Volume 5, Issue 18
May 3, 2012
Going to the mountains? Stop altitude sickness before it hits
With the weather starting to warm up, you might be considering a trip to the mountains. If you are, be careful. It’s very easy to go up in elevation too quickly and get altitude sickness.
Altitude sickness happens when your body comes to an altitude that it can’t quickly adapt to. It’s not uncommon at all for vacationers from the flatlands to get it when they go to the high country. It can be serious enough to kill you at altitudes above 15,000 feet. But at lower altitudes, all it does is make you miserable.
About four years ago, a friend of mine from Southern California and I decided to hike up the Kearsarge Pass outside of Independence, California. He was coming from sea level and I was coming from where I live, which is 4,500 feet. I was concerned that he might develop altitude sickness because the pass we aimed to get past was over 11,760 feet. So we stayed overnight in Lone Pine with the idea that he could acclimate and get used to a higher altitude before the big push. Well, it didn’t exactly work out as planned.
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About 7,000 feet into the climb, Barry gave out. He had nothing left. He pushed as hard as he could, but he had a headache and was queasy. He was so lost for energy that he could hardly move; much less carry a 50-pound back pack up a steep trail. We had to descend until he could regain his energy.
I wish that Barry and I had known about a new study that just came out last month. It showed a safe and easy way to prevent altitude sickness.
The exact causes of altitude sickness are not known, but this study looked at one suspected cause. They knew that there is some evidence that altitude sickness is the result of an inflammatory process. So some researchers looked at whether or not the anti-inflammatory medication ibuprofen (Advil, Motrin) might be able to prevent it.
To test the theory, they rounded up two groups of 43 healthy men and women, all of whom lived at low altitude.
They took both groups to an altitude of 4,100 feet at 8:00 a.m. There, they gave one group 600 mg of ibuprofen, and the other a placebo. The researchers then drove both groups to 11,700 feet where they took a second dose at 2:00 p.m. Then they hiked 2.7 miles to 12,570 feet, where they took the third dose at 8:00 p.m. They spent the night at 12,570 feet and received another dose the following morning.
This is an extremely rapid ascent. Most people will not travel form sea level to 12,570 feet in one day. It was much more stressful than what Barry and I had done. So here’s what happened.
The researchers said 43% of those in the ibuprofen group developed altitude sickness compared to 69% in the placebo group. Additionally, the symptoms in the placebo group were usually more severe than those in the ibuprofen group.
So while it’s clearly not a perfect solution for preventing altitude sickness, taking a few doses of ibuprofen is easy and safe. You might also try anti-inflammatory supplements, such as those found in Reduloxin. While there aren’t any studies showing they will work on altitude sickness, they often work as well as ibuprofen in reducing inflammation. So it’s worth a try.
By the way, if you are out of shape, you are at a much greater risk of having this problem. So it makes sense if you are heading to higher altitudes from sea level this summer to take 600 mg of ibuprofen three times on the day you go and again on the morning after. You just might save yourself some suffering.
And one last thing. There are better drugs to prevent altitude sickness. One is acetazolamide (Diamox) and the other is dexamethasone. But there are two problems with these drugs.
First of all, you need a prescription, whereas ibuprofen is over the counter. And second, they have side effects, which you just won’t see with a short course of ibuprofen. Dexamethasone can cause adrenal suppression, nervousness, delirium, depression, insomnia, and mania. And acetazolamide can cause nausea, dizziness, and fatigue.
Finding your Real Cures,
Frank Shallenberger, MD
Ibuprofen May KO Altitude Sickness By Michael Smith, North American Correspondent, MedPage Today Published: March 21, 2012
Lipman GS, et al "Ibuprofen prevents altitude illness: a randomized controlled trial for prevention of altitude illness with nonsteroidal anti-inflammatories" Ann Emerg Med 2012; DOI: 10.1016/j.annemergmed.2012.01.019.
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