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New Altitude Sickness approach??

post #1 of 20
Thread Starter 

So in doing my research on AMS I've come across all sorts of recommendations, suggestions and studies.

I understand to hydrate, avoid caffeine, alcohol, ascend gradually, perhaps take advil, aspirin, or get a perscription for diamox.

 

I've also been reading up on studies done with aspirin, ginko, advil, and viagra.

 

I've come across a new supplement and it's barely getting any mention. I think perhaps it's so new: "Altitude Adapt".

They have a website with their research and reasoning behind the product, that being increasing nitric oxide production. It all sounds good and I plan on trying it in my upcoming trip in early March to Breckenridge.

 

Just wondering if anyone else has tried it, heard about it, etc...

 

Thanks!

post #2 of 20

It is always strange when someone's first post is hyping a commercial product...   rolleyes.gif

post #3 of 20

Only gapers get sick from altitude.  For the rest of us, thin air of the mountains is like a drug we can never get enough of.

post #4 of 20
Thread Starter 

I was afraid that might happen and I can understand your comment.

 

Seriously, I don't work for or have any affiliation with "Adapt"....I'm just a 43 year old single mom with a 10 year old. I'm taking my daughter on her first ski trip to Breckenridge in March. I'm a research junkie and just happened across "adapt" when I was reading up on AMS.

 

I've been away from skiing for about 10 years...use to go all the time in college and in my 20's but then life got in the way.

 

Found this great forum about two weeks ago when I was looking up stuff on what to wear these days, what's the warmest - what works and what doesn't and part of my research was on AMS, because, I want to be able to do what I can for my daughter should I need too. I've never had a problem with AMS outside of the usual sleepless nights and short of breath but that may change in March. I was just about ready to stop my research on the subject when I read about aspirin, ginko biloba and advil...narrowing it down to using one of those 3 in the event I needed too; when I came across an article on nitric oxide depletion and it's relation to AMS...anyway...

 

So really, I'm just looking for opinions - I couldn't find any on the internet at all. I know these forums discuss AMS ad nauseum.

If no one knows anything...fine...if they do, great, hopefully someone will come along and have some input.

 

Thanks. 

post #5 of 20

I know something about this topic. First, AMS stands for Acute Mountain Sickness. It is not the typical shortness of breath, mild fatigue, changes in breathing patterns at night, or increased urination that many feel their first 24 to 36 hours at a ski resort with a base of 7,000 to 9,000 feet. It must include a headache, although that in itself is not diagnostic, and one or more additional symptoms such as nausea or dizziness. In other words, you feel unwell, like having the flu, not just out of sorts. Despite Wikipedia being as far as most people go for info, real AMS symptoms seldom become clinically obvious below 3,000 m. Thus, as climbers know, "climb high, sleep low." It's less about where the top of the lift is than where your hotel is. Suggest readers go here for a medically accurate description:  http://www.ismmed.org/index.php/home.htmlif

 

Second, this product's claims are chemically misleading. If you look at the list of ingredients, there's nothing there that has been shown to alter natural NO production. Rather, there's a typical linguistic sleight of hand: A couple of garden variety nutrients that have a (very) minor role in the routine metabolism of NO (along with a bunch of other metabolic pathways), and are typically already  oversupplied in most American diets, are then assumed to be able to alter NO production if you take more. Wrong. NO responses are fairly invariant in each of us, being under tight genetic control. That is, we make as much as our various genetic pathways tell us to when tissue becomes hypoxic. Production is rate limited by those genes, not by dietary intake. So it helps if your mom is Tibetan. Dietary supplements, nope.

 

If you go to their website (very slick) their information and scientific "proof" is equally misleading. AMS is not defined by a number of the "symptoms" they mention, nor is the diagnosis arrived at through a grab basket of "most common" effects (see first paragraph). Anyone experiences a transitory decline in pO2 (although the 78% claimed is more typical of patients with chronic obstructive pulmonary disease) when they abruptly transition to higher altitude. That they recalibrate at 95% at Vail is unexceptional. Whether they take a vitamin pill or not. 

 

Third, stuff like this is subject to powerful placebo effects. Thus the glowing testimonials. I tell you I have a little pill, that'll help altitude problems, and whooaa! Wow, it works, huh?

 

Fourth, I don't even see a diuretic, which has been shown to resolve AMS symptoms modestly (acetazolamide comes to mind).

 

Fifth, the consensus statement of the International Society of Mountain Medicine finds that children are at no higher biological risk from exposure to altitude than adults. The only issue may be their inability to accurately report symptoms, which shouldn't be an issue for a 10 year old. 

 

Last, you have one post. Whether you're a mom with a kid or an employee of this company remains unclear to me. nonono2.gif


Edited by beyond - 1/22/13 at 10:56am
post #6 of 20
Thread Starter 

Dear Beyond,

If you would refer to my 2nd post on this subject above, you see that I explain I am not spamming nor do I have an affiliation with this company.

Good grief. Just came to this site for some incite because the tone and acceptance was very apparent when reading...but not so much anymore.

 

I know the difference between AMS and general feeling the altitude...and I do go farther than wikipedia for my information.

I do appreciate your information and will take it into consideration.

 

And I imagine that every one of us at one point who started posting here had only 1 post.

post #7 of 20

Yep, we all started with one post. But it tended not to be an enthusiastic foregrounding of a product. Usually a question about skis. If I have you wrong, apologies. FWIW, I do primary research in this area, and am friends with the folks who worked out the relation between NO and adaptation, so I have a secure basis for being skeptical about the claims, not to mention the presentation. 

post #8 of 20
Thread Starter 

Thank you.

If I came across as enthusiastic about the product I apoligize. I'm just as skeptical too about "adapt"...hence my reason for the research and reaching out to this forum.

I'm certain that if this product truly did what it said it did, there would be a lot of talk about it.

 

It makes sense to supplement with L-citrulline and L-arginine but I'm sure it doesn't pan out in the body the way you think it would. Just trying to learn that's all.

 

Thanks for your time on all this.

post #9 of 20

Breck is pretty high,  I skied there about 10 years ago and was sick as a dog the first 2 days, good luck. I have  skied several times at Steamboat since then and had no problems at all .

post #10 of 20
Quote:
Originally Posted by beyond View Post

I know something about this topic. First, AMS stands for Acute Mountain Sickness. It is not the typical shortness of breath, mild fatigue, changes in breathing patterns at night, or increased urination that many feel their first 24 to 36 hours at a ski resort with a base of 7,000 to 9,000 feet. It must include a headache, although that in itself is not diagnostic, and one or more additional symptoms such as nausea or dizziness. In other words, you feel unwell, like having the flu, not just out of sorts. Despite Wikipedia being as far as most people go for info, real AMS symptoms seldom become clinically obvious below 3,000 m. Thus, as climbers know, "climb high, sleep low." It's less about where the top of the lift is than where your hotel is. Suggest readers go here for a medically accurate description:  http://www.ismmed.org/index.php/home.htmlif

 

Second, this product's claims are chemically misleading. If you look at the list of ingredients, there's nothing there that has been shown to alter natural NO production. Rather, there's a typical linguistic sleight of hand: A couple of garden variety nutrients that have a (very) minor role in the routine metabolism of NO (along with a bunch of other metabolic pathways), and are typically already  oversupplied in most American diets, are then assumed to be able to alter NO production if you take more. Wrong. NO responses are fairly invariant in each of us, being under tight genetic control. That is, we make as much as our various genetic pathways tell us to when tissue becomes hypoxic. Production is rate limited by those genes, not by dietary intake. So it helps if your mom is Tibetan. Dietary supplements, nope.

 

If you go to their website (very slick) their information and scientific "proof" is equally misleading. AMS is not defined by a number of the "symptoms" they mention, nor is the diagnosis arrived at through a grab basket of "most common" effects (see first paragraph). Anyone experiences a transitory decline in pO2 (although the 78% claimed is more typical of patients with chronic obstructive pulmonary disease) when they abruptly transition to higher altitude. That they recalibrate at 95% at Vail is unexceptional. Whether they take a vitamin pill or not. 

 

Third, stuff like this is subject to powerful placebo effects. Thus the glowing testimonials. I tell you I have a little pill, that'll help altitude problems, and whooaa! Wow, it works, huh?

 

Fourth, I don't even see a diuretic, which has been shown to resolve AMS symptoms modestly (acetazolamide comes to mind).

 

Fifth, the consensus statement of the International Society of Mountain Medicine finds that children are at no higher biological risk from exposure to altitude than adults. The only issue may be their inability to accurately report symptoms, which shouldn't be an issue for a 10 year old. 

 

Last, you have one post. Whether you're a mom with a kid or an employee of this company remains unclear to me. nonono2.gif

I agree.  From the web site: These statements have not been evaluated by FDA. This product is not intended to diagnose, treat, cure or prevent any disease.

 

As a supplement this product is not subject to FDA regulation and there is no guarantee that what it contains is what they say it contains.  The scientific references provided show that NO in the blood is higher in Tibetans and goes up in high altitude climbers.  This does not tell us whether the NO helps us adapt to altitude or whether it the high levels of NO are just a side effect of high altitude. None of the references shows that this particular product increases NO or helps with altitude adaptation.  The only evidence they provide are the testimonials. 

 

I differ with Beyond on one point--the beneficial effect of acetozalamide is due to it's acidifying action on the blood, which allows adaptive hyperventilation, which is stifled by high pH, to increase pO2. The diuretic effect is an (in my experience) unwanted, but unavoidable side effect.  (The blood is made more acid by excreting more base in the urine, which requires an increase in the amount of urine).

 

I personally would not give an unproven substance of uncertain composition ("proprietary herbs") to my child.. I personally take diamox if I'm going above 10,000 feet, which you are--base is 9600--but that's after having suffered AMS a bunch of times.  I wouldn't recommend it to someone going to Breck unless they had a history of AMS.    (My son did take it on a trek to Salkantay and Machu Picchu which involved a 15000 ft pass--and he was giving it away to other trekkers.) 

 

 I have no reason to doubt your motives in starting this thread..

post #11 of 20

Diamox is probably about as good as you are going to get....

post #12 of 20
Quote:
Originally Posted by beyond View Post

Yep, we all started with one post. But it tended not to be an enthusiastic foregrounding of a product. Usually a question about skis. If I have you wrong, apologies. FWIW, I do primary research in this area, and am friends with the folks who worked out the relation between NO and adaptation, so I have a secure basis for being skeptical about the claims, not to mention the presentation. 

Hey beyond since your in the field I know the Air Force Academy was doing studies with zinc supplements, I think. Do you know if anything came of that? I think it was to try and speed up long term acclimation   

post #13 of 20
Quote:
Originally Posted by Finndog View Post

Diamox is probably about as good as you are going to get....

I was about to post about acetazolamide, and when I looked it up on the Internet, I see that it's sold in the US under the trade name Diamox, like Finndog says. I have used it for several climbs here in the Andes, from 17.780 ft to 20.275 ft peaks. It's called "acetazolomida" down here and it can be bought over the counter at the pharmacy for next to nothing. The guide I use for these more serious excursions swears by it and, in my experience, it works, since I have never gotten sick, but I have decided to not use it anymore. It has two annoying side effects. The first, since it is a diuretic, is you have to pee a lot, and I mean A WHOLE LOT. That's not such a big deal when you are on a climb in the middle of nowhere, but I think it might be a bit of a problem while skiing in a resort, especially for the fairer sex. When you are at altitude, you should drink more liquids anyway, and when it runs through you like it does when you are taking acetazolamide, you have to drink even more. On my last climb I was supposed to drink 6 liters a day and we were taking acetazolamide. We always mix the water with a powder to replace electrolytes that tastes horrible, so drinking so much is not pleasant and was a real challenge. The other side effect is a tingling in the hands, which is worse for some, but I don't like it. It's especially annoying when you are trying to sleep at high altitude, which is hard enough as it is. One of the climbs I did was with a young doctor, the son of my business partner, and he later said he studied the drug at length. His conclusion was that it shouldn't be necessary and could cause damage to the kidneys if used exensively. I worry about Cristóbal, the guide.

There are a lot of climbers that use it, and I am sure it would work for Breckenridge.

post #14 of 20
Diamox should only be used for a few days before going to a high altitude and maybe a couple days after arriving. The tingling should only be transitory. If it continues, you need to reduce the dosage. The standard US prescribed dosage is 350 mg, and pills available here are scored for easy splitting. I made yearly visits to Western elevations with little difficulty for at least 30 years before I started developing a "sensitivity" that resulted in headache and nausea. Diamox relieved those symptoms significantly. After five years in Breck, I can spend a month or so at sea level and return with little difficulty, but a stay at low altitude for multiple months would make me want to resume diamox use.
post #15 of 20

The usual recommendation is 125mg -250mg twice daily beginning 2 days before altitude and continuing for 2 days after reaching.  125 doesn't do it for me. If you take blood pressure medicine cut back or stop it while using diamox--it lowers your blood pressure.  Obviously discuss this with your doctor. I don't know if it's approved for kids, but like I said before I wouldn't recommend it for Breck's altitude for child or adult if you haven't had symptoms of AMS in the past.  And diamox won't keep you from getting short of breath with exertion at altitude--that's not AMS, that's normal.

post #16 of 20
Quote:
Originally Posted by Kneale Brownson View Post

Diamox should only be used for a few days before going to a high altitude and maybe a couple days after arriving. The tingling should only be transitory. If it continues, you need to reduce the dosage. The standard US prescribed dosage is 350 mg, and pills available here are scored for easy splitting. I made yearly visits to Western elevations with little difficulty for at least 30 years before I started developing a "sensitivity" that resulted in headache and nausea. Diamox relieved those symptoms significantly. After five years in Breck, I can spend a month or so at sea level and return with little difficulty, but a stay at low altitude for multiple months would make me want to resume diamox use.

We always take half a 250 mg pill, beginning 24 hours before the trip and I always stop taking them the same morning of our summit attack. The tingling is definitely transitory, but everyone I know who has used it while climbing feels it, and it goes away within hours after having stopping taking the drug. Like I said before, I've never felt the least bit queasy, although I usually get a slight headache - sometimes not so slight. Above 18.000 ft, while climbing, I don't think there is a way to avoid a headache and it always goes away the day I come down to lower altitudes. I've never taken anything for altitude while skiing.

 

I certainly didn't intend to discourage the use of acetazolamide, just provide input from my own experience with taking the drug.

post #17 of 20

Good advice here and consult a dr for info. I have used it in Chile and in anything above 8,500 with excellent results. above 8k, I dont sleep well for 48 hours

post #18 of 20
Quote:
Originally Posted by AndesRider View Post

We always take half a 250 mg pill, beginning 24 hours before the trip and I always stop taking them the same morning of our summit attack. The tingling is definitely transitory, but everyone I know who has used it while climbing feels it, and it goes away within hours after having stopping taking the drug. Like I said before, I've never felt the least bit queasy, although I usually get a slight headache - sometimes not so slight. Above 18.000 ft, while climbing, I don't think there is a way to avoid a headache and it always goes away the day I come down to lower altitudes. I've never taken anything for altitude while skiing.

 

I certainly didn't intend to discourage the use of acetazolamide, just provide input from my own experience with taking the drug.

I've tried cutting back on the time before and on the dose--doesn't work for me, but there's a lot of individual variation.  Obviously the less you can get away with taking the better--since it dehydrates you and you can't use urine output and color as a measure of whether you've adequately rehydrated. Unfortunately the only way to know if you can get away with less is to take less and see if you get sick.

post #19 of 20

For those wanting to see an excellent and authoritative article on Epicski written by Dr. D.M Polanar, please follow this link:

 

http://www.epicski.com/a/altitude-adaptation-and-acute-mountain-sickness

 

I think there are some very good solutions suggested in the article to prepare for altitude, and both medical and non-medical approaches to mitigate AMS.  If you are suseptible to HACE or AMS, then the best advise is early recognition with the option to get below 8000 feet at night and possibly prophalctic treatment with Diamox or whatever generic equivalent applies.  For most people with out a history, good hydration may or may not be sufficient.  The important point is, this is not an issue of physical fitness.  The problem can affect atheletes as well as those with no experience or conditioning at altitude.

post #20 of 20
Quote:
Originally Posted by Cirquerider View Post

For those wanting to see an excellent and authoritative article on Epicski written by Dr. D.M Polanar, please follow this link:

 

http://www.epicski.com/a/altitude-adaptation-and-acute-mountain-sickness

 

I think there are some very good solutions suggested in the article to prepare for altitude, and both medical and non-medical approaches to mitigate AMS.  If you are suseptible to HACE or AMS, then the best advise is early recognition with the option to get below 8000 feet at night and possibly prophalctic treatment with Diamox or whatever generic equivalent applies.  For most people with out a history, good hydration may or may not be sufficient.  The important point is, this is not an issue of physical fitness.  The problem can affect atheletes as well as those with no experience or conditioning at altitude.

Some people think altitude intolerance actually improves with age,  whether due to physiologic changes or more likely due to older people being less active. rest is a good treatment for mild AMS (although not popular on expensive ski vacations)/

An additional point about altitude sensitivity--there are two kinds of people--skiers and snowboarders (whoops, wrong thread). I mean people who are sensitive to low oxygen in the blood who have no trouble breathing more to compensate, and people who are sensitive to high pH in the blood who aren't able to hyperventilate as much (hyperventilation raises the pH in the blood).  These two groups are not along a continuum (bell shaped curve) but are two distinct populations--bimodal curve (two camel humps instead of one). 

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