Diamox: The Acute Mountain Sickness (AMS) Solution

Diamox: The Acute Mountain Sickness (AMS) Solution

Occasionally, a dispute arises between traditionalists and the non-the-process of adapting to high altitudes during a trek.

The traditionalists argue that relying on substances like Diamox to hasten acclimatization deviates from the authentic trekking experience. They advocate for a more organic approach, allowing the body to adapt gradually through gradual ascension and regular breaks, thereby respecting the natural acclimatization process.

However, those who do not adhere strictly to a specific belief think that prioritizing safety over potentially experiencing the symptoms of high altitude sickness is more beneficial. They believe taking Acetazolamide (Diamox) before embarking on a high-altitude trek would increase their likelihood of a successful journey. As a result, they begin taking Diamox before starting their trek.

To determine the appropriate course of action, let’s first take a moment to consider the basics of Acute Mountain Sickness (AMS).

At higher elevations, the air pressure decreases, resulting in less oxygen being delivered to the bloodstream with each breath. To compensate, the body must work harder to obtain oxygen, which leads to increased respiration and longer breaths. This effect is magnified when climbing uphill, causing the body to produce more carbon dioxide as a byproduct of the increased breathing rate.

As you ascend to higher elevations, your body adapts naturally to the decrease in oxygen levels by developing a “zone of tolerance,” where it can function normally despite the lower oxygen levels. This zone shifts upward as your body acclimates to the higher altitudes. However, if the buildup of carbon dioxide exceeds your tolerance zone, your body will react, leading to Acute Mountain Sickness (AMS) or high altitude sickness.

Signs of Acute Mountain Sickness (AMS) include feeling sick, vertigo, exhaustion, and difficulty breathing.

It’s puzzling when hikers at 11,000 feet express complaints of headaches while others in their vicinity dismiss it as a typical occurrence. However, it’s not typical to experience a headache at high altitude. If you’re experiencing a headache, try drinking a liter of water, taking a Disprin, and observing for an hour. Dehydration is a common cause of headaches, and this routine can help alleviate it. If your headache persists after an hour, it’s likely a sign of Acute Mountain Sickness (AMS). In this case, descend to a lower altitude where you last felt well.

This leads me to the topic of utilizing Acetaziamox) for aiding in acclimatization and safeguarding against the occurrence of high altitude sickness.

Choosing between using Diamox or not shouldn’t be the primary concern for a trekker. Instead, the key factors to consider are the length of the trek and the amount of altitude gain. For a 6-day trek that reaches high altitudes (over 14,000 feet), starting a course of Diamox before the trek is recommended to help your body acclimatize, as the short duration doesn’t allow for sufficient acclimatization. However, for a longer trek of 12-14 days, your body has enough time to adjust to the altitude, making Diamox unnecessary for acclimatization.

In order to adjust to high altitudes (above 10,000 feet), giving your body 24-48 hours to acclimate is typically recommended. However, in modern trekking, we often do not have the luxury of this time. Typically, we arrive at a camp around 2 pm and then move to the next higher camp early the next morning, leaving us with less than 16-18 hours to acclimate. Unfortunately, this is often insufficient and can make trekkers more susceptible to AMS (Acute Mountain Sickness).

If your trek is limited in time and does not permit you to spend more than 24 hours at a high altitude, it would be advisable to take Diamox as a precautionary measure.

Frequently, I receive phone calls from hikers who claim to have completed numerous high-altitude treks without needing to use Diamox. I am perplexed by this reasoning. AMS can affect anyone, regardless of age, gender, physical fitness, or prior experience with high altitudes. It is possible to develop AMS on any trek, and it would be unfortunate to abandon a trek simply because one did not take this basic precaution.

What is the function of Acetazolamide (Diamox)?

90% of the blood’s carbon dioxide exists in a chemical called bicarbonate. After traveling through your blood, this carbon dioxide is exhaled by your lungs. Diamox forces the kidneys to excrete bicarbonate from your body (when you urinate).

Your body doesn’t like that. It needs the bicarbonate to exhale carbon dioxide through your lungs.

When Diamox forces you to excrete bicarbonate, your blood, which is used to a certain level of acidity, becomes more acidic. When the blood gets acidic, it is believed that it has more carbon dioxide in it. So, the body gets rid of this excess carbon dioxide in a simple way. It starts to breathe deeper and faster, getting rid of the carbon dioxide and taking in more oxygen.

In effect, the increased oxygen speeds up the acclimatization process. It also greatly reduces any symptoms of altitude sickness, which is why Diamox works best when you start on it a day or two before you get to high altitudes. 

Remember, Diamox accelerates acclimatization. It does not cure anything. If you have a headache with any of the above symptoms, even after taking Diamox, your acclimatization is incomplete, and you must descend. Under no circumstances should you climb higher if your symptoms still persist.

Take Diamox at 125 hours two days before your trek (or upon reaching Delhi). Raise the dosage to 250 mg every 12 hours upon arrival at the base camp and maintain this dosage until the trek is finished.

 

Precautions to Take When Using Diamox

It’s important to consult with your doctor before taking Diamox, especially if you have a history of allergies, high or low blood pressure, or diabetes. This will ensure that the medication is safe for you to use and that any potential side effects are minimized. Additionally, if you’re taking any other medications, inform your doctor, as some drugs may interact with Diamox. By taking these precautions, you can safely enjoy the benefits of Diamox while minimizing any potential risks.

If you have an aversion to sulfa drugs, it’s wise to steer clear of Diamox, as it’s formulated with sulfa compounds.

Trekup India has reassessed its stance on Diamox usage and now recommends that trekkers initiate their course two days before the start of their trek rather than only in emergencies. By beginning the medication upon arrival in Delhi, participants can significantly increase their chances of experiencing a successful and stress-free trekking adventure.

Acclimatization is key

Even with Diamox, it’s crucial to ready your lungs for lower oxygen levels. A trek-specific fitness program is ideal. Incorporate cardio, strength, and flexibility exercises. A 30-minute run covering 4.5 km is an excellent altitude training regime.

Why TrekupIndia?
Since 1993
  1. Trekup India has been one of the most recommended partners for trekking adventure tourism for more than 29 years. Featuring more than 75 Himalayan treks makes us supreme in the domain.
  2. We have explored trails like Kedarkantha Trek, Rupin Pass Trek, Borasu pass, Bali Pass, etc.
  3. Trekup India is India’s Oldest, Safest And direct operation trekking organisation. Trekup India has more trekkers than any other organization. 15,000 plus for 2022
We Are Approved And Certified By :-
  1. Adventure Tour Operators Association of India (ATOAI)
  2. Indian Mountaineering Foundation (IMF)
  3. State Tourism Department
What We Do?
  1. Trekup India is the most trusted trekking company in India. We also sets safety standards for the entire trekking industry.
  2. Trekup India is the pioneer of trekking in India. Trekup India has brought most trekking routes, trekking systems and trekking equipment to India for Indian trekking.
Save The Trail
  1. Trekup India’s Save The Trails program is a favorite among trekkers. Our Save The Trails program has made trails, where Trekup India runs trekking, pristine. Save The Trails is a great way for trekkers to leave our mountains better that we found them.
  2. Trekup India is a unique trekking company that offers the Trekup India’s Trekkers best experience. These transformative experiences are well-designed and leave an indelible impression on trekkers. These have been around for 29 years.

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