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Altitude sickness

Morbus montanus · Horská nemoc

What it is

Above about 2 500 m thin air starves the body of oxygen; the brain or lungs can swell (HACE, HAPE).

Symptoms & signs

  • Headache
  • nausea and poor appetite
  • dizziness and fatigue
  • poor sleep
  • breathlessness at rest and cough (HAPE)
  • confusion and staggering (HACE)

🚩 Get help if…

  • call 112 / 911 now Confusion, stumbling or very drowsy
  • call 112 / 911 now Breathless at rest, cough or frothy pink spit
  • see a doctor soon Headache and vomiting not better with rest or painkillers
  • see a doctor soon Symptoms getting worse instead of better

Where it strikes

Medical treatment

  • Descend — the most important treatment
  • acetazolamide to prevent and treat
  • dexamethasone for HACE
  • nifedipine and oxygen for HAPE
  • portable hyperbaric bag

Natural & lifestyle

  • Ascend slowly — above 3 000 m sleep no more than 300–500 m higher each day
  • a rest day every 3–4 days
  • 'climb high, sleep low'
  • fluids, no alcohol

Emerging & experimental

  • Ibuprofen for prevention (trials positive)
  • pre-acclimatisation in hypoxic tents
  • inhaled budesonide (trials mixed)

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Coca leaf tea — traditional in the Andes; little studied, no proven prevention anecdotal / traditional
  • Ginkgo biloba — early trials positive, larger trials found no prevention not confirmed in trials
  • Beetroot juice (nitrate) — small studies of oxygen levels early / small studies
  • Garlic and chlorophyll — anecdotal anecdotal / traditional

ICD codes