From the Guidelines
To treat altitude sickness that has persisted for 3 days with symptoms of lightheadedness, headaches, cough, and shortness of breath, you should descend to a lower altitude immediately if possible, as this is the most effective treatment. This recommendation is based on the principles of managing high-altitude illnesses, including acute mountain sickness, high-altitude pulmonary edema (HAPE), and high-altitude cerebral edema (HACE) 1.
Symptoms Management
For headache relief, consider taking acetaminophen (Tylenol) 650mg every 6 hours or ibuprofen (Advil, Motrin) 400mg every 6 hours. For altitude sickness specifically, acetazolamide (Diamox) 125-250mg twice daily can be considered, as it helps acclimatization by increasing breathing rate and reducing symptoms 1. It's essential to stay well-hydrated by drinking 3-4 liters of water daily and avoid alcohol and sedatives, which can worsen symptoms.
Prevention of Further Complications
Rest adequately and avoid strenuous activity until symptoms improve. If supplemental oxygen is available, it can help alleviate symptoms. However, if symptoms are severe or include confusion, difficulty walking, persistent vomiting, or worsening shortness of breath, seek immediate medical attention, as these may indicate life-threatening conditions like HACE or HAPE 1.
Understanding Altitude Sickness
Altitude sickness occurs because lower oxygen levels at high altitudes cause the body to compensate through faster breathing and heart rate, leading to uncomfortable symptoms until proper acclimatization occurs. The management and prevention strategies are crucial in reducing the risk of altitude-related illnesses, especially for individuals traveling to high-altitude destinations 1.
Given the potential severity of altitude sickness and its complications, prioritizing descent and medical evaluation for severe symptoms is critical, alongside the use of medications like acetazolamide for prevention and treatment, as supported by the most recent and highest quality studies available 1.
From the Research
Symptoms of Altitude Sickness
- Lightheadedness
- Headaches
- Cough
- Shortness of breath
Treatment Options
- Rest, descent or evacuation, and warmth are essential emergency measures 2
- Additional therapeutic measures can be helpful if evacuation to lower altitudes is delayed, including:
- Oxygen
- Portable hyperbaric chamber
- Ibuprofen or naproxen
- Nifedipine
- Dexamethasone
- Acetazolamide should not be used as an emergency therapy 2
- Ibuprofen may be slightly inferior to acetazolamide for preventing altitude sickness, but can still be used as a treatment option 3
Considerations
- Incidence, predisposition, and risk factors of altitude sickness vary individually and geographically 2
- The leading symptoms of altitude sickness, such as altitude headache, ataxia, and sudden loss of strength, are essential for diagnosis and treatment 2
- Individual responsiveness to altitude sickness can be determined by genotypological markers, which can play a role in indicating a "constitutional typological reaction norm" 4