Altitude Sickness

Nutritional and Herbal Supplements to Prevent Altitude Sickness

The Rocky Mountains draw thousands of visitors each year, and whether here to hit the slopes in the winter or hike a “fourteener” in the summer, they come for a relaxing mountain getaway. Somewhere in the tourist brochures and vacation package advertisements there is usually a line about acclimatizing to the altitude but it’s in small print. New York, San Francisco, and Los Angeles are at sea level. Denver is a mile higher. Arapahoe Basin tops out at 13,050 feet. Altitude sickness has ruined enough vacations that it is incumbent on us, the local hosts, to know about prevention and if necessary treatment. In this article I want to review which natural substances may be useful to prevent and treat altitude sickness and then tell you my favorites.

Vitamin C

Paul Petzoldt, the founder of Outward Bound and the National Outdoor Leadership School once wrote that whenever his students were out of sorts in the mountains he would give them a dose of vitamin C. If he says it works, it probably does. Rats dosed with vitamin C can endure higher altitudes in lab simulations.[1] People probably can too. So consider regular doses of Vitamin C for the duration of their stay. How much, I’ve heard anywhere from 500 mg to 10,000mg/day (from Dr. Randall Bradley of Nebraska).

Antioxidants

Many of the symptoms of altitude sickness appear to be related to free radical activity and a number of studies have used antioxidants to decrease the effects. A study monitoring humans on an Everest expedition found that daily doses reduced the effects of altitude. Climbers took daily doses of 1,000 mg vitamin C, 400 IU vitamin E, and 600 mg alpha-lipoic acid.[2]

Glutathione

A favorite of mine, glutathione appears to be quickly depleted at higher altitudes, quickly making the body susceptible to the many forms of damage that glutathione normally protects it from.

L-glutamine

Adding glutamine has a protective effect.[3] Rats fed doses that in a human would be equivalent to about 2-3 grams a day were 4.5 times as resistant to hypoxia than non-treated rats, more resistant to cold, and were able to gain weight at high altitudes. This may be because glutamine helps replenish the glutathione levels. If so other substances that help produce and protect glutathione in the body may also be useful. Glutamine is considered a conditionally essential amino acid. Under certain conditions of especially physical stress the body isn’t able to manufacture this amino acid in adequate amounts to keep up, thus supplemention is useful.

Three general categories of herbs have a beneficial effect: adaptogens, flavonoids, and cardiotonics. The most studied are the adaptogens. Herbs in this diverse group all affect the adrenal axis and increase the body’s capacity to endure stress. Some, such as cordyceps and Siberian Rose [4], have been studied and published on their protective effect. Other adaptogens have traditions of use and are probably just as useful. In the latter category I would put Eleutherococcus (Siberian ginseng), Panax ginseng (Korean ginseng), Ashwagandha, reishi mushrooms, and Schizandra.

The second group of herbs is the flavonoids and includes ginkgo, which has been shown to be useful in altitude sickness. [5] Ginkgo may work because it increases blood circulation and oxygen to the brain. It is useful in treating asthma, so perhaps the people who think it helps altitude sickness simply had asthma that responded. Another plant flavonoid, milk thistle, also has a positive effect on altitude sickness. [6]

The third general category of herbs is the cardiotonics. I was thinking specifically of extracts of Hawthorne berries, which help strengthen the heart’s contraction in a manner similar to digitalis. Technically we may not be treating altitude sickness but simply cardiac insufficiency, yet it still may help your older relatives get up the stairs while visiting. Coenzyme Q10 might be suggested for this same reason, though one could argue that it is an antioxidant.

Homeopathic medicines that have been suggested for altitude sickness are Arsenicum alba, Glonine, and Calcarea carbonica.

I also need to mention water. Few visitors to our high country from the humid lowlands have any comprehension of how quickly they become dehydrated while here. At high altitudes more water is lost through breathing and sweating than most people realize. People can quickly dehydrate without being aware of it and confuse their condition with altitude sickness. Bug your guests and make sure they are drinking enough water—enough so that they have to urinate as often, or more often, as they are accustomed to at home.

Summary:

 

Flavonoids:

Ginkgo: 120-180 mg/day (any history of asthma)
Milk thistle: 120-240 mg/day (any liver complaints)

Antioxidants:

Vitamin C: 2-3,000 mg/day
Vitamin E: 400 IU/day
Alpha lipoic acid: 150-300 mg/day
Selenium: 200 mcg/day (if you have a family history of cancer never stop taking this!)
N-acetyl-cysteine: 1-2000 mg/day (especially if prone to nasal congestion)
L-glutamine: 3,000 mg/day (especially if prone to stomach irritation)

Adaptogenic herbs:

Korean ginseng, Siberian ginseng, Ashwagandha, or Reishi

Cardiotonics

Hawthorne berry extract: 250-500 mg/day and CoQ10: 90 mg/day (both especially if you have a weak heart)


References

  1. Schreiber M. Protective effect of ascorbic acid in high altitude hypoxia in the rat. Physiol Res 1992;41(5):403-5
  2. Bailey DM, Davies B.Acute mountain sickness; prophylactic benefits of antioxidant vitamin supplementation at high altitude.High Alt Med Biol 2001 Spring;2(1):21-9
  3. Kumar D, Bansal A, Thomas P, Mongia SS, Sharma SK, Sairam M, Grover SK, Singh MV, Prasad D, Ilavazhagan G, Selvamurthy W.Improved high altitude hypoxic tolerance and amelioration of anorexia and hypophagia in rats on oral glutamate supplementation.Aviat Space Enrion Med 1999 May;70(5):475-9
  4. Kelly GS. Rhodiola rosea: a possible plant adaptogen. Altern Med Rev 2001 Jun;6(3):293-302
  5. McKenna DJ, Jones K, Hughes K. Efficacy, safety, and use of ginkgo biloba in clinical and preclinical applications. Altern Ther Health Med 2001 Sep-Oct;7(5):70-86, 88-90
  6. Schreiber M, Trojan S. Protective effect of flavonoids and tocopherol in high altitude hypoxia in the rat: comparison with ascorbic acid. Cesk Fysiol 1998 Jun;47(2):51-2