The following information is graciously provided by and reproduced with the permission of the Institute of Altitude Medicine at Telluride Colorado. Please visit their site for a wealth of information about altitude health.
How can I optimize my health at altitude?
All of the San Juan Hut Systems' ski huts lie above 9,000 feet and you can ski form summits as high as 14,000 feet. Acclimatizing well is an important part of staying healthy at altitude and having a good time.
The following are ways to optimize your adjustment to altitude and improve your chances of not getting altitude illness.
Altitude Myths
Myth # 1 - Don't drink caffeine at altitude.
We don't know where this false assumption came from, but likely from the fact that caffeine is a mild diuretic (makes you pee). The concern is that it could dehydrate you and contribute to altitude sickness. This concern is unfounded unless you drink pots of black sludge coffee a day and little else. In reality, caffeine stimulates your brain, kidneys and breathing, all of which are helpful at altitude. And for those people who drink several caffeinated beverages a day, stopping abruptly can cause a profound headache.
Myth #2 - Diamox masks symptoms of altitude sickness.
Taking Diamox to prevent AMS will not mask symptoms. It works on the same pathway that your own body uses to help you acclimatize. It is a carbonic anhydrase inhibitor which makes you urinate a base chemical called bicarbonate. This makes your blood more acidic and therefore stimulates breathing thereby taking in more oxygen. It speeds up your natural process of acclimatization and if you stop taking it you will not have rebound symptoms. It is one of the main medicines doctors use to prevent and treat acute mountain sickness (AMS).
Myth #3 - Physical fitness protects against altitude sickness.
Physical fitness offers no protection from altitude illness. In fact, many young fit athletes drive themselves too hard at altitude prior to acclimatizing thinking they can push through' the discomfort. They ignore signs of altitude illness thinking it can affect them because they are fit and healthy. Everyone, regardless of fitness, is susceptible to AMS.
Athletes and Altitude
VO2max is the body's maximal ability to extract oxygen from the air and deliver it to the tissues. Above 5000 feet the maximum work a person can do decreases by 3% for every 1,000 feet. This means your body's ability to utilize oxygen diminishes with increasing altitude. Even after acclimatization, this only improves a little bit and a person can never perform as well at altitude as they can at sea level. With increasing altitude, you need to take more air into your lungs, contributing to the breathless feeling that many athletes experience when first coming to altitude, and especially if trying to perform at the same intensity as at sea level. One of the processes in acclimatization important for athletes is the production of a hormone called EPO or erythropoietin. This hormone acts on the bone marrow to produce more red blood cells. These cells carry oxygen from the lungs to the tissues. Increasing these cells effectively increases the 'oxygen carrying capacity' in your blood. However, this process takes weeks. EPO is a big topic among competitive endurance athletes.
Competing at Altitude
For those athletes doing aerobic events over 5000 feet, 10-20 days of acclimatization at the performing altitude is ideal. Athletes participating in events over 12,000 feet must have acclimatization at an intermediate altitude prior to performance. Performing without acclimatization at this altitude could cause altitude sickness. Those participating in anaerobic sports (short intense events lasting less than 2 minutes, such as sprinting) at altitude do not require extended acclimatization, and may perform better because of lower air density.
Training at Altitude for Sea Level Events
Training at moderate altitude may enhance sea level performance in endurance athletes. This was noted after the 1968 Olympics in Mexico City (7600 feet) when some athletes found an improvement in their performance after return to sea level. However, other athletes did not notice any difference in performance. Studies have shown improved aerobic power in runners who trained at 6,000 feet for 10 days then performed at low altitude. Lower oxygen levels at altitude stimulate EPO leading to increased red blood cells or hematocrit. This effectively allows more oxygen to be carried to the tissues. Essentially, this is blood doping � the natural way.
Recent studies do suggest benefits from 'training low' and 'sleeping high'. This includes hypoxic tents that many athletes are now using. These tents have a generator which extracts oxygen from the air, creating a moderate altitude environment. Athletes then sleep/lounge in them for several hours a day. This stimulates erythropoietin, thereby increasing the hematocrit (red blood cell count). Indeed the 'live high, train low' concept may allow the best combination. One study divided 39 competitors into three training groups; living and training at sea level, living at altitude and training at sea level, living at altitude and training at altitude. Both groups who lived at altitude had increased red blood cells and VO2max, but only the group who lived high and trained at sea level had improved race times. One explanation for this is that the live high, train low group is able to train harder and better utilize their blood's oxygen carrying capacity. Because of increased red cell production, all athletes training and/or sleeping at altitude should make sure they have appropriate iron stores and nutrition. This is especially true for women, as they tend to have lower iron stores due to periodic loss of blood through menstruation.
Limitations
The response of erythropoietin to hypoxia is quite individual. While some have a significant response, others barely respond at all and may not have a benefit from sleeping and/or training at altitude.
While training at moderate altitude can be beneficial there are limitations. Athletic training above 8,000 feet is not generally recommended. At these higher altitudes, your exercise capacity decreases to the point that "deconditioning" can take place. Prolonged recovery time increases time required between training sessions. At even higher altitudes increasing catecholamines (epinephrine and norepinephrine), the body's stress hormones, contribute to weight loss and muscle wasting.
Other considerations of training at altitude
Nutrition becomes increasingly important when training even at moderate altitude. Rising stress hormone levels in response to lower oxygen levels place a higher demand for fuel on your body. As resting metabolism rates increase, athletes need to add to their caloric intake. Moderately increasing carbohydrate intake is key in replacing glycogen stores in your body after training and compensating for the increased caloric demand at altitude.
Hydration in the athlete is more important at altitude as well. Some athletes sweat 0.5 to 1.5 liters an hour. In addition, the lungs must humidify the air, which requires more water in the dry air at high altitude. To monitor hydration, a good rule of thumb for an athlete is to weigh themselves before and after training. Hydration to the pretraining weight will help athletes stay on top of their individual fluid needs.
How can I optimize my health at altitude?
All of the San Juan Hut Systems' ski huts lie above 9,000 feet and you can ski form summits as high as 14,000 feet. Acclimatizing well is an important part of staying healthy at altitude and having a good time.
The following are ways to optimize your adjustment to altitude and improve your chances of not getting altitude illness.
- Slow ascent to altitude is the key to acclimatizing well. Almost anyone can get altitude illness if they go too high, too quickly. Because of the individual differences, a preventive rate of ascent for one person may be too slow or fast for another.
- An overnight stay at an intermediate altitude such as Denver (5280 ft) or preferably a bit higher prior to further ascent into the mountains is very helpful. If traveling to Telluride, overnighting in Ridgway, Ouray, Placerville or Durango would be helpful, especially if the destination is Mountain Village.
- Staying hydrated is important as it aids your body in acclimatizing.
- Avoid use of alcohol or sleeping agents of the benzodiazepine family, since they both suppress breathing and result in lower blood oxygen. Other sleeping pills like Ambien or Lunesta do not affect breathing at high altitude and are safe. Avoid over-exertion for 1-2 days after arrival to altitude.
- Acetazolamide (Diamox®) taken 24 hours prior to arrival to altitude and the first 2 days at altitude is 75% effective in preventing AMS. It speeds up the acclimatization process in the body, stimulates breathing, raises blood oxygen and increases urination.
- Gingko biloba, according to some studies was effective in preventing AMS when started 5 days prior to ascending to altitude, at a dose of 100 mg twice a day.
- Avoiding exposure to viral illness such as coughs and colds will improve your chances of staying healthy. When traveling consider wearing a mask if exposed to someone with a severe cough. Use proper hand washing and good hygiene to avoid transferring germs.
Altitude Myths
Myth # 1 - Don't drink caffeine at altitude.
We don't know where this false assumption came from, but likely from the fact that caffeine is a mild diuretic (makes you pee). The concern is that it could dehydrate you and contribute to altitude sickness. This concern is unfounded unless you drink pots of black sludge coffee a day and little else. In reality, caffeine stimulates your brain, kidneys and breathing, all of which are helpful at altitude. And for those people who drink several caffeinated beverages a day, stopping abruptly can cause a profound headache.
Myth #2 - Diamox masks symptoms of altitude sickness.
Taking Diamox to prevent AMS will not mask symptoms. It works on the same pathway that your own body uses to help you acclimatize. It is a carbonic anhydrase inhibitor which makes you urinate a base chemical called bicarbonate. This makes your blood more acidic and therefore stimulates breathing thereby taking in more oxygen. It speeds up your natural process of acclimatization and if you stop taking it you will not have rebound symptoms. It is one of the main medicines doctors use to prevent and treat acute mountain sickness (AMS).
Myth #3 - Physical fitness protects against altitude sickness.
Physical fitness offers no protection from altitude illness. In fact, many young fit athletes drive themselves too hard at altitude prior to acclimatizing thinking they can push through' the discomfort. They ignore signs of altitude illness thinking it can affect them because they are fit and healthy. Everyone, regardless of fitness, is susceptible to AMS.
Athletes and Altitude
VO2max is the body's maximal ability to extract oxygen from the air and deliver it to the tissues. Above 5000 feet the maximum work a person can do decreases by 3% for every 1,000 feet. This means your body's ability to utilize oxygen diminishes with increasing altitude. Even after acclimatization, this only improves a little bit and a person can never perform as well at altitude as they can at sea level. With increasing altitude, you need to take more air into your lungs, contributing to the breathless feeling that many athletes experience when first coming to altitude, and especially if trying to perform at the same intensity as at sea level. One of the processes in acclimatization important for athletes is the production of a hormone called EPO or erythropoietin. This hormone acts on the bone marrow to produce more red blood cells. These cells carry oxygen from the lungs to the tissues. Increasing these cells effectively increases the 'oxygen carrying capacity' in your blood. However, this process takes weeks. EPO is a big topic among competitive endurance athletes.
Competing at Altitude
For those athletes doing aerobic events over 5000 feet, 10-20 days of acclimatization at the performing altitude is ideal. Athletes participating in events over 12,000 feet must have acclimatization at an intermediate altitude prior to performance. Performing without acclimatization at this altitude could cause altitude sickness. Those participating in anaerobic sports (short intense events lasting less than 2 minutes, such as sprinting) at altitude do not require extended acclimatization, and may perform better because of lower air density.
Training at Altitude for Sea Level Events
Training at moderate altitude may enhance sea level performance in endurance athletes. This was noted after the 1968 Olympics in Mexico City (7600 feet) when some athletes found an improvement in their performance after return to sea level. However, other athletes did not notice any difference in performance. Studies have shown improved aerobic power in runners who trained at 6,000 feet for 10 days then performed at low altitude. Lower oxygen levels at altitude stimulate EPO leading to increased red blood cells or hematocrit. This effectively allows more oxygen to be carried to the tissues. Essentially, this is blood doping � the natural way.
Recent studies do suggest benefits from 'training low' and 'sleeping high'. This includes hypoxic tents that many athletes are now using. These tents have a generator which extracts oxygen from the air, creating a moderate altitude environment. Athletes then sleep/lounge in them for several hours a day. This stimulates erythropoietin, thereby increasing the hematocrit (red blood cell count). Indeed the 'live high, train low' concept may allow the best combination. One study divided 39 competitors into three training groups; living and training at sea level, living at altitude and training at sea level, living at altitude and training at altitude. Both groups who lived at altitude had increased red blood cells and VO2max, but only the group who lived high and trained at sea level had improved race times. One explanation for this is that the live high, train low group is able to train harder and better utilize their blood's oxygen carrying capacity. Because of increased red cell production, all athletes training and/or sleeping at altitude should make sure they have appropriate iron stores and nutrition. This is especially true for women, as they tend to have lower iron stores due to periodic loss of blood through menstruation.
Limitations
The response of erythropoietin to hypoxia is quite individual. While some have a significant response, others barely respond at all and may not have a benefit from sleeping and/or training at altitude.
While training at moderate altitude can be beneficial there are limitations. Athletic training above 8,000 feet is not generally recommended. At these higher altitudes, your exercise capacity decreases to the point that "deconditioning" can take place. Prolonged recovery time increases time required between training sessions. At even higher altitudes increasing catecholamines (epinephrine and norepinephrine), the body's stress hormones, contribute to weight loss and muscle wasting.
Other considerations of training at altitude
Nutrition becomes increasingly important when training even at moderate altitude. Rising stress hormone levels in response to lower oxygen levels place a higher demand for fuel on your body. As resting metabolism rates increase, athletes need to add to their caloric intake. Moderately increasing carbohydrate intake is key in replacing glycogen stores in your body after training and compensating for the increased caloric demand at altitude.
Hydration in the athlete is more important at altitude as well. Some athletes sweat 0.5 to 1.5 liters an hour. In addition, the lungs must humidify the air, which requires more water in the dry air at high altitude. To monitor hydration, a good rule of thumb for an athlete is to weigh themselves before and after training. Hydration to the pretraining weight will help athletes stay on top of their individual fluid needs.
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