Altitude Sickness: Why?

In today's episode, we are taking a look at Altitude Sickness- what it is, why it happens, and why it affects some people more than others.

Altitude sickness is not your body failing. It’s  a response. It’s your body’s response to having less available oxygen while it tries to acclimate to higher altitude.

And it's important to not that it doesn’t just happen to those of us who live at sea level.  People who live in the mountains can get altitude sickness if they climb higher than their body is accustom to.

Think of altitude like lifting weights.

 If you normally lift 20 pounds and suddenly pick up a 50 pound weight, you will notice the difference. If you normally lift 50lbs and pick up an 80 pound weight  you notice that  too. It’s not about where you started. It’s how big of jump it is.

We all respond to altitude. We just don’t all respond the same way. Anyone at altitude experiences, faster breathing, an elevated heart rate, and changes in their blood chemistry. There is no such thing as a person immune to the effects of thin air. Your body is reacting whether or not you feel anything.

It affects men and women, young and old,  elite athletes, and avid hikers.

I will share with you what happens inside your body the moment you arrive at higher elevations, why your lungs, heart, brain and even your kidney's all work together to help you acclimate. 

And how to recognize the difference between altitude sickness and look- alikes like a hangover, dehydration, or the flu.

We will talk about what you can do before and during your mountain trip to help your body adjust, including, hydration, nutrition, alcohol, sleep and pacing yourself during those first few days.

Whether you are planning a hiking, skiing, backpacking or mountain vacation, this episode will help you understand what's happening inside your body- and how to give it the time and support it needs to acclimate.

I was thinking that today’s take away isn’t only about altitude, it’s also about adaption.

Your body is constantly adapting:

-to altitude

-to heat

-to Cold

- to Exercise

-And even to aging

Altitude is just one of the most dramatic examples.

Your body is incredibly adaptable.

Sometimes it just needs a little time.

Whether its adjusting to mountain air, recovering from exercise or navigating the changes that come with aging, your body is always trying to find balance.

And the healthiest thing you can do is give our body the time, patience, and support it needs to acclimate.

Enjoy!

Joanne Demers

The Aging Mask- A Lifestyle Medicine Podcast

(949) 236-1529

Follow along on Instagram:
https://www.instagram.com/theagingmask

Transcript

SPEAKER_00 0:00

Hi, welcome back to the Aging Mass Podcast, a lifestyle medicine podcast where together we explore lifestyle, wellness, and our everyday choices that shape the way we age. I am Joanne Demers, your weekly wellness companion. Thank you for spending your time with me today. I greatly appreciate it. Today I want to talk about altitude sickness. Now, before you think that this won't apply to you, just stay with me for a few minutes because if you've ever gone skiing, hiked in the mountains, biked in the mountains, or even just visited a mountain town and wondered at that time why you didn't feel your best, why you weren't performing at your best, and you started feeling like you were getting sick, then this episode is for you. I personally have spent enough time in the mountains to know that my body does not love the altitude. It has a love-hate relationship with altitude. And I always wondered: am I that out of shape? Is that why I am so out of breath? That I am the last in the hiking line. I'm the last to come down off the mountain. What is wrong with me? Am I dying? Is my heart like gonna pound out of its chest or my lungs too small? I didn't know what was going on. At one time, I thought I got carbon monoxide poisoning. That's what I thought. Oh my gosh, that was the worst. I could not figure out what was wrong with me every time I went to the mountains and come to find out I'm prone to altitude sickness. And that made me really curious about what exactly altitude sickness is and why some people get it like me, and some don't. Altitude doesn't affect some people, and I found that fascinating. I literally thought something was wrong with my heart and my lungs. I even, believe it or not, had them checked. True story, not lying. So, what exactly is altitude sickness? Well, first and most importantly, altitude sickness is not your body failing you. There is nothing wrong with your body. Altitude sickness is a response, it's your body's response to having less available oxygen while it tries to acclimate to higher altitude. That's all. That's all it is, and all the trouble it causes. It's just a response. It's just a response to having less available oxygen while your body tries to acclimate to higher altitude. It affects men, it affects women, young kids, old people, elite athletes, avid hikers, bikers, and to myth bust off the top. It doesn't just happen to those of us who live at sea level. We can't pull that card either. If you live at sea level, you can't pull that card. You cannot be blaming you living at sea level for your low performance. Even people who live in the mountains can get altitude sickness if they climb higher than their body is accustomed to. I thought of it, I thought of altitude at the time when I learned about it. It's like lifting weights. I know that sounds really ignorant, but that's what I thought. But I thought of it like lifting weights. If you normally lift 20 pounds and suddenly you pick up a 50 pound weight, you're gonna notice the difference. If you normally lift 50 pounds and pick up 80 pounds, you're gonna definitely notice that. It's not about where you started, it's how big of a jump it is. Does that make sense? It's all in how big of a jump it is, how much elevation you climb or how much elevation you go up. And we all respond to altitude. We just don't all respond the same way. Anyone at altitude experiences faster breathing, an elevated heart rate, and changes in their blood chemistry. There is no such thing as a person immune to the effects of thin air, altitude. Your body is reacting whether you're feeling anything or you're not feeling anything. Let's start with the air at altitude. The amount of oxygen in the air doesn't really change as you climb higher. The air is still about 21% oxygen, whether you're standing at sea level or you're standing on top of that mountain. The difference is in the air pressure. As the elevation increases, the air becomes thinner. So every breath you take contains fewer oxygen molecules because they are spread further apart. Therefore, your lungs have to work harder to pull oxygen into your bloodstream. And less pressure pushing oxygen into your blood means your body is effectively getting less oxygen per breath, even though the air is made of the same stuff. Does that make sense? Think of it like trying to drink a thick milkshake through a straw. You can still get the milkshake, you just have to work a lot harder to get the same amount. Altitude sickness starts in your lungs. Am I wrong in saying that's probably where you feel it first? If not with the headache, you feel it in your lungs, you're breathing. Your lungs are the first to notice that something has changed. They're saying, wait a minute, there isn't as much oxygen here up here. What's going on? Your lungs sense the drop in oxygen and respond immediately. You start breathing faster and you start breathing deeper, just trying to bring in more oxygen with every breath. Then your heart joins in. Because there is less oxygen entering your blood per breath, your heart compensates by beating faster in order to move blood through your lungs and around your body more quickly. This way it can pick up and deliver as much oxygen as it can to your muscles, organs, and brain. Then your brain notices what's going on and wants to join in. Now, your brain is one of the most oxygen-hungry and altitude-sensitive organs in your body. So when oxygen levels drop, your body responds by increasing blood flow to the brain in an effort to deliver more oxygen. That change, along with the other changes in the brain's response to the altitude, is what contributes to the classic altitude headache, which I would go out on a limb and say we've all experienced it that one in our life, that altitude headache. They are not fun. Then the kidneys join the team. Who would have thought your kidneys would join the team? They do, but they work behind the scenes. Your kidneys adjust your body's chemistry to help you adapt to the lower oxygen levels. And if you stay at altitude long enough, your kidneys tell your bone marrow to make more red blood cells, helping your body become more efficient at carrying oxygen. And a little side note here: if you notice that you are peeing a lot more during the first day or two at altitude, it's one of the ways your kidneys are helping your body start that acclimation process. Now, when do you notice altitude sickness normally? A lot of people begin noticing subtle changes in their breathing and exercise performance at about 5,000 feet. At around 8,000 feet, this is the altitude where altitude sickness becomes a lot more common. And above 10,000 feet, everyone will notice some physical changes. Some people can hike the mountain all day up there without a problem. And some of us will get that headache before we've even unpacked. Now, how do you know? This is important. How do you know if it's altitude sickness and not a hangover? That's a good question. I do know that altitude sickness does feel pretty much like a hangover or the flu. That's just it feels the same, to be honest. Altitude sickness usually starts with a headache. And I know you're gonna say so does a hangover, but this is the hallmark headache. You can feel the difference. And another way to tell that it's not a hangover headache is this headache, if you want to know the difference between the hangover and altitude sickness, is look for a partner. When you have that headache, look for a partner. If it comes with nausea, dizziness, or fatigue, or a loss of appetite, or if you have recently gained elevation and your headache is traveling with one or more of those symptoms, altitude sickness is most likely what it is. And another clue that it's altitude sickness is its timing. Altitude sickness usually begins within six to 24 hours after arriving at higher elevations. And symptoms often improve as your body acclimates, which usually takes a day or two if your symptoms are mild. I know that it still sounds like a hangover, but or you might think it's the flu, but it's not the flu if you don't have a fever, a sore throat, or body aches. Altitude sickness does not cause a fever. And it's probably not a hangover because, well, timing is the giveaway here. A hangover peaks and then it fades within a day. And you can tell because it tracks with how much you drank. So, and most likely it's not just exertion fatigue because exertion fatigue improves with rest and doesn't usually come with a headache and nausea together. Practical rule of thumb: if you're at elevation and you have a headache plus one of those other symptoms, treat it as altitude sickness until proven otherwise. Good. The good news, most altitude sickness improves with rest, hydration, and avoiding further climbing. The bad news? Unfortunately, altitude sickness doesn't come with a label that says, Hi, it's me, it's altitude sickness. It does borrow symptoms from the flu, it borrows symptoms from a hangover, and it does borrow symptoms from dehydration. That's why paying attention to when your symptoms start is one of your biggest clues. So pay attention to when they all start. Now let's talk about sugar and carbs, carbohydrates in the mountains, because this one still shocks the heck out of me. At sea level, we're told to avoid sugar and we're told to reach for protein and healthy fats to keep us full longer. But at altitude, it temporarily flips. Simple carbs become the smart choice. I know that's surprising. Now, if you're spending the day hiking or skiing at altitude, your body has different priorities at that point. During prolonged exercise at higher altitudes, your body actually shifts toward using carbs as its preferred fuel. Why? Because simple carbs require a little less oxygen to produce energy than fats do. Okay, carbs require less oxygen to produce energy than fats do. Now, simple carbs, if you're not aware, are carbs made of small, quickly digested sugar molecules, which your body breaks down faster and gets energy from almost immediately. Okay, simple carbs. At altitude, with less oxygen available, your body prefers fuel that's cheap to burn. Simple carbs are a more efficient fuel source when oxygen is a limiting factor. That's why when you hike or you climb or mountain bike or ski, keep in your snack bag, lean toward things like dried fruits, bananas, honey packets, energy chews or those little gels, sports drinks, pretzels, even fig bars, because they provide fuel that your muscles can use right away. And if you're wondering about your fats and your protein, like your beef jerky and your trail mix, they all still have their place, just not in your snack bag while you are doing activities up on the mountain. Fat and protein are really important for your overall nutrition. They keep you full and they are great for recovery. And both protein and those fat heavy trail mixes and jerky are great. They're great for walking or hiking at sea level or wherever you live, but they ask more of your oxygen-starved body to convert into usable energy. So they're just harder. Now, salt, unlike carbs, salt doesn't become your body's preferred fuel at altitude. That doesn't mean that you should avoid it either. Okay, don't just avoid it. When you're up there on the mountain, or even if you're just spending hours out there in the mountain air, you are losing both water and sodium through your sweat. And replacing those electrolytes can actually help you stay hydrated and maintain your performance. That's why snacks like whole grain crackers and salted nuts they make sense while you're hiking, also. Okay, because they're yeah, whole grain crackers and salted nuts are a good snack for your pack while you're hiking. I mean, as with everything, the key is balance. A handful of pretzels during a hike is very different from eating a large salty restaurant meal the night before without drinking enough water. One helps replace what you've lost, and the other leaves you feeling thirsty and dehydrated. And at altitude, hydration is the priority. So instead of worrying about avoiding every gram of salt, focus on drinking enough fluids, replacing your electrolytes, and choose those foods that your body can use for quick energy. And they're all great, great little snack foods. And another piece of good news is that while we can't completely prevent altitude sickness, we can give our body the best chance to adjust. So if you're gonna head up on into the mountains, think of your first day as acclimation day, not a performance day. Try and resist hitting the ground running, and this will give your body a chance to catch up before asking it to perform at its best. And then drink your water. Drink, drink, drink your water. Stay well hydrated. Mountain air is dry and very drying. So hydration is the single most important thing that you can control at altitude, and it's so simple. Be aware that you lose water faster up there without realizing it. You lose a lot of water up in the mountains and you lose it fast because it is so dry and very drying. What happens is you're breathing quicker and deeper to compensate for that thinner air. And every one of those breaths carries moisture out of your body. So just breathing at altitude dehydrates you faster than it would at sea level. That's why it is so important to stay hydrated. And on top of that, you pee more as part of that, you know, your body's natural acclimation process, those kidneys. So you're going to the bathroom a lot more, so you're losing that hydration. Now, the tricky part is that dehydration causes almost the exact same symptoms as altitude sickness, headache, fatigue, dizziness. So if you're not drinking enough water, you can't tell if it's the altitude or just plain thirst that's making you feel awful. So when you're at altitude, drink more water than you think you need. It's one of the best things you can do to feel your best up there. Drink a ton of water. And don't be afraid of having to go to the bathroom on the mountain, especially as a woman. I used to never drink, I drink water incessantly, but on the mountains, doing any activity, I didn't drink because I didn't want to go to the bathroom. But that just makes you feel more like crap and you can't perform. Don't be afraid of it. If you're hiking, there's a zillion bushes, logs, trees. Go. The only pain. Is really when you're skiing to have to come in and go, but it's worth it. You do not want to have altitude sickness, and you don't want to be a weak performer. We have to talk about alcohol, we just have to. Have you ever noticed that having just one drink in the mountains hits you stronger? Well, you're not imagining it because it does. Obviously, the alcohol is not stronger, it's the altitude. Alcohol dehydrates you and it slows your breathing rate right when your body needs to breathe faster to get more oxygen. And remember, altitude already lowers the amount of oxygen reaching your brain. Alcohol adds another layer by slowing your brain function, relaxing your breathing, and contributing to dehydration. Alcohol also masks early symptoms. So you might not notice you're getting altitude sickness until it's really bad. So try really hard to limit your alcohol at least during the first 24 hours that you're in the mountains. And trust me when I say this, night one drinking to oblivion is not worth it. It just makes everything worse. It just is that one domino you need for them to just all collapse. And make sure that you eat your regular meals. And don't be afraid of healthy carbs while you're in the mountains, your oatmeal, your fruits, your potatoes, your rice, and your whole grains. They will provide your body with the perfect amount of energy while it's adapting to those low oxygen levels. And get a good night's sleep if you can. I know that the first night's sleep is not always the best. So many of us sleep differently at altitude, and that's just what it is. It's just adjustment. But if you don't push yourself day one and you don't drink alcohol day one, and you drink your water and eat your carbs, you will definitely get a good night's sleep that first night. And the most important thing, don't try and outsmart the mountain. If your body is telling you to slow down, please slow down. If you need to take a thousand breaks, take them. So let your body do what it's designed to do, which is to acclimate. Allow it time to acclimate. I was thinking that today's takeaway isn't only about altitude, it's also about adaption. Your body is constantly adapting when you think about it to altitude, to heat, to cold, to exercise. It's even adapting to aging. Altitude is just one of the most dramatic examples of it, but your body is incredibly adaptable. Sometimes it just needs a little time. Whether it's adjusting to mountain air, recovering from exercise, or navigating the changes that come with aging, your body is always trying to find balance. And the healthiest thing that you can do is give your body the time, patience, and support it needs to acclimate. That's all I have for today. Thank you again for listening. Until next week, live in gratitude, keep on moving, and go live your best day yet. I'll talk to you next week. Enjoy. If you enjoyed this episode and just can't wait to hear and learn more, don't forget to subscribe to the Aging Mask, a lifestyle medicine podcast, wherever you listen to podcasts. And I would love to hear your thoughts on this episode. So please leave a review on the Aging Mask Instagram. Or if you don't have socials, feel free to text me at the Aging Mask 949-236-1529. We can talk about this episode or any of my prior episodes. Let's have a conversation. I want to help where I can. Bye.