Altitude Sickness and Diamox

On this page:

• What is altitude sickness and what are its symptoms?

• What is Acetazolamide (Diamox) and how does it work against AMS? Is it effective?

• What are the side effects of Diamox? Is it necessary to consult a doctor before taking it?

• When and why does one get AMS?

• Can Diamox be taken as a preventive measure or only when symptoms appear? Is it necessary?

• Are there any alternatives to Diamox for dealing with AMS?

• How do you prevent AMS?

• What is the treatment for AMS?

• Conclusion

Disclaimer: The information provided here is for general purposes and should not substitute professional medical advice. Always consult a qualified healthcare professional before starting any medication, and for personalised guidance concerning altitude sickness.

What is altitude sickness and what are its symptoms and complications?

Altitude sickness, also known as acute mountain sickness (AMS), is a condition that occurs when the body doesn't adapt well to high altitudes. Symptoms include headache, loss of appetite, nausea, dizziness, fatigue, and shortness of breath, among others.

AMS can become life threatening if it develops into high altitude pulmonary edema (HAPE) or high altitude cerebral edema (HACE) (edema is swelling caused by too much fluid trapped in the body's tissues). HAPE can be life-threatening within 12 hours, and HACE within 24 hours. That’s why recognizing altitude sickness of any kind is critical to preventing severe complications.

© Third Rock Adventures

What is Acetazolamide (Diamox) and how does it work against AMS? Is it effective?

Diamox is a medication that helps with altitude sickness by stimulating breathing, increasing oxygenation of the blood, and in helping reduce fluid build-up in the body. It has been found to be quite effective in preventing AMS when taken properly. It helps speed up the acclimatisation process, i.e. it allows the body to adjust more quickly to high altitudes.

What are the side effects of Diamox? Is it necessary to consult a doctor before taking it?

Some common side effects of Diamox include tingling sensations, increased urination, and altered taste perception. These side effects are usually mild and temporary.

It is advisable to consult a doctor before taking Diamox, especially if you have any underlying medical conditions (such as as high/low blood pressure and diabetes), allergies (especially to sulphides) or are taking other medications. Consult your doctor and see the medicine information leaflet for the correct dose and use of Diamox.

When and why does one get AMS?

AMS occurs when ascending to high altitudes where the air pressure is lower and, consequently, the oxygen levels are reduced. As a result, every breath you take, less oxygen reaches your blood, and you need to breath for harder and longer to get the oxygen. This persistent breathing also builds up carbon dioxide in the blood.

Symptoms of AMS can begin to occur at altitudes as low as 2,500 m above sea level. As you ascend, your body needs time to adjust to the decrease in oxygen availability. If you ascend too quickly, your body may not have enough time to adjust or acclimatise, leading to AMS.

However, most people typically don't experience symptoms up until around 4,000 meters. Beyond this, one may consider using Diamox as a preventive measure or treatment.

Oxygen Levels at High Altitude

8500 m - 32% Oxygen

7500 m - 39% Oxygen

6000 m - 48% Oxygen

4500 m - 58% Oxygen

3000 m - 70% Oxygen

1500 m - 84% Oxygen

Sea Level - 100% Oxygen

Can Diamox be taken as a preventive measure or only when symptoms appear? Is it necessary?

Diamox can be taken both as a preventive measure and when symptoms of altitude sickness appear. It is often recommended to start taking Diamox a day before ascending to high altitudes (a day before starting your hike), and to continue until you finish your hike.

The need for Diamox will largely depend on the maximum altitude you'll reach during your hike, the rate at which you'll be ascending, your altitude history and physical health, as they all influence your rate of acclimatisation.

Are there any alternatives to Diamox for dealing with AMS?

While Diamox is a commonly used medication for altitude sickness, there are other strategies such as gradual ascent (ascending at a much slower rate), adequate hydration, and proper nutrition that can also help prevent and alleviate symptoms of altitude sickness.

However, if your hike is only 4 days long (assuming you are with a hiking organisation), you may not have the option of a slower, gradual ascent. Likewise, if you have never been at high altitudes before, you may be more prone to AMS, so it is important to take these factors in consideration when making your decision.

Therefore, it is important to take all these factors into consideration, in addition to consulting the hiking leader's experience and your doctor.

How do you prevent AMS?

The best way to prevent altitude sickness is to ascend slowly. A typical guideline is to ascend no more than 300 to 500 meters ) in elevation per day once above 3,000 meters. This slower ascent rate allows the body time to acclimatize to the decreasing oxygen levels at higher altitudes, reducing the risk of developing AMS. Extra rest is recommended for every subsequent 1000 m.

What is the treatment for AMS?

Treatment for AMS typically involves descending to a lower altitude as quickly and safely as possible, if symptoms do not resolve within an hour. Additionally, ensuring proper hydration, rest, and oxygen supplementation can help alleviate symptoms.

If symptoms are severe or life-threatening, administering supplemental oxygen or utilising a portable hyperbaric chamber may be necessary. In HACE or HAPE, prompt medical attention is essential, and descent is the primary treatment along with administration of medications. It's important to monitor individuals closely and seek medical assistance if symptoms worsen or fail to improve with initial treatment measures.

In conclusion, these are the factors you should consider when deciding whether to take Diamox or not:

• Individual health and fitness, including pre-existing medical conditions or allergies. Consult with a healthcare professional to ensure Diamox is safe for you.

• Altitude experience, whether you have been at high altitudes before, and if you have previously experienced AMS symptoms.

• Maximum altitude reached, Diamox is typically considered at altitudes above 4000 m.

• Acclimatisation rate, slower, longer hikes allow gradual acclimatisation, compared to faster paced hikes.

• Personal comfort and risk tolerance, some may prefer to take Diamox as a precautionary measure to minimise the risk of AMS and ensure a smoother and more enjoyable hiking experience.

• Emergency medical services, take into account the availability of medical facilities in the event of severe AMS. Diamox can provide an additional layer of protection in remote or high-risk environments.

Ultimately, the decision to take Diamox should be based on a thorough assessment of these factors, individual preferences, and consultation with healthcare professionals when necessary.