Whilst I’m doing some cycling to help get fit I’m clearly no Lance Armstrong. However the topic of performance enhancing drugs in cycling and Mr Armstrong is big news at present and it has got me thinking.
Acetazolamide (brand name Diamox) is a drug that can help altitude acclimatisation and so help reduce the severity of Acute Mountain Sickness (AMS) which all Kilimanjaro climbers will be affected by to some degree. It works by altering the kidney’s ability to reabsorb Bicarbonate and so increases the acidity in the blood. This re-acified blood chemistry acts a respiratory stimulant that can help the body accelerate acclimation.
It’s not a magic bullet though; there are no medicinal cures or prevention for AMS. Common side effects of Diamox include numbness, tingling, or vibrating sensations in hands, feet, and lips. Also, taste alterations, and ringing in the ears. It also acts as a diuretic so you’ll be urinating more and need to keep your fluid intake up (dehydration is a big problem at altitude and will contribute to AMS).
I’ve read accounts of very fit people failing to make it to top due to AMS. It is a serious set of conditions and if not acted upon can become life threatening in severe cases. There seems to be a range of view high altitude trekking / mountaineering world about taking Diamox.
- Don’t use it as it’s all about man vs. the mountain naturally
- Use it only if you have significant AMS symptoms
- Use it prophylactically to help your acclimatisation and reduce the change / severity of any AMS systems
My current mind set is focused on making the summit and meeting the commitments I’ve made to the task, my sponsors and myself that I don’t have a moral objection to using Diamox. In fact one of the biggest concerns (and so motivators) is not making it and letting people down. I’m open to using all the resources and techniques I can to help me achieve my goal. I’m even considering taking it as soon as I begin the climb – I might as well get all the help I can.
I don’t know if my GP will prescribe it though and even then it’s unlikely to be on a NHS prescription. This is probably something to broach when I book in for some pre-Tanzania inoculations. With so much counterfeit medication in the world I figure it’s better to try and source Diamox in the UK where I can be confident in its credentials and authenticity.
Guess I’m a pill popper looking for dealer then…
Kilimattjaro 
December 30, 2012 at 12:27 am
Hey, we just got back from Machu Picchu. When we first got to Cusco, Ceyda had pretty bad altitude sickness. It was about 3500m high, cold and I think a combination of not eating, not being warm enough, all contributed to the AMS. I was just having headaches whole day and a little dizziness. On the way back, my headache got worse. Anyway, the locals kept asking us to drink coca leaves tea, which is supposed to help with AMS. They also sell them in sweets format. I read that lots of water helps and Ceyda was given oxygen by the doc and that helped her. So eventually we made it without taking any pills. Some slight discomfort but we made it. Just wanted to share….
December 30, 2012 at 9:49 am
Hi Lina,
Thanks for sharing your experience. I’ve read that keeping energy levels up and fully hydrated are very important to minimise AMS. I have read recommendations that Kilimanjaro climbers need to be drinking 3-4 litres of water a day, even more if they’re taking Diamox (as it’s a diuretic ). I’ve also read that taking Ginkgo Bilboa can be helpful too – I’ve found a vitamin supplement for altitude trips but it’s expensive – http://altivit.com/index.html I might just go for some generic Ginkgo Bilboa capsules.
The use of supplemental oxygen is interesting. Most climbing organisations reserve it for emergency use during descents. Their rationale being that introducing it to support an accent actually fools the body into acting as is there is more oxygen available and so slows down the physiological changes of acclimatisation.
Of course the real answer is to ascend slowly and always sleep lower than your peak altitude of the day. I’ll be doing the latter on Kili but even on my 8 day climb schedule we’re still going to ascending faster than is ideal. Hence taking all the precautions possible to minimise AMS will be key.