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Simple Solution Found to Prevent Mountain Sickness

acute mountain sickness, acute altitude sickness

Do you plan to head to the mountains for a hike over Spring Break? A preventative treatment for acute altitude sickness, or mountain sickness, may already be in your backpack. A report from Stanford University School of Medicine finds that ibuprofen may be useful for lowering the risk.

Grant S. Lipman MD and colleagues first theorized that anti-inflammatory drugs could counter the brain inflammation that is a response to decreased atmospheric pressure at higher elevations. The team tested their hypothesis in a study of 58 men and 28 women, all of whom were healthy and lived at low altitudes.

Over the course of 4 weekends in the summer of 2010, the participants gathered at a spot at 4100 feet in the White Mountains of California. The volunteers received either 600 mg of ibuprofen or a placebo, then were driven to a staging area at 11,700 feet and received a second dose. The group hiked to 12,570 feet and received a third dose before stopping to spend the night. The participants completed questionnaires about symptoms and had oxygen saturation levels measured before the first dose and before and after the final ascent.

While 43% of the test subjects given ibuprofen did ultimately develop altitude sickness, it was lower than the 69% of subjects who took the placebo. The researchers did notice that symptom severity was lower in those taking ibuprofen, although the result was not statistically significant.

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Approximately 25% of people who travel to altitudes above 8000 feet (2400 meters) suffer from acute altitude sickness which includes headaches, nausea, dizziness, fatigue, and vomiting. Symptoms typically start 6 to 12 hours after reaching the high altitude. If left untreated, mountain sickness may progress to a potentially fatal condition known as high-altitude cerebral edema, a swelling of the brain tissue.

Typically acetazolamide (Diamox) or Dexamethasone (Decadron) are given to prevent mountain sickness, but these drugs have adverse effects such as nausea, dizziness, and fatigue for acetazolamide and delirium, insomnia, mania, adrenal suppression and hyperglycemia for dexamethasone. Ibuprofen may be a better substitute as it has fewer side effects and is easily obtained. It is also effective taken 6 hours before ascension, whereas Diamox must be taken the day before the climb.

Dr. Lipman suggests taking 600 mg before ascent and 600 mg three times on the day of travel. “Ibuprofen needs to be taken with lots of fluids and foods,” he reminds potential users. Also remember that a gradual ascent may reduce the risk of developing altitude sickness.

Also, while ibuprofen may help ease the effects of mountain sickness, it is not a cure. "If you are at high altitude and start feeling sick, I'd suggest you go downhill to the last elevation you felt well at," Dr. Lipman said. Most cases are easily resolved when the hiker returns to a lower altitude as quickly and safely as possible.

Source Reference:
Grant S. Lipman MD et al. Trial for Prevention of Altitude Illness With Nonsteroidal Anti-inflammatories. Annals of Emergency Medicine Available online 20 March 2012. http://dx.doi.org/10.1016/j.annemergmed.2012.01.019