If the thought of hiking and mountaineering at high altitude makes you anxious enough to pee your pants, I'm here to assure you that you are not alone! My mountaineering Facebook group is filled with questions about altitude. People wonder:

• How will I feel up there?

• Will I get sick?

• Can I train for high altitude?

• Should I take altitude sickness medications like Diamox?

We'll answer all of these questions and more in today's episode.

For those of you who didn’t know, I actually got my start in the outdoors as a backpacking guide in Colorado. This means I’ve seen literally hundreds of people travel from sea level or the Midwest to an elevation of 9,000 feet, put on a pack, and head into the mountains for five days. One of my most important responsibilities as a guide was to help clients prevent and manage altitude sickness. This gave me a firsthand look at who gets altitude sickness. The results were interesting … and as we’ll discuss, often unexpected!

Listen now!

Links/Resources Mentioned

Additional Reading on the blog

• More on altitude sickness prevention

• Interval training workouts for high altitude

• Bolivia high-altitude mountaineering trip report (Pequeno Alpamayo, Huayna Potosi, Illimani)

More on Diamox and high-altitude medications

For those of you who are curious about this topic, here’s a live video broadcast that I did discussing the pros and cons of Diamox (acetazolamide) for mountaineers. It goes a bit more in depth than the podcast.

Episode sneak peak

Welcome to high altitude!

• [1:30] Why the thought of altitude sickness freaks us out, the science behind it, and why it’s usually nothing to fear.

• [3:40] Here’s where we dive into altitude sickness symptoms: what’s normal and what could indicate a more serious illness like HAPE or HACE. Learn who’s most at risk for altitude sickness (also known as acute mountain sickness), and some simple ways to treat mild-to-moderate symptoms. Also, we’ll discuss why older people usually do better at high altitude (it’s true!).

Altitude sickness prevention tips

• [10:30] Planning is your number one weapon. Why planning an acclimatization period into every high-altitude trip is essential, who long to acclimatize, and what happens to your body during acclimatization. Plus, what to do during acclimatization if you’re feeling restless.

• [14:30] Pace yourself during your high-altitude hike. How to use physiological cues to distinguish between aerobic and anaerobic metabolism and keep yourself aerobic as you go higher. Also, what to do if you are gasping with every step. And why it’s important to know your daily itinerary and take plenty of time to reach your destination.

• [17:47] Hydration matters! Learn how much to drink and when to drink it. We’ll also cover what thirst means and look at the pros and cons of water bottles versus hydration system. Finally, I’ll share some ways to make water taste better.

High altitude medications

• [21:38] Learn about the benefits and limitations of medications like Diamox (acetazolamide), where to get them, and why they’re no substitute for good planning and pacing.

Training for high altitude

• [26:20] Here’s why having a good VO2 max probably helps performance at altitude, and some simple ways to improve yours. Adding intensity to your program is a good way to prepare for the rigors of high-altitude hiking and climbing. However, this need not be super high-intensity unless you’re training at a high level.

Listen now!

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