Altitude acclimatization

High altitude sickness is rarely a problem for people who live at high altitudes. This is because their bodies are acclimatized and able to utilize the available oxygen efficiently.  Conversely, when people accustomed to lower elevations ascend rapidly to above 5800 feet, many will experience some degree of dyspnea related to hypoxia.

Travelers don’t usually experience symptoms of High Altitude Sickness below 8000 feet.  For medical purposes, elevations are classified in 3 categories:

• 5000 - 11,500 feet: high altitude
• 11,500 - 11,500 feet: very high altitude
• above 18,000 feet: extreme altitude (no one has successfully acclimatized to long-term residence above 17,000 ft.)

Most travelers can avoid the more serious complications of High Altitude Sickness by allowing the body time to adapt to the new conditions. Our bodies have built-in mechanisms which allow us to function at high altitude, but it takes time to balance our physical processes with environmental changes.

Each person will have a different response to ascent; an altitude line beyond which he/she cannot safely pass without taking time to acclimatize. Travelers will know they are approaching this line when they develop a headache and at least one of the following symptoms: dyspnea at rest, fatigue or weakness, nausea, vomiting or anorexia, dizziness or lightheadedness, difficulty sleeping. The message the body is sending is stop ascending.

Prudent high altitude travelers will prepare for the risks and keep a few things in mind:

1. Before ascent to high altitude, seek medical evaluation.
2. Rapid ascent increases risk.
3. The longer you stay and the higher you sleep, the greater the risk.
4. If you have experienced altitude sickness in the past, you will likely experience it again.
5. Symptoms should be assumed to be altitude sickness.
6. Symptoms invariably worsen if time is not allowed for acclimatization.
7. Each traveler will have a different altitude which they can not safely cross without acclimatizing.
8. An extended high altitude travel itinerary should include the ability to acclimatize for several days and to rapidly descend if symptoms worsen while at rest.
9. Symptoms that do not get worse at rest will likely improve with a day or two at the current altitude, allowing further ascent.
10. Hydrate! Hypoxia stimulates hypoxic ventilatory response (HVR) which increases water vapor loss. Hypoxia also causes high altitude diuresis (HAD). Together they can quickly lead to dangerous dehydration.

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