High Altitude Climbing and Acute Mountain Sickness

I have been researching the impact that high altitude climbing will have on my body, what I can expect, what I can do to assist my body’s ability to cope.

And importantly, to be able to recognise the onset of Acute Mountain Sickness in its more serious forms.

Acute Mountain Sickness, AMS as it is often referred to, is the effect the declining number of molecules of oxygen in the atmosphere has on our body as we ascend in altitude. It can range from a mild illness, to the more severe life-threatening forms of the illness, such as High Altitude Pulmonary Edema (HAPE), and High Altitude Cerebral Edema (HACE).

The latter two conditions require immediate attention and descent from altitude otherwise death is the most likely outcome.

I’m not intending to go into a great discussion on either, nor am I qualified to do so, but as part of my “journey to the mountains” and extreme  altitude climbing I want to gain a better understanding of both conditions.

High altitude is defined as 5,000 to 11,500 feet, very high altitude 11,500 to 18,000, and extreme altitude as 18,000 feet and above.  At extreme altitudes physiologic function will outstrip  acclimatisation eventually.

My reading has taken me across a wide variety of topics, but the one that caught my attention was the connection between muscle and the requirement to fuel our muscles with oxygen when under exertion.

Over the years I have trained as a power-lifter for strength purposes and I have achieved results I am happy with.  As a consequence I have grown muscularly and currently weigh-in around the 95 kilogram mark.  This has given me a good power-for-weight ratio and has enhanced my speed on the kayak over the short to mid sprint distances.

Power-lifting has helped me develop strong legs, especially my quads through squatting, and dead-lifting.

Will this muscle help, or hinder me on the mountain as I trudge up the side of an 8,000 metre peak??

When exercising, the body, or more specifically the contracting muscles, have an increased need for oxygen and this is usually achieved by a higher blood flow to these muscles.

And therein lies the dilemma as I see it.

Due to the less dense air at altitude the number of oxygen molecules for any given mass of air will drop. Consequently, mental and physical performance will decline. The larger the muscles, the larger the requirement for oxygen to prevent muscular fatigue…

So what can I do?

There is not a lot that you can do to prepare for the effect of AMS, some people will adapt and perform better at altitude than others and this is hard to predict from one individual to another.

What I can do is decrease my muscle mass. Whilst that will mean a decrease in overall strength I can try and maintain the power for weight ratio balance.

The upshot of all this is that ahead of my expedition Nepal where I will be climbing three 6,000 metre peaks, including Lobuche East, I will deliberately take around 12-15 kilograms out of my frame…

The climbs in Nepal will be done without the aid of supplemental oxygen.

Essentially, I will not change my training routine at all, I will maintain my same level of weight training, kayaking, rowing and other activities. I have found the best way to control weight change, either gaining, or losing, is via the kitchen and diet.

In fact I won’t even modify my diet to any great extent, simply quantity control.

Baz - Meteor Peak
Baz – Meteor Peak

19 thoughts on “High Altitude Climbing and Acute Mountain Sickness

  1. Jason Keck March 21, 2013 / 5:24 pm

    Hello, I am a high altitude training and acclimatization researcher. There are several things that you can do to help prevent HAPE and HACE. I have trained a few elite mountaineers in developing a breathing practice called pranayama. You can learn how to control your breath, strengthen your lungs, and incorporate other muscle groups to increase your lung function. Two components of the practice to focus on are called “bellows breathing” and “breathing ratios.” Your ability to move oxygen in and out of your lungs effectively is the major factor in preventing HAPE. I usually also add in a few apnea training techniques to my athletes regiment. There are also breathing techniques you can use while at altitude including “hook breathing” which involves breathing to full capacity and then flexing the abs, diagram, and back. This increases pressure in the lungs to open your alveoli. In terms of medications and supplements there are 2 I recommend. The first i Viagra, which dilates your pulmonary blood vessels to improve 02 absorption in the lungs. The second is N-acetylcysteine, which activates your body’s natural response to high altitude and thereby increases ventilatory strength and red blood cell count, Thanks, I hope I helped and good luck on your adventures.


    • Baz - The Landy March 21, 2013 / 8:44 pm

      Jason, thankyou for taking the time to give your thoughts on this topic. A Lot for me to take in and I will take a more thorough look at your web site over the next day. Once again, thanks !


  2. Beth March 21, 2013 / 8:47 am

    Officially the only area of your endeavors over which I have an edge! I live at approximately 7,000 feet in elevation. 🙂 And if I have out of town company, they very often suffer altitude sickness… and if we take them to the top of the Peak (it’s a 14er), I’m fine but they’re toast. The extra pint of blood you generate when living in high altitude is no joke! It helps get additional oxygen spread throughout the body.


  3. mrsptravels March 20, 2013 / 6:01 am

    Really good, informative article! Learnt a lot not just from the article but the helpful comments too! Thanks 😉


    • Baz - The Landy March 20, 2013 / 6:51 am

      Thankyou, and comments from Grant are first hand knowledge…


  4. sweetlybalanced March 19, 2013 / 9:49 pm

    I actually wanted to climb Mt. Kilimanjaro when I was in Tanzania last year. We ended up skipping it since we were only there for 2 weeks and we had heard that the biggest reason people don’t make it to the top is AMS. We decided that it would have been a bummer to spend half our trip trying to climb a mountain and not making it, so we opted for a beach then Safari! Maybe next time we can go for longer than 2 weeks and try again!!


    • Baz - The Landy March 20, 2013 / 5:06 am

      People I know that guide that trip say it has the highest rate of AMS that they see, including trips to Nepal/Everest etc. It is due to the short acclimatisation period allowed.


  5. Deliberately Delicious March 19, 2013 / 10:05 am

    I’m impressed, Baz, by how carefully you’re preparing for this expedition in all different ways. It would never have occurred to me that being more muscular could be a disadvantage at high altitude. It’s good that you are researching this so methodically.


    • Baz - The Landy March 19, 2013 / 10:22 am

      Yes, and I’ve have written on this previously, in fact this is a post I had done before. But I am focussing on it again now. And was keen to see if there were others with thoughts on the topic.

      Grant Rawlinson has commented above and he has first hand knowledge, and a great source of knowledge.

      And inspiration!

      Fitness is one thing, but high altitude is just that.


  6. desertrose7 March 19, 2013 / 10:00 am

    Knowledge is power, in your case even more than that. It’s imperative!
    Good luck with your research and your diet.


    • Baz - The Landy March 19, 2013 / 10:18 am

      Thanks! I’ve still got your tunes floating around in my head!


      • desertrose7 March 19, 2013 / 11:29 am

        That’s sweet of you to say. 🙂 thank you.


  7. Grant Axe Rawlinson March 19, 2013 / 9:32 am

    Hi Baz, everyone gets hit by the altitude. Some people get a headache and then run around saying “help I have altitude sickness!”. Headaches. nausea, insomnia, lack of appetite, yawning, lethargy are all just part of the journey. Don’t expect to go to any significant altitudes anywhere and not feel these effects. Having almost died from HAPE I would like to share with you some idea’s from my journey.

    Getting seriously altitude sick with either HAPE or HACE is a different story to just feeling the effects of altitude. You really need to watch this, and over time and from experience you will learn how fast your body acclimatises to higher altitudes. Don’t listen to people who tell you exactly how many days you need here, and how many days you need there and give you rigid acclimatisation schedules. Everyone is different and how many days you need resting on your ascent depends completely on how well you are feeling. The basics of acclimatising are really very very simple. Drink lots and lots of water. (I drink 4 – 6l per day). Rest, take short walks but do NOT over exert yourself while you are trying to acclimatize. If you feel good then ascend. If you feel bad then don’t go higher. if you feel really bad the descend.

    You are thinking along the right lines with the power to weight ratio. I would also recommend that before your trip (around 6 weeks before) you drop the gym sessions off (maybe one or max 2 per week for maintenance). And you work more on high intensity interval training (short hill sprints of 30s to 2 min max are great with rests in between, pad work with the boxing gloves for 1 – 2 min rounds is also great). This will condition your cardio vascular system for the intense demands of high altitude climbing.

    I also personally stay away from any form of altitude drugs (e.g. Diamox). I drink lots of water and follow the guidelines I wrote above. I do use Ibuprofen to control the headaches.

    And the golden rule of all at altitude – slow and steady my friend, like the tortoise. The highest proportion of people who get altitude sickness are young fit males. Why? Because they go to fast!

    Good luck bud,




    • Baz - The Landy March 19, 2013 / 10:18 am

      Thanks Grant, that is a great summary and sound advice.

      And I was hoping you would have some thoughts on this.

      I am commencing a program of high intensity cardio starting the beginning of April and this will help reduce my mass.

      I have been holding off as I resolve my Achillies problem, which is recovering quite well now.

      To be honest, I like weight training, but know I need to reduce it substantially as part of my preparation for Nepal…

      I’ve just ordered a 20 kilogram weight vest to assist the hill climbs and sprints.

      Once again,thanks for the insight and I know that many others will benefit from your input.

      And for the benefit of others reading, Grant is a successful high altitude mountaineer who has climbed many high peaks, including Mt Everest.

      Be sure to take a look at his website which you can find here.




  8. Cowboys and Crossbones March 19, 2013 / 5:51 am

    Fingers crossed this doesn’t hit you too hard while you’re climbing!


    • Baz - The Landy March 19, 2013 / 7:26 am

      Well I think everyone suffers from altitude sickness, but you need to be careful not to get the advanced forms of it.

      I have been learning as much about it as I can…so I can at least try and recognise it in myself, and others!


  9. Scribelife March 19, 2013 / 5:22 am

    Can you do any high altitude training first? I guess this isn’t your first rodeo, so you know what you’re doing, but it would be nice to condition your lungs for that kind of efficiency. When I first moved to the Rocky Mountains, any type of trail running or hiking would leave me with altitude sickness and I would get a strange case of the yawns. My lungs simply didn’t know how to get enough air, and this altitude is much lower than the peaks you are planning to hike. I know they have specialized tents you can sleep in that lowers the O2 levels to help climbers train, but I doubt they would be much fun. Good luck, Baz – I am cheering for you!


    • Baz - The Landy March 19, 2013 / 7:21 am

      Well, it is a little trial and error!

      Not a lot of pre-work, really a case of acclimatising with plenty of time. There is a local gym that replicates higher altitudes for training, but I think the effectiveness for what I want would be very limited…

      But I find the whole process and journey enjoyable, and this is what facet of it…

      Thanks for the support! Baz…


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