Avoid Altitude Sickness

What is Altitude Sickness?

At over 3,000 meters (10,000 feet) 75% of people will have mild symptoms. The occurrence of AMS (Acute Mountain Sickness) is dependent upon the elevation, the rate of ascent, and

individual susceptibility. Many people will experience mild AMS during the acclimatization process. The symptoms usually start 12 to 24 hours after arrival at altitude and begin to decrease in severity around the third day.

The symptoms of Mild AMS include:

1. Ÿ Breathlessness & Headache
2. Ÿ Nausea & Dizziness
3. Ÿ Loss of appetite
4. Ÿ Fatigue
5. Ÿ Shortness of breath
6. Ÿ Disturbed sleep
7. Ÿ General feeling of malaise

Almost every visitor is affected by the high altitude in Tibet. The reaction may vary from person to person. This has nothing to do with age or sex, but it does have to do with physical fitness. Most of the visitors get acclimatized to the high altitude by taking it easy for one or two days. All these symptoms can be potentially life-threatening conditions that may only be relieved by moving to a lower altitude; travelers should inform themselves about the symptoms so that they can recognize them. The high altitude and people’s reaction to it is one of the difficulties to travel to Tibet. But it is not as serious as you imagined if you know it and get prepared for it.

Prevention of Altitude Sickness

The major cause of altitude illnesses is going too high too fast. Given time, your body can adapt to the decrease in oxygen molecules at a specific altitude. This process is known as acclimatization and generally takes 1-3 days at that altitude. For example, if you hike to Yampachen at 4,300 meters, and spend several days at that altitude, your body acclimatizes to 4,300 meters. If you hike to EBC at 5,200 meters, your body has to acclimatize once again. A number of changes take place in the body to allow it to operate with decreased oxygen.

1. Ÿ The depth of respiration increases.
2. Ÿ Pressure in pulmonary arteries is increased, “forcing” blood into portions of the lung which are normally not used during sea level breathing.
3. Ÿ The body produces more red blood cells to carry oxygen.
4. Ÿ The body produces more of a particular enzyme that facilitates.
5. Ÿ The release of oxygen from hemoglobin to the body tissues.

Acclimatization

1. Ÿ Do not over-exert yourself or move higher for the first 24 hours.
2. Ÿ If you go above 10,000 feet (3,048 meters), only increase your altitude by 1,000 feet (305 meters) per day and for every 3,000 feet (915 meters) of elevation gained, take a rest day.
3. Ÿ “Climb high and sleep low.” This is the maxim used by climbers. You can climb more than 1,000 feet (305 meters) in a day as long as you come back down and sleep at a lower altitude.
4. Ÿ If you begin to show symptoms of moderate altitude illness, don’t go higher until symptoms decrease (Don’t go up until symptoms go down).
5. Ÿ If symptoms increase, go down, down, down!
6. Ÿ Keep in mind that different people will acclimatize at different rates. Make sure all of your party is properly acclimatized before going higher.
7. Ÿ Stay properly hydrated. Acclimatization is often accompanied by fluid loss, so you need to drink lots of fluids to remain properly hydrated (at least 3-4 quarts per day). Urine output should be copious and clear.
8. ŸTake it easy; don’t over-exert yourself when you first get up to altitude. Light activity during the day is better than sleeping because respiration decreases during sleep, exacerbating the symptoms.
9. Ÿ Avoid tobacco and alcohol and other depressant drugs including, barbiturates, tranquilizers, and sleeping pills. These depressants further decrease the respiratory drive during sleep resulting in a worsening of the symptoms.
10. ŸEat a high carbohydrate diet (more than 70% of your calories from carbohydrates) while at altitude.
11. Ÿ The acclimatization process is inhibited by dehydration, over-exertion, and alcohol and other depressant drugs.

Preventive MedicationsDiamox (Acetazolamide) allows you to breathe faster so that you metabolize more oxygen, thereby minimizing the symptoms caused by poor oxygenation. This is especially helpful at night when respiratory drive is decreased. Since it takes a while for Diamox to have an effect, it is advisable to start taking it 24 hours before you go to altitude and continue for at least five days at higher altitude. The recommendation of the Himalayan Rescue Association Medical Clinic is 125 mg. twice a day (morning and night). (The standard dose was 250 mg., but their research showed no difference for most people with the lower dose, although some individuals may need 250 mg.) Possible side effects include tingling of the lips and finger tips, blurring of vision, and alteration of taste. These side effects may be reduced with the 125 mg. dose. Side effects subside when the drug is stopped. Contact your physician for a prescription. Since Diamox is a sulfonamide drug, people who are allergic to sulfa drugs should not take Diamox. Diamox has also been known to cause severe allergic reactions to people with no previous history of Diamox or sulfa allergies.

Dexamethasone (a steroid) is a prescription drug that decreases brain and other swelling reversing the effects of AMS. Dosage is typically 4 mg twice a day for a few days starting with the ascent. This prevents most symptoms of altitude illness. It should be used with caution and only on the advice of a physician because of possible serious side effects. It may be combined with Diamox. No other medications have been proven valuable for preventing AMS.

Both Diamox and Dexamethasone are Western Medicine. You are recommended to consult your doctor for the prescription as they can have some serious side effects.

Tibetan Herbal Medicine-Hongjingtian and Gaoyuan’an are very good preventive and treatment effects for Altitude Sickness and AMS (Acute Mountain Sickness). Honjingtian and Gaoyuan’an (Rhodiola Eoccinea and Hippophae) may help sleep at high altitude and thus increase oxygenation at night. The two Tibetan Medicines can be quite effective in treating altitude sickness. But it also has one side effect: if you take the medicine, your alcohol resistance will be higher, i.e. you can drink more before you get drunk. In accordance with theories of modern medicine,” oxygen deficit is the mother of all sickness”. Highland Hongjingtian can better regulate oxygen deficit in the local parts of the internal organs of human beings, can increase the degree of blood oxygen saturation, generating self-cure immunity, and thereby enhance life vitality. In addition, Hongjingtian has also function of relieving alcoholism (more alcohol can be consumed when in taking this kind of beverage before or after).

The altitudes of different places in Tibet

Place	Altitude	Place	Altitude
Lhasa	3658 m	Nyingchi	3000 m
	12001 ft		9843 ft
Nagqu	4507 m	Tsedang	3500 m
	14787 ft		11483 ft
Qamdo	3205 m	Shigatse	3836 m
	10515 ft		12585 ft
Damshung	4200 m	Gyantse	4040 m
	13780 ft		13255 ft
Pome	2750 m	Tingri	4300 m
	9022 ft		14108 ft
Amdo	4800 m	Zayui	2325 m
	15748 ft		7628 ft

Who’d better not come?

1. Everyone should have more or less altitude symptoms. However, those who have the following symptoms may not come to Tibet
2. Someone relating to tuberculosis, pneumonia, serious tracheitis, bronchitis
3. People who suffer from high blood pressure and severe heart disease should seek medical advice before going to Tibet.
4. Have already got a serious cold.

Health Considerations

Because of its high altitude, largely remote destinations, and semi-arid weather Tibet comprises a unique set of health concerns. You don’t need to worry about Malaria or odd strains of para-typhoid here, but you should certainly consider the sun and altitude.

We do not want to supplant advice from professionals and more complete suggestions available in guidebooks, so we suggest you consult appropriate sources before coming. Our trips our designed so you do not over-exert yourself in the first few days, and our guides are experienced and aware of the dangers of altitude sickness. There is preventative and symptomatic medication to help with the minor symptoms of altitude sickness (headaches, nausea) and we recommend that you bring some.

We also strongly suggest that you bring sunglasses, hat and sunscreen — Tibet is not the place to work on your tan. Further clothing and equipment depends on the type of trip you are doing here. We are happy to make suggestions or recommend published sources for more information on appropriate supplies.

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