How to Prepare for High Altitude Hiking: 9 Tips
Nothing derails a hike faster than succumbing to altitude sickness. A pounding headache, difficulty making decisions, shortness of breath, and dizziness is enough to change the trip plan, and as a high altitude hiker you need to know how to prepare, prevent, and treat acute mountain sickness. In this post, we’re going to go over what altitude sickness is, what the symptoms are, and 9 tips to make sure your next high altitude adventure goes smoothly.
The first time I experienced acute altitude sickness was a snowboard trip to Mammoth Mountain in the Sierra Nevada's in California. At first I couldn’t figure out why I felt a painful throbbing behind my eyes, why I was so winded, and why my head couldn't stop spinning. Luckily my partner knew exactly what was happening and why; I was suffering from acute mountain sickness.
That first experience at Mammoth wouldn’t be my last time getting ill at high altitude however. I experienced the same symptoms in Utah, and again during a backpacking trip to the Sabrina Lake basin in the Sierras. After my backpacking trip to Sabrina Lake ended was derailed almost entirely by these symptoms, I made a promise to myself to learn as much as I could about altitude sickness and to implement those steps for my next high altitude adventure.
Sure enough, my last backpacking trip to high Sierras went much better as I had almost no symptoms and it was a fantastic trip. Now that I have the process dialed in for myself, I'm going to share my process, so that you too can have a fun and safe trip up in the mountains, or wherever your next adventure takes you.
*Note that I am not a medical professional, these are merely tips that I have researched and experimented with to get you started, and to give you an idea of what altitude sickness is. Please speak with your doctor if you have underlying health conditions and wish to adventure over 8,000 feet.
Understanding High Altitude Hiking
What constitutes high altitude?
High altitude refers to elevations typically above 8,000 feet (2,500 meters) above sea level. While every body is different and some people are more susceptible to altitude sickness, the vast majority of people will begin to feel symptoms at 8,000 feet.
How does altitude impact the air you breathe?
At high elevation, the amount of oxygen molecules in the air decreases due to the lower atmospheric pressure. This means that each breath contains fewer oxygen molecules than you may be used to at sea level, where the air is "thicker" with more oxygen molecules as the pressure is greater at lower elevation. This results in less oxygen being available to the body, a condition known as hypoxia. Your body can adjust to the lower amount of available oxygen, but it does take time. Altitude sickness occurs when your body does not have the time it needs to adjust to the lower levels of oxygen available to it.
Altitude illness is caused by a decrease in oxygen available in the atmosphere due to a decrease in pressure.
Common Altitude Sicknesses and Symptoms
1. Acute Mountain Sickness (AMS)
Acute Mountain Sickness, or AMS, is the most common type of altitude sickness. As you ascend from low elevation you may begin to experience these common symptoms:
Difficulty sleeping
Dizziness or lightheadedness
Fatigue
Headache
Loss of appetite
Nausea or vomiting
Rapid pulse (heart rate)
Shortness of breath with exertion
For me, I’ve noticed that the symptoms of altitude sickness comes on gradually. At first I may not notice that my nose is stuffed and my head is pounding, and I may notice it once I begin to feel dizzy and nauseous. If you find yourself in too much discomfort with these symptoms, it may be best to descend to a lower elevation quickly. AMS symptoms are only felt when at high altitude, and subside after returning to below 8,000 feet.
2. High Altitude Pulmonary Edema (HAPE)
A more severe type of altitude sickness than AMS, HAPE is a life threatening condition and should be taken very seriously. It occurs when fluid accumulates in the lungs due to the effects of low oxygen available at high altitudes. This can severely impair the body's ability to exchange oxygen, leading to significant respiratory distress. Make sure that if you’re hiking at altitude you’re keeping a watchful eye on yourself and your partners for the following symptoms:
-Shortness of breath
Chest tightness
Coughing
If you or anyone that you’re hiking with are experiencing any of these symptoms, make sure that you descend to a lower elevation immediately and seek medical attention. Note that these are severe symptoms.
3. High Altitude Cerebral Edema (HACE)
The most severe of high altitude sickness, HACE can be a deadly condition. It occurs when the brain swells with fluid due to the lack of oxygen at high altitudes. This can lead to severe neurological symptoms and, without prompt treatment, can be fatal.
Symptoms:
Severe Headache, often not relieved by standard pain medications.
Confusion, disorientation, or altered mental state.
Loss of Coordination.
Nausea and Vomiting.
Drowsiness or even loss of consciousness or coma.
Visual Disturbances such as blurred vision or hallucinations.
Seizures.
If you or anyone that you’re hiking with experience these symptoms, make sure to descend immediately to lower elevation and provide supplemental oxygen if available. Dexamethasone is a steroid that can help reduce brain swelling and inflammation. Note that you are unlikely to experience this level of illness unless you’re mountaineering, and that these are severe symptoms that typically only occur in severe cases.
More information about AMS:
Tips to Prepare for High Altitude Hiking
I have had quite a few experiences with altitude sickness, and since then I’ve been on a mission to get those symptoms improved. After much experimentation and research, I have finally cracked the code to what works the best for my body when hiking at altitude. I’m going to share the exact method that I use to keep my body performing on the trail, as well as share some prep tips so that you can start training now for your next high altitude hike. Note that every body is different, and you may find that what works for me and my body does not work for you. That’s why I’ve included bonus tips that you can try and experiment with!
1. Acclimate
Taking the time to properly acclimate to high elevation has been a game changer for me. Symptoms of acute mountain sickness occurs by not giving your body time to adjust to the lower oxygen levels available above 8,000 feet. When you give your body enough time to make the adjustment slowly, the symptoms of AMS may not even happen, or they may be mild symptoms that don't impact your trip. For me, I found that staying a night at 5,000 feet, then a night at 8,000 feet is enough time to prevent mild symptoms of altitude sickness. Due to how sick I have gotten in the past, I find the extra 2 days of acclimation worth the time and effort.
2. Stay hydrated- no drinking alcohol!
Staying hydrated will keep your body running the best it can as it adapts to the environment around you. Drinking plenty of water and electrolyte water will help keep symptoms at bay as you make the necessary adjustments. I find that water with electrolytes, such as Liquid IV, Propel, or Pedialyte is very helpful in reducing the symptoms of altitude illness. Not only does it taste delicious so that I want to drink more water, it also aids your body by increasing the rate of hydration absorption. It's also very important that you say away from alcohol the day before your hike, and to avoid drinking during your hike. Seriously, just don't drink!
3. Take your time ascending
I’ve found that taking my time hiking, especially while backpacking, makes the whole experience more enjoyable. As I’m headed up, taking lots of breaks to eat some food, drink some water, and catch my breath makes the symptoms of AMS or altitude sickness mostly go away. Taking my time allows me to adjust to my changing environment, it’s a great opportunity to take in the views, and it allows me to check in with my body to assess the symptoms. There’s no rush- so enjoy the hike!
4. Take time to rest and recover
Along with slowing down your hike by taking lots of breaks, when you take a long lunch break or are winding down for the night, make sure that you’re truly taking the time to rest and recover. Prioritize a good night’s sleep the night before your hike, this is a time that you really need your 8 hours! Being well rested the day before a high altitude hike will make all the difference. Taking time to rest and recover allows your body to adapt to your environment.
5. Eat Nutritious food
You want to make sure that you are eating nutritious food so that you get consistent energy and nourishment on the trail, allowing you to keep going all day long. When you eat fresh food that isn’t processed with added sugars and refined grains, you are getting important vitamins and minerals that give you sustained energy. When preparing for a strenuous hike, thinking about your nutrition can go a long way. I find that eating fruit, protein and carbs before a hike can help. Oatmeal, nuts, apples, bananas, light dairy and lean meats are some of my favorite staples for a nutritious meal plan.
It's also a good idea to pack an appealing lunch as you may experience a lack of an appetite, and eating and staying healthy on the trail is very important!
6. Take medicine
Over the counter painkillers such as ibuprofen will do wonders for your mild symptoms. As you're hiking along and taking breaks, you may notice a slight headache starting up. If that's the case, taking an ibuprofen is a great way to resolve it. If you are very concerned about the effects of altitude it may be worth it to stop at the doctors to get a prescription for Acetazolamide (Diamox). This drug is a steroid used to help with cases of altitude illness, and is available only as a prescription. Make sure that you are working with an MD to keep you safe on the trail.
7. Train for cardio
It’s no secret that hiking is a lot of cardio, so planning ahead a few weeks and training for a high altitude hike is a good idea. Going on runs, long walks, up hills, up stairs, and going on a hike here or there is a great way to prime your heart and lungs to keep you moving up a long trail. If you want to be a superstar about training, you could incorporate HIIT style exercises. HIIT increases your stamina by pushing yourself to your limit, giving yourself a short break, and then pushing your limit again. Doing this style of short bursts of high energy followed by a short period of rest will quickly increase your stamina.
Looking for more information about how to train for hiking? We’ve got you covered in this blog post:
8. Recognize the symptoms
As you’re hiking along and taking rests, you should be monitoring your body for signs of altitude sickness. At each break make sure that you’re drinking water and eating when needed, that way you’re able to mitigate the symptoms by staying hydrated and fueled. If you start to feel a headache coming on or you’re suddenly feeling nauseous, you can get ahead of the symptoms by taking an over the counter pain med. If you know that the symptoms are there, you can also recognize the need to slow down, take more breaks and drink more water. If your symptoms start to become overwhelming, you may need to consider going back down to a lower elevation, which brings us to the next point.
9. Make a plan
“If you fail to plan, you are planning to fail ”
Taking the time to make a plan for a high altitude hike is the best way to ensure that you have a safe, successful, and enjoyable hiking experience. I found that when I took the time to prep for the hike by training, researching, hydrating, and acclimating I had the least amount of symptoms (almost none!), compared to previous hikes when I had little time to plan which led to uncomfortable symptoms and a derailed hike. So, what I have found to be the most successful plan for hiking at high altitude is the following, which may help you as well:
| 1 Month Before Hike | 2 Weeks Before Hike | 1 Week Before Hike | 3 Days Before Hike | 1 Day Before Hike | During Hike/Day of Hike |
|---|---|---|---|---|---|
|
Train for cardio vascular, especially trail running, HIIT, or running hills. |
Continue to train for cardio. |
Continue to train for cardio. |
Take some rest from cardio training. |
Take some rest from cardio training. |
Take your time hiking and take lots of breaks. |
|
Focus on a balanced, nutritious meal plan. |
Continue to enjoy a balanced meal plan. |
Continue to enjoy a balanced meal plan. | Continue to enjoy a balanced meal plan. | Continue to enjoy a balanced meal plan. |
Continue to enjoy a balanced meal plan, focusing on lean proteins, fruits, and whole grains. |
|
|
Prioritize hydration. |
Prioritize hydration. | Prioritize hydration. |
Prioritize hydration. Do NOT drink alcohol today. |
Prioritize hydration. Do NOT drink alcohol today. |
|
|
Begin to acclimate. Sleep at least 3,000-5,000 feet above sea level. |
Continue to acclimate. Sleep at least 7,000 feet above sea level. |
Monitor yourself for any altitude sickness symptoms, ensuring to treat them if/as they arise. Only ascend 1,500 to 2,100 ft in a single day |
Mental resilience is key; stay motivated about completing your hike and educated about the risks and responsibilities that you have to yourself and to your hiking partners. Hiking at elevation is tough- there's no getting around it. But the rewards are well worth the struggle, and coming to the trailhead with a good Positive Mental Attitude (PMA) can go a long way to success.
Hiking at altitude can be risky and uncomfortable if you are unprepared, but can be an incredibly rewarding experience if you take the time to research your adventure and take these tips seriously.
How about you? Have you had an experience hiking at altitude? Or am I the only one to experience the symptoms, only to have a backpacking trip majorly altered due to illness? Let me know in the comments! For now, happy trails and thanks for reading. Make sure you enter your email below to receive your FREE hiking checklist!
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