DNC News

Altitude Sickness:

Subject: nutritional and herbal supplements to prevent altitude sickness.

The ski season has arrived and with it out of town guests who assume they can travel from sea level and ski our continental divide unscathed. Somewhere in the tourist brochures and vacation package advertisements there is usually a line about acclimatizing to the altitude but it's in small print. New York, San Francisco, and Los Angeles are at sea level. Denver is a Mile higher. Arapahoe Basin tops out at 13,050 feet. Altitude sickness has ruined enough vacations that it is encumbent on us, the local hosts, to know about prevention and if necessary treatment. In this article I want to review which natural substances may be useful to prevent and treat altitude sickness and then tell you my favorites.

Vitamin C: Paul Petzoldt, the founder of Outward Bound and the National Outdoor Leadership School once wrote that whenever his students were out of sorts in the mountains he would give them a dose of vitamin C. If he says it works, it probably does. Rats dosed with vitamin C can endure higher altitudes in lab simulations.[1] People probably can too. So consider regular doses of Vitamin C for the duration of their stay. How much, I've heard anywhere from 500 mg (which I think was what Petzoldt talked about) to 10,000mg/day from Dr Randall Bradley of Nebraska.

Antioxidants: Many of the symptoms of altitude sickness appear to be related to free radical activity and a number of studies have used antioxidants to decrease the effects. A study monitoring humans on an Everest Expedition found that daily doses reduced the effects of altitude. Climbers took daily doses of 1000 mg vitamin C, 400 iu vitamin E and 600 mg alpha Lipoic Acid.[2]

Glutathione, that favorite of mine, appears to be quickly depleted at altitude quickly making the body susceptible to the many forms of damage it normally protects one from.

l-glutamine: Adding glutamine has a protective effect.[3] Rats fed doses that in a human would be equivalent to about 2-3 grams a day were 4.5 times as resistant to hypoxia than non-treated rats, more resistant to cold and were able to gain weight at high altitudes. This may be because glutamine helps replenish the glutathione levels. If so other substances that help produce and protect glutathione in the body may also be useful. Glutamine is considered a conditionally essential amino acid. Under certain conditions of especially physical stress the body isn't able to manufacturethis amino acid in adequate amounts to keep up and supplemention is useful

Three general categories of herbs have a beneficial effect; adaptogens, flavonoids and cardiotonics. There is one additional herb which is illegal. The most studied are the adaptogens. Herbs in this diverse group all effect the adrenal axis and increase the body's capacity to endure stress. Some, such as Cordyceps and Siberian Rose [4], have been studied and published on their protective effect. Other adaptogens have traditions of use and are probably just as useful. In the later category I would put Eleutherococcus (Siberian Ginseng), Panax ginseng (Korean ginseng), Ashwagandha, Reishi mushrooms and Schizandra. Ginkgo not considered an adaptogen is also useful [5]. Ginkgo may work because it increases blood circulation and oxygen to the brain. Itis useful at treating asthma so perhaps the people who think it helps altitude sickness simply had asthma that responded. Technically, ginkgo is a flavonoid so my second category are the flavonoids. Another plant flavonoid, milk thistle also has a positive effect o n altitude sickness. [6]

Probably the most famous plant used to treat altitude sickness is Coca, the plant from which cocaine is derived. Coca leaves were and are still used by the Indians of the Peruvean Andes to prevent the ill effects of altitude and increase stamina, but for obvious reasons we are not going to suggest their use. Altitude sickness might quickly become the least of your worries. Especially if you have to trave thrgh airpor secuity prior to your high altitude experience. Homeopathic preparations of Coca have also been used for altitude sickenss. Our experience is that homeopathic coca does in fact work quite well for symptomatic complaints of high altitude, the headache nausea etc. Unfortuantely this homeopathic medicine is a great example of the inconsistancies of modern medicine and law. Homeopathic Coca is so diluted that most medical and scientific authorities say there is no measureable chemical left in the medicine so it can not work. On the other hand the FDA still considers it a narcotic and prohibits its use without prescription. Other homeopathic medicines that have been suggested for altitude sickness are Arsenicum alba, Glonine, and Calcarea carbonica.

The third general category of herbs I was thinking about when I first started writing this several weeks ago were the cardiotonics. I was thinking specifcally of extracts of hawthorne berries which have the effect of strengthening the heart's contraction in a manner similar to digitalis. Technically we might not be treating altitude sickenss but simply cardiac insufficiency, yet it still may help your older relatives get up the stairs while visiting. I could find no references to this use.

Co Enzyme Q 10 might be suggested for this same reason though one could argue that it is an antioxidant and so on.

For all my fancy footnotes and scientific explanations and rationales, when it comes to my favorite high altitude trick, I can not tell you how or why it works. It is a proprietary formula called Cataplex E2 manufactured by an old nutritional company called Standard Process. This company prides itself in its whole food extracts rather than synthetic vitamins or chemicals. They've been selling their line of products for almost a hundred years. Most of their products were developed in the 1920's by early nutritional researcher, Dr. Royal Lee. In the company's literature, Cataplex E2 somehow increases the ability of red blood cells to deliver oxygen to the tissues. So it is frequently used to help conditions like congestive heart failure, emphysema and the like. I first learned the altitude trick from Dr. Clive Armstrong on a ski trip a few years back. Clive who regularly leads high altitude climbing expeditions to South America or the Himalyas swears by it. He has methodically timed climbers going over the sa me stretch of mountain with and without taking Cataplex E2. As I can never keep up with him I gave it a try. I still can't keep up with him, but I can sure feel a difference using it. Standard Process does not sell their products through retail stores, but only through health practitioners. This is one product we try to never run out of. So give us a call if you want to try it.

I need to mention water. Few visitors to our high country from the humid lowlands have any comprehension of how quickly they become dehydrated while here. At high altitudes more water is lost through breathing and sweating than most people realize. People can quickly dehydrate without being aware of it and confuse their condition with altitude sickness. Bug your guests and make sure they are drinking enough water that they are having to urinate as often or more often as they are accustomed to at home.

Summary:
Drink a lot of water

Ginkgo: 120-180 mg/day (any history of asthma)
Milk Thistle: 120-240 mg/day (any liver complaints)

Antioxidants:
Vitamin C 2-3,000 mg/day
Vitamin E 400 iu/day
alpha lipoic Acid 150-300 mg/day
Raise glutathione levels:
Selenium 200 mcg/day (if you have a family history of cancer never stop taking this!)
N-acetyl-cysteine 1-2000 mg/day (especially if prone to nasal congestion)
l-glutamine: 3,000 mg/day (especially if prone to stomach irritation)

Adaptogenic herbs: your choice: Korean Ginseng, Siberian Ginseng, Ashwagandha, Reishi,(which has a growing reputation of being useful ) etc.
Cardiotonics: Hawthorne Berry Extract (Crataegus): 250-500 mg/dayand Co Q 10 90 mg/day (both especially if you have a weak heart)

The Bottom Line:
My favorite thing to use Cataplex E2: 2 tablets 3-4 times per day plus a multivitamin with high antioxidant levels. Having read through all these abstracts I am going to try to start adding l-glutamine, ginkgo and glutathione to my ski morning breakfast.

References:
1. Schreiber M. Protective effect of ascorbic acid in high altitude hypoxia in the rat. Physiol Res 1992;41(5):403-5 2. Bailey DM, Davies B.Acute mountain sickness; prophylactic benefits of antioxidant vitamin supplementation at high altitude.High Alt Med Biol 2001 Spring;2(1):21-9
3. Kumar D, Bansal A, Thomas P, Mongia SS, Sharma SK, Sairam M, Grover SK, Singh MV, Prasad D, Ilavazhagan G, Selvamurthy W.Improved high altitude hypoxic tolerance and amelioration of anorexia and hypophagia in rats on oral glutamate supplementation.Aviat Space Enrion Med 1999 May;70(5):475-9
4. Kelly GS. Rhodiola rosea: a possible plant adaptogen. Altern Med Rev 2001 Jun;6(3):293-302
5. McKenna DJ, Jones K, Hughes K. Efficacy, safety, and use of ginkgo biloba in clinical and preclinical applications. Altern Ther Health Med 2001 Sep-Oct;7(5):70-86, 88-90
6. Schreiber M, Trojan S. Protective effect of flavonoids and tocopherol in high altitude hypoxia in the rat: comparison with ascorbic acid. Cesk Fysiol 1998 Jun;47(2):51-2


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