Many travelers to China feel that a trip to Tibet is a highlight of their stay. It can be a fantastic vacation — but many trips have been ruined by getting altitude sickness. Let’s review what this is, and what medicines you can consider taking to prevent this.

Symptoms

At elevations over 8,000 feet (2,500 meters), your body can start to feel symptoms related to the lack of oxygen as you travel higher. Lhasa, at 12,500 feet/3,810 meters, definitely can give you altitude sickness. The symptoms are similar to a hangover; headache is the classic symptom, followed sometimes by tiredness, nausea and no appetite. This usually starts within 2-12 hours upon rapid ascents (flying in to Tibet), and it usually lasts up to 3 days. Everyone is susceptible, including children, especially those under 2 years old. It’s estimated that 25% of travelers get this mountain illness.

With this “mild” form of altitude sickness, a bad headache for a couple days usually isn’t a big deal, and Tylenol here and there will get most people through just fine. But there are more serious forms of altitude sickness, causing acute brain swelling or fluid in the lungs. It is these severe forms, which can be fatal within just a few hours, that worry doctors the most.

Medicines

For the headache, Tylenol (paracetamol) is the best choice; take the high dose of 1 gram up to 4 times a day. Everyone should take some of this, as well as ibuprofen-style pain medicines as a backup.

There is one common prescription medicine called Diamox (acetazolamide) which can very effectively decrease your risk of getting severe altitude sickness. It can also make the milder symptoms even milder. The trick is to start taking it the day before you ascend or get on the plane, and continue for 2 days until your body has finished adjusting.

It’s a very effective preventive medicine that may save your trip as well as your life, but there are common side effects including increased urination and a pins-and-needles sensation in the fingertips. So, it’s a risk vs benefit decision that you can have with your travel companions and your doctor. Another prescription medicine, the steroid dexamethasone, is also effective in both prevention and treatment. Other agents such as gingko have mixed evidence; those poppy leaves you chew on while climbing in the Andes work a tiny bit. But really, it’s a decision you need to make before you leave; if you want true prevention you should stick to the best researched choices.

Other Tips

Other tips for the first 48 hours of adjusting are to drink lots of fluids, avoid alcohol, and not have too strenuous exercise.  If you continue to climb (say, to base camp), always ascend gradually. And if you do feel sudden severe symptoms, especially bad shortness of breath, get to a clinic immediately, or at least descend quickly if you’ve been climbing.

Resources:
Altitude Sickness – a nice review from the CDC