Travel sense: How to avoid altitude sickness

A traveler's guide for altitude sickness: what is it; common symptoms and concerns; and management strategies.
by Steff LazoHerencia

Puervian Andes, high altitude, Peru For LessDon’t let high altitude sickness ruin your adventure.
Photo from Peruvian Andes website

You’ve been waiting your whole life to see the Andes. You walk off the plane, and shortly after feel like you’re going to pass out — you have altitude sickness. What locals call soroche or altitude sickness is something visitors to high elevation areas dread. It is the body’s natural reaction to a dramatic change in elevation. Although it can make some people feel very sick, others are unphased and their bodies acclimatize quickly. Though generally not serious, it’s best to be informed and well prepared to manage it.

Traveler’s Guide

What is altitude sickness?
Common symptoms
How to prevent altitude sickness
How to manage altitude sickness
Summary of advice

What is altitude sickness?

Altitude Illness or Acute Mountain Sickness (AMS) is a condition caused by a rapid change in elevation without the necessary time for acclimatization. At higher elevations the air is less dense and the body requires a larger amount to obtain the equivalent concentration of oxygen compared to sea level.

This translates to an increased effort in breathing, shortness of breath, lightheadedness, and fatigue. Some travelers experience gastrointestinal problems, such as an upset stomach, nausea or loss of appetite. You may also notice that food takes longer to digest. This is why it is recommendable to avoid heavy meals for the first couple days. You may notice dryness of skin or increased thirst. For this reason it is particularly important to stay hydrated. Another effect of being at greater altitude is increased urination—you should be urinating a lot. Experts advise that you limit or avoid consumption of alcoholic beverages until your body is acclimated. In general, experiencing a little swelling or puffiness is normal. However, if the change is significant, you should keep an eye on other symptoms to assure AMS does not progress.

The myth persists that AMS is determined by the general fitness level of a person, but the symptoms can affect anyone. It is a good idea to monitor your physiological behavior for change (even better to have a friend keep an eye on you and vise versa) in order to prevent complications and have adequate time to descend if necessary.

Common symptoms

Altitude sickness can affect individuals in many different ways. The most common symptoms are shortness of breath, dizziness, headache, dehydration, nausea or vomiting, gastro intestinal trouble, difficulty sleeping and general tired feeling.

Monitor symptoms to assure they do not worsen. If they worsen and medical attention is not provided they could develop into High Altitude Cerebral Edema (HACE), swelling of the brain; High Altitude Pulmonary Edema (HAPE), swelling of the lungs; or Periodic breathing.

HACE and HAPE are serious illnesses that require immediate medical attention. In both cases descent and medical assistance are required. If your group has an oxygen tank, use it immediately.

ALL medications should be taken under advisement of your healthcare provider. Recommendations in this article should be discussed with your doctor. If you suffer from cardiac problems or low blood pressure, you should consult with your physician prior to traveling to topographically high areas.

How to prevent altitude sickness

Pretrip: The only true way to prevent AMS is by gradually acclimating your body to higher elevations. It is important to train and prepare if you will be trekking in the mountains. Make sure you are ready for that level of physical exertion, keeping in mind that carrying excess weight and being at increased elevation will affect your endurance. If you are struggling, remember to lighten your load. If you’d rather not face the added hazard of carrying a heavy backpack while trekking, ask about porters or horses to aid with carrying the load. This has the added benefit of freeing you up to enjoy the views and take pictures.

Upon Arrival: There are a couple of easy steps you can take to help your body acclimate to new elevation. Most locals drink coca tea to help with altitude. This might be a useful natural medicine for you. Avoiding alcohol and smoking for at least one week after arrival at high altitudes, and limiting physical activity for the first 36 to 48 hours after arrival at high altitudes will help ease the acclimatization process. Some people consult with their doctor’s to receive a prescription to acetazolamide to aid with acclimatization or symptoms of AMS. Keep in mind that Acetazolamide (diamox) is a carbonic anhydrase inhibitor, so it will make certain foods, such as carbonated beverages, taste bad. (Other side effects.)

drinking water, high altitude, Peru For LessDon’t forget to drink a lot of water!
Photo from Your PH Life website

How to manage altitude sickness

Travelers encounter high elevation in Arequipa (7,661 ft or 2,335 m), Cusco (11,020 ft or 3400 m) and Lake Titicaca (12,507 ft or 3,812 m). Most travelers have little to no problems in Arequipa, a good midpoint between sea level (Lima) and high altitude (Cusco). This makes Arequipa an ideal destination to gradually acclimatize prior to further ascent. Some hotels in the Andes offer supplemental oxygen directly into your room to aid with sleeping. If this is something that interests you, ask your travel adviser to book accommodations providing such services. Most mid-range hotels will have an emergency oxygen tank. This is less common or unheard of in remote locations. It is best to be well prepared to manage symptoms of soroche (altitude sickness).

“When in Rome, do as the Romans.” This old cliche resounds truth: it is very common to drink coca tea or chew coca leaves in the Andes. This is a traditional medicine used by natives to help aid acclimatization, colds and even stomach sickness. If coca tea isn’t really your thing, talk to your doctor about taking acetazolamide pills with you while you travel, or start taking them one week prior to assure you have no allergies to sulfa-drugs. Worse case scenario you may purchase soroche pills at a local pharmacy. Most of these are a form of acetazolamide (diamox) are sold over the counter in Peru and can aid significantly if AMS symptoms persist. Also, regular ibuprofen can help deal with headaches associated with AMS. Sometimes headaches and dizziness are just a sign of dehydration, which is why you should drink plenty of water or an electrolyte beverage.

coca tea, high altitude, Latin America For LessDrinking coca tea is a local remedy for altitude sickness.
Photo from Verd1der/Flickr

Summary of advice

  • It’s recommended not to climb more than 2,000 feet per day (sleeping altitude).
  • Take it easy for the first couple days; give yourself time to adjust to the new elevation.
  • Drinking coca tea or chewing coca leaves can aid acclimatization.
  • Avoid heavy meals, alcoholic beverages, and smoking for the first few days. (Drinking alcoholic beverages will increase dehydration and mask your body’s ability to sense thirst or cold).
  • Remember to drink plenty of water!