5 alternatives to Diamox for dealing with Acute Mountain Sickness

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The popularity of trekking in our country is ever increasing. As a result, a record number of people are seen flocking to the Himalayas. Normally a human body needs 24 to 48 hours to acclimatize at an altitude of 3,000 meters. Guided trekking companies find it impossible to put this in the itinerary keeping the demand for shorter duration treks for clients.

Diamox of late has become the preferred choice among trekkers. Many Trek Organizers insist their trekkers take a dose of Diamox before they come for the trek. As a trek organizer, this makes sense. If trekkers acclimatization is put on an accelerated mode, the less of a headache to manage their well-being.

Taking Diamox has become synonymous as taking a pill of aspirin. However, there recent studies have shown Diamox is not an easy pill to handle. Its side effects deter many trekkers to avoid it all together.

There must be alternatives to Diamox for dealing with Acute Mountain Sickness. We have listed five of them here.

1.Ibuprofen (also known as Advil) surprisingly is as effective as Diamox for preventing Altitude Mountain Sickness. A recent study conducted by Dr. Grant Lipman, assistant professor of emergency medicine at Stanford University School of Medicine states Ibuprofen can prevent 26% of cases of altitude sickness and help people who are without symptoms to stay without symptoms.

Many trekkers complain of an uncomfortable tingling of the fingers, toes and face, carbonated drinks tasting flat, excessive urination when on a Diamox prescription. Ibuprofen does not come with such side effects as Diamox and Dexamethasone, making it a more attractive, preventive drug in the market.

Ibuprofen gets absorbed by the human body much faster than Diamox making it a quick acting drug.

2. Believe it or not, chewing Coca leaves is better than having Diamox. Trekkers in latin American countries swear by the magical AMS preventive properties of Coca leaves. Alternatively having Coca leaves tea works as well but not as effective as chewing leaves. Coca has homeopathic properties. Make sure the one you get  is without cocaine (decocainized). Coca 200 is a good option to begin with.

3. Drinking Beet juice can help prevent AMS on treks. Dr. Svein Erik Gaustad, an author of the study and a professor at Norwegian University of Science and Technology says about Beet juice, “It may be the extra boost your body needs to deliver enough oxygen to your tired muscles and keep you healthy when you are climbing a high mountain.”

At high altitudes, our bodies are less likely to produce enough Nitrate Oxide as it needs plenty of oxygen. That’s where beet juice comes in; it’s packed with nitrate, a compound that the body can use to convert into NO.

The study is still new, but there is no harm in having Beet juice. So next time carry a bottle of Beet juice with you on your Himalayan trek.

4. Limited evidence indicates that an herbal remedy, Gingko Biloba, may prevent altitude sickness when started before the ascent. The usual dosage is 100 mg every twelve hours.

5. Ginger and Garlic have natural properties to help when suffering from AMS. Ginger is useful in cases of indigestion and nausea. Chewing small portion of Ginger herb while trekking can be very useful.

Garlic helps in blood thinning. Make small capsules like dosage can help in countering the effect of AMS on treks. Nutrilite Garlic capsules are readily available in prescription stores.

 The Purist way for dealing with Altitude Sickness

The purist way of dealing with AMS is to avoid taking any prescription drugs before hand and monitor the health condition.

There is a simple way one can keep track over AMS symptoms by keeping a scoring tab in the following way.

 AMS score chart

Score of 1 – 2 = Mild AMS

Score of 3 – 5 = Mid AMS

Score of 6 and more = Severe AMS

(The Lake Louise scoring system*)

Follow preventive measures once the level of AMS is ascertained. A mild AMS can be cured by taking a headache pill. Sometimes the reason for symptoms may be due to dehydration. Have one pill of Disprin along with 1-liter water. This should help in curing the migraine, fatigue. If after an hour there is no relief you would need to be treated for AMS.

Read about 6 ways to avoid AMS on a Himalayan Trek here

Monitor the person suffering from AMS by staying in the same altitude for a day. If the symptoms improve, ascend only by 300 – 500 meter a day. This will be a good time to take Ibuprofen.

If the improvement is not seen, arrange for an immediate descent. By keeping a thorough monitoring of health condition, one can avoid conditions of deadly HAPE (high altitude pulmonary edema) and HACE (high altitude cerebral edema) to develop.

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20 thoughts on “5 alternatives to Diamox for dealing with Acute Mountain Sickness

  1. Sorry Vaibhav but I can’t agree on Ibuprofen. 1800 mg per day is a big dose and if you do a long trek you may need to have it for as long as two weeks. There are many major side effects to this drug ibuprofen. In my view Diamox is a far better alternative.

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    1. Thank you for your counter argument. Ibuprofen and Diamox have been compared and field tested by many independent research parties. The results have been polarizing. Personally I never liked Diamox. I do occasionally have periodic breathing trouble at night at an altitude of 10,000 to 11,000 feet. Ibuprofen was helpful. And you don’t need to take the dose for the entire​ trek. By 3rd or 4th day into the trek, you can do without it. I am very curious to try Beet Juice in my next trek.

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  2. Interesting debate! Fortunately, since I trekked and climbed in days of yore when there was no pressure to compress a mountain adventure into very brief time slots, I had the luxury of letting my body acclimatise the old fashioned way which I think is still he best!

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  3. Used diamox when I went on the Markha trek. But only for the first couple of days to acclamatize and then we chose to not medicate. Also consumed garlic pearls, but am not sure if this helped in any way. But thanks for the info and choices.

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  4. I have suffered from AMS when I attempted Roopkund that too at a low altitude of 11000 ( Bedni Bugayal ). I saw people successfully completing trek and accrediting it to Diamox.

    I am attempting Mount Kinabalu Malaysia next week . The altitude gain is quick without any time for acclimatization . I am in double minds to take Diamox as precautionary measure in the view of my history of AMS. What do you say .?

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    1. You should rethink and evaluate your trek to Mt. Kinabalu. If my info is correct, Kinabalu is at an elevation of over 13,400 feet. A friend of mine did it in 1 day and suffered from an acute case of Altitude sickness. See if you can opt to camp in between. There is one camp at around 10,000 feet. I suggest on day one attempt to climb not more than 4,500 feet and see how you feel. If you feel lethargic, nauseated, dizzy, take a rest day. Popping Diamox is not going to give you a pleasant experience. You would have to take any prescription drug a day prior to starting your trek and continue the dose till you descent down to the base. I do not believe in advising people in popping prescription pills. I am afraid to say if you cannot modify your itinerary then the call for taking Diamox is on you. P.S – If you do feel the need of taking the pill, do visit a Doctor for consultation.

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      1. I would be camping at 11k feet , a break of almost 6- 8 hrs I guess , and then would be doing the further ascend and entire descend next day .

        I also abide by your suggestion to rest and return in case of AMS symptoms .. The only thing I am afraid about disappointment of not climbing Lowe’s peak as I would be paying bomb for trek permit and other things. Plus , haunting memory of another unsuccessful attempt . Hence , I have made up my mind to increase my chances with the aid of diamox .

        P.S I have tried 125 mg of diamox today just to check sulfa allergies .. So far it is good .

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  5. I wonder if the beet juice is to be taken up the hills to drink when you feel dizzy; it would already be too late I think.
    Would it not help if it is taken for several days; if not weeks, prior to the trek to build a higher hemoglobin levels?

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