From the Guidelines
To mitigate dizziness associated with acute mountain sickness (AMS), adequate acclimatisation, slow ascent speed, and/or preventive medication such as acetazolamide are essential solutions. According to a recent study published in 2024 in the journal Sports Medicine 1, sex-dependent physiological reactions to hypoxia may contribute to an increased AMS vulnerability in some women, highlighting the importance of tailored approaches to prevention and management.
Key Management Strategies
- Gradual ascent to higher elevations, allowing the body time to acclimate
- Slow ascent speed to reduce the risk of AMS
- Preventive medication such as acetazolamide, which can be taken 24 hours before ascent and continued for 48 hours after reaching high altitude
- Targeted training of the respiratory musculature as a valuable preparation for altitude training, particularly in women 1
- Consideration of sex hormones' influence on hypoxia responses and the potential impact of hormonal-cycle and/or menstrual-cycle phases on acclimatisation to altitude and efficiency of altitude training 1
Additional Recommendations
- Staying hydrated by drinking plenty of water
- Avoiding alcohol and sedatives, which can exacerbate AMS symptoms
- Considering over-the-counter pain relievers such as ibuprofen for headache relief, but using them judiciously due to potential side effects
- Exploring alternative remedies like ginger supplements or ginger tea for dizziness relief, although their effectiveness may vary
Importance of Acclimatisation
Proper acclimatisation is crucial in mitigating dizziness associated with AMS, as it allows the body to produce more red blood cells to carry oxygen and adjust to the lower oxygen environment, thereby reducing symptoms 1. If symptoms persist or worsen, descending to a lower altitude immediately is the safest course of action to prevent further complications.
From the Research
Management Strategies for Mitigating Dizziness Associated with Acute Mountain Sickness (AMS)
- Descent to a lower altitude is considered the primary treatment for AMS, as it helps to alleviate symptoms by increasing oxygen availability 2, 3, 4
- Medical therapy, such as acetazolamide, can be effective in preventing AMS when started 12 to 24 hours before ascent 2, 5
- Acetazolamide can also be used to treat mild AMS, but its effectiveness for this purpose has not been extensively studied 2
- Dexamethasone has been found to be effective in treating AMS, including early cerebral edema, but its use is limited by side effects 2, 6, 4
- Oxygen therapy can be effective in treating HAPE and mild AMS, but it is not as useful for cerebral edema 2, 3
- Other therapeutic measures, such as rest, warmth, and the use of a portable hyperbaric chamber, can be helpful in managing AMS symptoms 6
- Nifedipine can be effective in preventing and treating HAPE, but it is not effective against AMS 3, 4
- Ibuprofen and naproxen may be used to manage symptoms such as headache and ataxia 6
Prevention Strategies
- Slow ascent to high altitudes can help prevent AMS by allowing the body to acclimatize to the lower oxygen levels 3, 4
- Acetazolamide and dexamethasone can be used as preventive measures against AMS, with acetazolamide being the more commonly recommended option 2, 3, 5
- Pre-treatment with low-dose acetazolamide at least two days before arrival at high altitude may be more effective in reducing AMS incidence than starting treatment on the day of ascent 5