Going to the Mountains? Stop Altitude Sickness Before It Hits

Dr. Frank Shallenberger, MD
December 24, 2018


Now that winter is here, you might be considering a trip to the mountains. There are all kinds of winter activities this time of year in the mountains. So it’s worth the trip. But if you’re going to high altitude, be careful.

It’s very easy to go up in elevation too quickly and get altitude sickness. Here’s an easy way to avoid it and have a wonderful time in the mountains.

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.

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 backpack up a steep trail. We had to descend until he could regain his energy.

Research Finds a Simple Fix

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 from 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.

Or you can take CircO2. This supplement provides a boost of nitric oxide to your blood, and is said to work exceptionally well at preventing and treating altitude sickness. If you go to the mountains, I’d rather see you take this than the ibuprofen. It won’t cause any digestive problems. But it will give you other health benefits in addition to giving you a great time on vacation.

FDA Approved Treatments Don’t Measure Up

CircO2 and ibuprofen are also a lot easier to take than what the FDA has approved for altitude sickness. The FDA has approved a low-pressure “mild” portable HBO fabric chamber for use in high altitude sickness. And, amazingly enough, the latest research is showing that the lower pressure easily achieved by these fabric chambers is all that it takes to get the desired results. While these are fantastic, you’re not likely to have access to one when you need it. So stick with the CircO2 and ibuprofen.

The FDA has also approved two 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. These aren’t any better than altitude sickness.

Other Quick Tips

If you’re traveling to high altitudes, regardless of the time of year, here are some simple tips that will help you avoid getting sick.

1. Drink plenty of water – The first thing anyone who lives at altitude will tell you upon arrival is to drink lots of water. That’s because this (along with CircO2 and ibuprofen) is the best way to avoid altitude sickness. Carry a water bottle with you everywhere you go and make sure you keep it filled. It’s your best friend whether you’re walking around town shopping, hiking up the trail, or taking the ski lift to the top of the mountain. Water is crucial.

2. Avoid alcohol – While drinking water will help, drinking alcohol will have the opposite effect. Alcohol, along with cigarettes and sleeping pills can make altitude sickness symptoms worse. So it’s best to avoid these if at all possible. You shouldn’t be taking sleeping pills anyway, as melatonin is all you need to sleep. And melatonin won’t make altitude sickness worse. If you want to drink alcohol, wait at least 48 hours at elevation before you do. This will give your body time to adjust.

3. Climb slowly – Even though Barry was walking at a relatively slow pace, he was still ascending too fast. In order to adjust, your body needs about two to three days of slowly going higher. So it’s best if you can avoid flying or driving directly to your destination. Instead, go up a little higher each day, then stop to rest for the night. Continue moving up the next day, and stop to rest again. If you have to fly or drive, pick a lower altitude to stay at for 24 hours before going all the way up. For instance, if you’re going to Colorado, fly into Denver and stay there for a night or two before driving up to the mountains.

Even when you’re hiking, be careful not to go up too fast. Make sure you have stopping points at lower elevations where you can stop to rest before reaching your final destination. Try to ascend no more than 1,000 feet each day. And plan to rest for a day for each 3,000 feet you go higher.

4. Eat carbs – This one might surprise you, since I tell you to avoid carbs. But when traveling to higher altitudes, you need more calories. But don’t eat junk carbs, such as chips and fries. Eat whole grains and other complex carbs that will give you good nutrition and energy.

5. Rest regularly and don’t overdo it – Make sure you take it easy when you’re at altitude. You’ve come to have a good time. But it’s easy to overdo it. There are a lot of activities you can do. But make sure rest is on your schedule of events. And make sure you don’t exercise too strenuously.

Be aware that altitude sickness can get worse at night when you’re sleeping. So try to move to lower elevations when you’re going to sleep. This is especially important if you climb more than 1,000 feet in a day. Which brings us to the final tip.

6. The cure – The best, fastest, and easiest way to cure altitude sickness once you have it is to move down in elevation. It will usually go away as soon as you do. You’ll quickly recover and feel normal again.

Finally, don’t let all of this dissuade you from going up in altitude. Just make sure you’re healthy enough to make the trip and take these precautions. You’ll have a great time and feel great doing it.


Lipman, G.S., 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.

Smith, Michael. “Ibuprofen May KO Altitude Sickness,” North American Correspondent, MedPage Today Published: March 21, 2012.

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