinking lots of water. If your pee is crystal clear, thats a good sign.

As far as your headache goes, I've been there. I moved here from Chicago 9 months ago and after 9 14ers...I feel your pain. After I summited Evans, I had a headache so bad that I was throwing up. It didn't help that I was getting hailed on at the same time for an extra kick in the teeth. What I've found works is to take a couple gatorades with you and pound those along with water. I did that for the last 2 14'ers and I noticed a BIG difference.

And grats on your 1st 14er


We moved here from Chicago too (Western Suburbs) a little over 5 years ago! :)

I feel a lot better after reading these responses, thank you everyone! It was very clear, and not discolored at all so maybe it was just all the drinking = all the peeing as you've said :) Maybe next time we'll bring some Gatorade as well, hopefully that helps. We also plan to work on our fitness level for next season as well, which will no doubt help as well.


Where at? I lived in Naperville and Geneva most of my life. Lots of Chicago transplants here!

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Re: 14er newbie - frequent urination while hiking, AMS??

Postby laxcountrypiper » Tue Sep 18, 2012 8:56 pm

I have at least some of the symptoms of altitude sickness nearly every time I go above 13K feet. I do believe the frequent urination thing is a symptom, but I typically only experience that symptom if I have not climbed in the last 6 months. I'll easily get a headache if the pace is fast and I did not climb the weekend before. And before the headache, I get dizzy and really have to be more conscious of my movements. I didn't really notice that I getting dizziness until I went above 14k feet two days in a row and it didn't happen on the second day. Having a clear head on top makes the expierence so much better.

hahah, HAFE is no joke.

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Re: 14er newbie - frequent urination while hiking, AMS??

Postby iholdthepain » Tue Sep 18, 2012 9:03 pm

Speaking as a fellow 14er newbie...

...since it's being discussed, what IS the proper etiquette for making pitstops on hikes/climbs? My wife and I both tend to overhydrate and make frequent stops where possible. Unfortunately, there are not always discreet places to stop, and some of the privies along the trails are horrendous!!! This problem is relatively simple for me (being male), however, it's not so inconspicuous for the females... and I don't think the wife wants to be caught squatting someday behind Granite Pass... :oops:
To quote the great Paul Petzoldt,

“…Some people say that experience is the best teacher. To heck with that. I know people who have been making the same mistakes for forty years.”

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Re: 14er newbie - frequent urination while hiking, AMS??

Postby summerspirit » Tue Sep 18, 2012 9:03 pm

MUni Rider wrote:Did you consume anything with salt or other electrolytes? If you are low on that, then copious amounts of straight water would exacerbate the situation, especially while your body is undergoing continued physical exertion. Even more so if you are participating in a activity that your body is not used to, and in an environment that your body is not accustomed to, ----> 14,000 ft.

If the physical conditions you felt after you got home went away after a day or two then I wouldn't be too worried about next years 14er hikes. I recall feeling like total udder crap after my first few crossfit workouts a couple years ago. Now that I am used to it, occasionally I may still feel nauseous after a really good hard workout, but it goes away within 10-20 minutes. My body just got used to it. The sore muscles? That may take a day or so. :wink:

BTW, My medical credentials are ZERO so keep that in mind in regards to my statements. Remember, you know your body better than anyone else in the world. Just don't let a few sore muscles stop you from pushing harder.

----Congrats on your 1st summit, and welcome to your new addiction!


Thank you! :) I had some salt in my trail mix (nuts, pretzels, etc.) but I really didn't eat that much. My headache went away the next day, and the nausea only lasted for about 30 minutes or so, so maybe that was due to pushing myself so hard? My leg muscles were sore for 2 days though! :)

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Re: 14er newbie - frequent urination while hiking, AMS??

Postby summerspirit » Tue Sep 18, 2012 9:05 pm

Somewhat of a prick wrote:Where at? I lived in Naperville and Geneva most of my life. Lots of Chicago transplants here!


I grew up in West Chicago, but also lived in Lisle and Naperville as an adult. Small world!

Re: 14er newbie - frequent urination while hiking, AMS??

Postby forbins_mtn » Tue Sep 18, 2012 9:05 pm

iholdthepain wrote:Speaking as a fellow 14er newbie...

...since it's being discussed, what IS the proper etiquette for making pitstops on hikes/climbs? My wife and I both tend to overhydrate and make frequent stops where possible. Unfortunately, there are not always discreet places to stop, and some of the privies along the trails are horrendous!!! This problem is relatively simple for me (being male), however, it's not so inconspicuous for the females... and I don't think the wife wants to be caught squatting someday behind Granite Pass... :oops:


most people on the mountain don't care. you should try to aim for rocks when possible. when you pee on shrubbery, the animals will go after it from the salt content in urine.

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Re: 14er newbie - frequent urination while hiking, AMS??

Postby speth » Tue Sep 18, 2012 9:19 pm

iholdthepain wrote:Speaking as a fellow 14er newbie...

...since it's being discussed, what IS the proper etiquette for making pitstops on hikes/climbs?


Just turn your back on the people on the trail. They might even think you're just enjoying the view.
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Re: 14er newbie - frequent urination while hiking, AMS??

Postby MountainMedic » Tue Sep 18, 2012 9:22 pm

I'm going to be a medical elitist here, so bear with me or just ignore this post.

Excessive urination, or polyuria, is not necessarily a symptom of AMS so much as a sign of your body adjusting to the altitude. You did everything right by drinking tons of water (overhydration is certainly possible, but is much harder to achieve than people think). The exact pathophysiology (mechanism) of AMS is poorly understood, but it starts with hypoxia. This is pretty basic - there's less oxygen up high, so you breathe faster. Breathing faster means you breathe off more carbon dioxide than you normally would at sea level or in Denver, where you live (and are acclimated to the altitude). This is where it starts to get complicated, which always seems to be the case when the kidneys get involved.

Your respiratory drive is based primarily off of high levels of CO2 (and less off of low levels of oxygen). As you exhale excess CO2, your respiratory rate slows again, and you are no longer getting enough oxygen. CO2 makes the blood more acidic (I won't go into this), which is a large part of what comprises your respiratory drive. Your kidneys compensate for this decrease in respiratory drive by essentially mimicking CO2 increases in your blood. In order to do this, they excrete bicarbonate, a salt, into the urine. If you all recall HS biology (hypertonic, hypotonic, isotonic), water follows salt. This means that as your kidneys buffer your body's pH, they also produce absurd amounts of urine. Diamox (acetazolamide) actually works on the kidney, making it excrete bicarbonate - one "side effect" is that you piss like crazy.

This "renal buffering" effect is diminished with adjustment, as hemoglobin molecules become more capable of releasing oxygen to tissue. In other words, this won't keep happening to you unless you're just unlucky (adjustment to altitude is almost entirely genetic).

Your headache, on the other hand, is the first step to AMS. High altitude headache (HAH) is pretty much defined as a headache at altitude - no shocker there. AMS is HAH with the addition of one or more of the following symptoms: nausea/vomiting, dizziness, fatigue, insomnia. The headache is generally throbbing, as you described, and diffuse/global (70% of patients describe it this way). Photosensitivity is common, and the headache is generally worsened by motion: pretty much just like a really bad hangover. It's not at all uncommon for this to set in after descent and fade after a couple hours.

While I'm on the subject, I might as well mention HAPE and HACE. They're rare in Colorado, and it's not really understood how they happen. One leading theory is that as the pH of your blood changes, albumin - a ubiquitous plasma protein that binds tons of stuff and carries it in the bloodstream - loses its ability to bind calcium. Calcium is released en masse, and, being an ion that does just about everything, it results in vasoconstriction (your blood vessels constrict). Simply put, this "squeezes" plasma out of the bloodstream, often through the small capillaries in the brain (HACE) or lungs (HAPE). Again, this is somewhat theoretical.

Sorry for the rant! I love this stuff and think all high altitude folks should have some idea how it works. Congrats on your first 14er, and keep climbing!

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Re: 14er newbie - frequent urination while hiking, AMS??

Postby LuLuLuv » Tue Sep 18, 2012 9:30 pm

It could be TBS, that is what I have...tiny bladder syndrome. Its nothing for me to urinate up to 8 times, I do drink a lot, usually carrying 3 liters. But I stay pretty hydrated most of the time.

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Re: 14er newbie - frequent urination while hiking, AMS??

Postby iholdthepain » Tue Sep 18, 2012 9:33 pm

speth wrote:
iholdthepain wrote:Speaking as a fellow 14er newbie...

...since it's being discussed, what IS the proper etiquette for making pitstops on hikes/climbs?


Just turn your back on the people on the trail. They might even think you're just enjoying the view.


...again, easy for me, but what about the Mrs? Should I just send her back to the Goblin Forest?! Nobody checks out the view from a 2ft high crouching position, pants around the ankles... it gets a little wide open o some of these hikes... especially above 11,500ft.
To quote the great Paul Petzoldt,

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Re: 14er newbie - frequent urination while hiking, AMS??

Postby summerspirit » Tue Sep 18, 2012 9:40 pm

MountainMedic wrote:I'm going to be a medical elitist here, so bear with me or just ignore this post.

Excessive urination, or polyuria, is not necessarily a symptom of AMS so much as a sign of your body adjusting to the altitude. You did everything right by drinking tons of water (overhydration is certainly possible, but is much harder to achieve than people think). The exact pathophysiology (mechanism) of AMS is poorly understood, but it starts with hypoxia. This is pretty basic - there's less oxygen up high, so you breathe faster. Breathing faster means you breathe off more carbon dioxide than you normally would at sea level or in Denver, where you live (and are acclimated to the altitude). This is where it starts to get complicated, which always seems to be the case when the kidneys get involved.

Your respiratory drive is based primarily off of high levels of CO2 (and less off of low levels of oxygen). As you exhale excess CO2, your respiratory rate slows again, and you are no longer getting enough oxygen. CO2 makes the blood more acidic (I won't go into this), which is a large part of what comprises your respiratory drive. Your kidneys compensate for this decrease in respiratory drive by essentially mimicking CO2 increases in your blood. In order to do this, they excrete bicarbonate, a salt, into the urine. If you all recall HS biology (hypertonic, hypotonic, isotonic), water follows salt. This means that as your kidneys buffer your body's pH, they also produce absurd amounts of urine. Diamox (acetazolamide) actually works on the kidney, making it excrete bicarbonate - one "side effect" is that you piss like crazy.

This "renal buffering" effect is diminished with adjustment, as hemoglobin molecules become more capable of releasing oxygen to tissue. In other words, this won't keep happening to you unless you're just unlucky (adjustment to altitude is almost entirely genetic).

Your headache, on the other hand, is the first step to AMS. High altitude headache (HAH) is pretty much defined as a headache at altitude - no shocker there. AMS is HAH with the addition of one or more of the following symptoms: nausea/vomiting, dizziness, fatigue, insomnia. The headache is generally throbbing, as you described, and diffuse/global (70% of patients describe it this way). Photosensitivity is common, and the headache is generally worsened by motion: pretty much just like a really bad hangover. It's not at all uncommon for this to set in after descent and fade after a couple hours.

While I'm on the subject, I might as well mention HAPE and HACE. They're rare in Colorado, and it's not really understood how they happen. One leading theory is that as the pH of your blood changes, albumin - a ubiquitous plasma protein that binds tons of stuff and carries it in the bloodstream - loses its ability to bind calcium. Calcium is released en masse, and, being an ion that does just about everything, it results in vasoconstriction (your blood vessels constrict). Simply put, this "squeezes" plasma out of the bloodstream, often through the small capillaries in the brain (HACE) or lungs (HAPE). Again, this is somewhat theoretical.

Sorry for the rant! I love this stuff and think all high altitude folks should have some idea how it works. Congrats on your first 14er, and keep climbing!


Thanks so much for your very thorough post! It helps understanding how the body works, so I appreciate you taking the time to type it all out. I was curious about my headache getting worse as I descended, as I figured it would improve instead, which made me think it was caused from something else but I guess most likely it was AMS, with the brief nausea being the second symptom. One question - how can you tell if you may have HAPE/HACE or just AMS?

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Re: 14er newbie - frequent urination while hiking, AMS??

Postby HikerGuy » Tue Sep 18, 2012 9:41 pm

iholdthepain wrote:it gets a little wide open o some of these hikes... especially above 11,500ft.


I will stand behind or in front of my wife and hold a jacket open as a blind, thus covering the backside or front side. One blinded direction usually suffices in an emergency.

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