[brettcarroll0928]

After years of thinking that everyone felt terrible/experienced S/Sx of moderate AMS when traveling at altitude, I have finally realized that I think my body does a poor job of acclimating. I have experienced near debilitating AMS several times near/above 6000 meters, but even experience what I consider worse than average AMS at/above 4000 meters in the lower 48. I understand the basic tips/advice for acclimating (slow ascent to new altitudes, avoid respiratory depressents, high carb diet, etc) and also know that ability to acclimate can often be genetically linked, but I was wondering if anyone has had any success in finding ways of improving how their body responds to high altitude?

For additional context I was just in Peru where at the end of our trip, after having spent 10 nights at 3000 meters, 18 nights between 4-4500 meters, 3 nights at 5000 meters, and having climbed higher than 5500 meters 3 times, we climbed/skied Nevado Copa (6188m). Even with all this time acclimating I developed moderate AMS with loss of appetite, nausea, headache, foggy mind, and general fatigue. I live in SLC and climb/ski at up at 11000 ft regularly without issue. I had strong aerobic fitness going into our Peru trip, routinely doing days with twice the elevation gain we did on Copa. I would love to find a way to improve how my body acclimates, as it is frustrating to feel so sick every time I climb to a new altitude above 4000m.

Topic

[cnikirk]

cnikirk on June 13, 2019 at 11:58 am #23510

I have a couple of friends that seem to struggle each time they go above 10,000 feet, so there certainly seems to be a strong genetic component.

I used to use Diamox but hate the side effects. I just started hyrdrating really well and using ibuprofen. I take anywhere from 2 – 8 OTC ibuprofen each day I’m 10K or higher. It is anecdotal I know, but some studies also suggest ibuprofen helps. I usually come from sea level as well, so I always try to stay in front of altitude sickness.

[Anonymous]

Anonymous on June 14, 2019 at 9:48 am #23545

What we do not know about acclimatization would fill a book.

Steve and I were presenters at an international Special Forces conference 18 months ago. One of the other presenters was Dr Rob Roach of the CU medical center. We are trying to get permission to place a video of Rob’s talk on our site. Rob is the world’s authority on acclimatization. He conducted a study in Bolivia where he took an entire genetics lab to a 16,000 ft observatory for 2 weeks and tested 20 well trained endurance athletes during this time. Some of his remarks are very interesting and impact heavily what Brett is talking about. Over 1/4 of the entire human genome is affected when we move up in altitude. That’s 5000 genes!! About 1/2 are up regulated and the other 1/2 are down regulated. A small handful were dramatically affected. Those are genes that they see as dominant in high altitude indigenous populations. The function of all but 2 is not known.

So, the state of the art tells that the ability to, and rate of acclimatization is highly genetically determined, hence highly individual. But there a vast amount on undetermined information out there right now as far as how the body reacts to altitude.

The good news is that Rob said that he envisions within a few years being able to tweak some of these genes with drugs so that one can pre-acclimate at sea level.

Sadly, one thing neither he not Peter Hackett mentioned during their talks was how to improve acclimatization.

Scott

[brettcarroll0928]

brettcarroll0928 on June 14, 2019 at 3:33 pm #23562

I agree, I also don’t like Diamox very much. It doesn’t feel too helpful, and I’m not a fan of the side effects. Ibuprofin helps with the headache, but doesn’t seem to do anything for the other symptoms. Thanks for the thoughts, cheers!

Thanks for the response Scott, too bad there’s no silver bullet (yet?). I’d be interested in watching the video of that talk if/when you’re able to get it up on the site. It’ll be interesting to see what progress we make in high altitude medicine in the coming years.

[psathyrella]

psathyrella on June 16, 2019 at 3:07 pm #23613

I can definitely relate. I climb with a wide variety of people from much less fit to much fitter, and on any kind of day where altitude is part of the challenge, my speed almost always takes way more of a hit than my partner’s. I’ve finally admitted that it’s something that is worth devoting time to improving, which is frustrating since legitimately high altitudes do not figure into even medium term goals for me. But despite making a lot of progress in fitness and fat adaptation the last few years, I haven’t seen much improvement in altitude tolerance.

It would be great to have more ideas (in particular that ^ video would be amazing) but my understanding is that increasing the number of times you’ve acclimated to a given altitude is a great way to improve your acclimatization for future trips to that altitude. While it’s not particularly appealing, planning trips whose primary goal is acclimatization training rather than skiing or climbing something interesting is as far as I can tell a thing that people do.

I live at sea level, and my immediate goals aren’t much above 4000m, so for me I’m just scheduling trips to Colorado. This makes me cranky, since climbing-wise I would much rather hang out in Canmore than Ouray, but hopefully it will prove worthwhile. It sounds like you’re well adapted to 3000-4000m, but trying to go to 6000m. Trips to 6000m are of course much more expensive and time consuming, but it seems possible that several years of 6000m trips (maybe going a week early to acclimatize before your likely more genetically advantaged partners) might make a big difference to trips in future years. And at least for me it has helped my motivation to admit that I’ve tried the I’ll-just-tough-it-out approach long enough to be pretty darn sure the end result will be a good chance we’ll have to bail because I suck at altitude.

I tried to fix a link and it seems to have instead deleted the post, so apologies if this shows up twice.