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Ken Jensen of Achieving Adventure looking out from Mt Evans

This is meant to be the ultimate guide to Acute Mountain Sickness (AMS) and the worse Altitude Sickness. I wanted to give you what took me MONTHS to research and learn because no one could tell me all that I needed to know. I simply couldn’t find the info that I needed in any one place!

I want you to be fully prepared for high altitudes, so you aren’t worried as shit of the possibilities.

You are probably aware that high altitudes are super hard on the human body, but did you know that people actually die from it?! Don’t worry, you probably will have nothing to worry about after reading this.

High Altitudes Effect Everyone Differently

Some people do well at higher elevations, but others pass out, get severely ill, or even die.

Our bodies are best at sea level where oxygen is 20.9% and the oxygen carrying part of red blood cells, hemoglobin, is saturated.

As we go up in elevation:

  1. We have to acclimatize to the reduced oxygen in the air.
  2. We have to deal with a lower pressure around us.
  3. We are at risk of Acute Mountain Sickness (AMS) or Altitude Sickness


Acclimatization at High Altitudes

Your body has stuff it does to allow you to function at higher altitudes. There are both short term and long term changes your body undergoes.

Short Term Acclimatization

In the Short Term your body increases breathing rate and depth. At really high altitudes, your body can’t keep up and this causes elevated blood pH (Alkalosis) causing a shit-storm of bad stuff in the body with proteins

Your heart beats faster allowing you to get more oxygen carrying blood to the muscles.

Non essential functions like digestion are suppressed so more oxygen can be delivered to the muscles and the brain.

Long Term Acclimatization

Your body will undergo changes in the long term. Over a course of days or weeks, the following changes will occur:

  • 4 days in, your body begins renal excretion (peeing) of bicarbonate (basic chemical) to lower blood pH so there is less risk of alkalosis.
  • Physiological changes occur in the body to raise the efficiency of your body to oxygenate blood and reduce pressure in the body.
  • Full hematological adaptation (blood and junk gets better) occurs in a time period of altitude in kilometers multiplied by 11.4 days. 4 km high would be about 45.6 days to fully acclimatize.

Don’t worry, there is more we can do about this. But what happens if you don’t properly acclimatize to the elevation? The answer is Acute Mountain Sickness, or more severely, Altitude Sickness.

Altitude Sickness

This is a very real possibility over about 8000 feet of elevation. It can make you horribly sick, cause you to vomit (dehydrating yourself even more), hospitalize you, or has even killed people.

Symptoms of Altitude Sickness

You can become aware of Altitude Sickness before it is actually a problem. Things that indicate that you may be getting attitude sickness are:

  • Most often, you will start getting headaches or even get nausea.
  • Vomiting
  • Lethargy
  • Dizziness
  • Poor Sleep

The altitude sickness, in general, can start off with headaches but can feel as bad as a nasty hangover.

Causes of Acute Mountain Sickness (AMS) or Altitude Sickness

Two things are believed to contribute to Altitude Sickness:

  1. The higher pH in the body is terrorizing you due to lack of oxygen (I’m not a doctor, but this has lots of effects on your health.)
  2. A swelling of the brain causes the symptoms. This swelling raises pressure on the brain causing many of the symptoms.

How to Prevent Altitude Sickness

An ounce of prevention really is worth a pound of cure. I would do whatever I could not to get sick, so what can you do to help your body handle the higher altitudes?


Sorrry, you gotta lay off the beer and liquour. You get drunker and hung over worse at high altitudes. You also get more dehydrated.

Drink Water

No matter who you ask, they all agree that plenty of water will help you out during a high altitude adventure. DRINK A LOT.

Take it Easy

You may be a trail running marathoner or cross country mountain biker extrordinaire, but the effect of high elevation often seems independent of physical fitness levels.

All those people telling you to drink water also tell you to take it easy and don’t overdo yourself. After all, it is the lack of oxygen that is the problem!

Take Your Time

When scaling mountains cliffs, or even hiking up your favorite 14er (14k+ feet), take plenty of breaks so you body has a chance to properly acclimate as you are going up. Breaks really do help provide extra time.

Canned Air

I have never used canned air, but it will be basically 20.9% oxygen and can give you shots of air to help. I don’t know if this is proven, but it makes sense. Why don’t I carry these shots? Usually I don’t want to carry the added weight of these canisters.


Acetazolamide (the popular brand name is Diamox) is a known diuretic helpful for glaucoma, edema, or epilepsy. A huge side effect of this drug is its ability to trick your body to thinking the blood is more alkaline than it really is, so you will piss out that bicarbonate and reduce chances of alkalosis. It also reduces chances of altitude caused edema (fluid retention).

A prescription is required, but doctors are usually pretty willing to write one for you. What we generally do is take 250mg twice a day from a day prior to going up until a few days after. If symptoms of Acute Mountain Sickness begin, we take 500mg.


Ibuprofin can also be a life-saver. Any time I went above tree-line (12000 ft) I would pop 600mg of Ibuprofin because it would combat the swelling of the brain and keep you from getting gnarly headaches. I do this 30 minutes before going at high altitudes.


Dexamethazone, or “Dex”, is a known corticosteroid that, for us, is known to reduce high-altitude cerebral edema (HACE) and high-altitude pulmonary edema (HAPE). This medicine is taken on climbing expeditions in the “dead zone” like Mt. Kilimanjaro. Taking 4mg every 12 hours has proven effective for HACE and HAPE.

What to do if You Get Altitude Sickness

Well Shit!!! I’m sorry if you got to this point. It sucks ass, but there are some golden rules that you need to follow if you are getting acute altitude sickness.

  1. If you think you have Altitude Sickness, you do until proven otherwise.
  2. Stop Ascending immediately
  3. If it continues to get worse AT ALL, descend immediately
  4. If possible, getting oxygen treatment can help greatly. This is basically just canned oxygen.
  5. Take Acetazolamide or Dexamethazone as previously recommended by a doctor.


Sources for my research and junk:

Altitude Sickness

11 High Altitude Sickness

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Ken is addicted to fitness and mountain biking. He is such a thrill seeker, people are starting to be concerned!He enjoys MTBing, Hiking, Climbing, Geocaching, Orienteering, Weight Lifting, and Wilderness Survival.

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