Preparing for activities at altitude

The best way to prepare for a climb, trek or endurance event at high altitude is to NOT listen to the stories you will be told about how terrible it is or how horrible you are going to feel throughout your stay.  Even if those stories are your own!

Altitude is challenging to the human body.  And so is the training that you do every day as an athlete, so if you don’t shrink away from a hard workout just because it’s hard, you don’t need to avoid a fun opportunity just because it’s at altitude!  High altitude areas on this earth also tend to be spectacularly beautiful  so learn a little bit then get out there and try!  Here are 10 things to know about altitude, acclimatization & performance at altitude to help you get prepared and feel better while doing what you do. 

  • Compared to a oxygen rich breath that you take a sea level, the same breath at 3000 meters has only 71% of the oxygen molecules, at 4000m 63%, and at 5000m 55%.  This means that prior to acclimatization, your blood passes through your lungs without being fully recharged with oxygen from the air.  As such, your body must make some adaptations in order to perform in its new environment
  • The body adapts to the altitudes it is taken to, it typically takes 1-3 days to adjust to each new height.  During this adjustment the body will have an
    • Increased heart rate
    • Increased depth of respiration
    • Increased production of red blood cells
    • Increased need for fluids
  • The process of acclimatization utilizes and disposes of an increased amount of liquid in your body.  Faster respiration as well as dry air also contributes to fluid loss.  Positive hydration contributes to better adjustment and higher, sustainable performance at altitude.  Drink 3-4 liters of water per day and expect to be thirsty at night the first few nights.    
  • Whether or not you are acclimatized, you will still absolutely feel the effects of exertion at altitude.  Your heart rate will be higher and your power output will be lower, and your body’s effort to oxygenate the muscles will cause you to reach your max output quicker.  Recovery from max efforts is also slower, and catching your breath is harder.  Know this, then adapt your pacing strategies and be careful not to “attack” too often or dig too deep to stay with other climbers, trekkers or riders surging on the climbs if you feel it will put you in an unrecoverable condition. 
  • Move slow during acclimatization.  Don’t expect to be fast and strong.  Your muscles will feel fatigued because they are oxygen starved and your breathing will be heavy because your body will want more O2.  Your goal in acclimatization is not to train, it is to pump blood around your body and reach your new acclimatization point for each day.  If your expedition will take you between 4500-5000 meters in the first few days, try to reach an acclimatization height of at least 4500 meters.     
Laguna 69. Great acclimatization hike, 4600m
  • Pressure breathing is a technique the Sherpas use when climbing 8000 meter peaks.  It involves breathing out hard against pursed lips, making a slight whistling sound as you exhale.  While science does not stand behind it (yet!), these people are the true altitude gurus and we think it seems to help, so give it a whistle!
  • You might experience the following discomforts during acclimatization:
    • Thirst (drink!)
    • Fatigue (go slower!)
    • Loss of appetite (add amino acids to your water, eat easy digestible carbs)
    • Headache (drink more water! Take a Tylenol if you like) 
    • When you get back down to your sleeping altitude you can typically reverse all of these symptoms with a small nap and a liter of water.  These are not life-threats, nor permanent.  They are signs that your body is working on the adjustment.
  • There is a drug called Diamox (Acetazolamide) which allows you to metabolize more oxygen, thereby minimizing the symptoms caused by poor oxygenation.  It is helpful to those who are slow to acclimate or suffer the above symptoms to a larger extent, but it is NOT a substitution for going to altitude.  It is advisable to start taking it 24 hours before you go to altitude and continue for at least three days at higher altitudes at a dose of 125 mg. twice a day (morning and night).  Possible side effects include tingling of the lips and finger tips, blurring of vision, alteration of taste and significantly increased urination which subside when you stop taking the drug.  Diamox is a sulfonamide drug, therefore people who are allergic to sulfa drugs should not take it.
  • Remember, the altitude is not only going to target you… everyone is on the same playing field.  If you are participating in a race, you can set your advantage by preparing yourself better and taking better care of yourself once out in the hills.  If you are with friends, make a deal before you leave that you’ll give everyone on the team the time they need to adjust to the altitude & eliminate any pressure to perform early on.  As with any physical challenge: eat before you are hungry, drink before you are thirsty, don’t get too cold or too hot, and stay positive!  Psychology is also a powerful altitude  & attitude tool! 
  • Lastly, here is a sample acclimatization schedule we use in Huaraz… it’s not too fast but it is certainly not slow either!  If you have more time.. definitely take it!
    • Day 1 – Travel to Huaraz, 3100m.  Drink water.  Walk around town.  Relax.  Drink Water.  Sleep. 
    • Day 2 – Gentle hike or bike to 3700 meters.  Drink water.  Eat carbohydrates.  Drink water.  Return to Huaraz. Relax.  Drink Water.  Sleep. 
    • Day 3 – Hike or bike to 4000-4500 meters.  Drink water.  Eat carbohydrates.  Drink water.  Return to Huaraz. Relax.  Drink Water.  Sleep. 
    • Day 4 –   Hike or climb to 4500+ meters (you could climb to as high as 5500 meters so long as you come back to sleep in Huaraz). Drink water.  Eat carbohydrates.  Drink water.  Return to Huaraz. Relax.  Drink Water.  Sleep.
    • Day 5 – Rest. Prepare your things for your event or expedition.  Drink Water.  Sleep.
    • Day 6 – GO! (don’t sleep above 4500 meters this day… move your sleeping altitudes up gradually)