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.