Positive Health Online

Earlier this year I visited my daughter who is living in Ecuador and despite the fact that throughout my life I have travelled to many parts of the world, often at much higher altitudes than we were, I suffered from altitude sickness. We spent a week travelling along the coast and then drove in a day to Quito, which is at an altitude of about 12,000 feet. I felt light headed and breathless initially, but little else. 12 hours later I woke with extreme head pain, nausea and malaise which did not respond to painkillers. Having never experienced this before I was unprepared, and the symptoms developed so rapidly that I was too ill to help myself, and ended up in hospital at the hands of doctors who tried to convince me that I was suffering from a gut infection and wanted to give me antibiotics. When I managed eventually to persuade them in bad Spanish that it was probably related to the altitude, I was given blood pressure checks and a brain scan to rule out aneurysm.

They found my blood pressure high and diagnosed cerebral oedema. I was medicated accordingly and put on oxygen and drips. My frightening experience has prompted me to give some thought to the herbal prevention and treatment of altitude sickness generally known as Acute Mountain Sickness (AMS) to help others prevent or remedy the same problem should it occur on their travels.

The primary cause of altitude sickness is the decrease in air oxygen levels. At 8000 feet, oxygen levels are about half those at sea level. If one ascends slowly the body has a chance to acclimatize by making physiological adjustments and symptoms can be prevented. If one ascends too quickly, fluid moves from the blood stream into the tissues, the blood thickens due to fluid loss, and slows elimination of toxins and wastes from the body. The resultant dehydration inhibits the normal distribution of nutrients and oxygen to the cells and transport of wastes from the tissues, causing thirst along with other symptoms, including breathlessness, sleep disturbances, increased heart rate, nausea, vomiting, headache, oedema and fatigue. Symptoms can present within 12 to 48 hours of arrival at high altitude and are intensified by alcohol and vigorous exercise. If symptoms persist for more than 2-3 days, it is best to return to lower altitude.

In some people fluid can accumulate in the brain (High Altitude Cerebral Oedema) or lungs, (High Altitude Pulmonary Oedema), with potential serious or life threatening consequences, so those with heart or lung conditions need to be especially well prepared. Actually I was diagnosed with cerebral oedema despite the fact that I have no such medical history. Often people with cerebral or pulmonary oedema do not realize how ill they are, and should not be left on their own or travel to lower altitudes without help.

Obviously to help prevent dehydration it is important to drink plenty of fluids, avoid alcohol and vigorous exercise. Free-radical-mediated damage to the blood-brain barrier may be implicated in the development of acute mountain sickness, and so taking antioxidant supplements such as vitamins A, C and E, alpha-lipoic acid or selenium could be very helpful.  B-vitamins work as catalysts for many biochemical reactions, including the utilization of oxygen by the cells.  Vitamin C acts as a major antioxidant, protecting nutrients like the B-vitamins, and helping the body deal with stress. Daily doses of 1000 mg vitamin C, 400 iu vitamin E and 600 mg alpha Lipoic Acid are recommended.

There are several herbs which could be very helpful to help prevent or treat altitude sickness, particularly those which are classed as adaptogens and cardiotonics. Adaptogens such as Siberian ginseng (Eleuthrococcus senticosus and Panax ginseng), Ashwagandha (Withania somnifera), Reishi mushrooms (Ganoderma lucidum), Rosiola rosea and Schizandra chinensis support the  adrenal glands and increase resilience to both physical and psychological stress.

Ginkgo biloba and Rhodiola have been shown in several studies to prevent and treat altitude sickness.[1] They improve blood flow, especially through cerebral vessels, and the uptake and utilization of oxygen in the brain and nervous system, reducing toxic brain oedema.[2,3] Ginkgo has also been shown to inhibit platelet clumping and stickiness, keeping red blood cells evenly dispersed, which improves delivery of oxygen to tissues.[4]

Rhodiola is native to the Himalayas and found growing in at high elevations in Asia, Europe and North America. The root, stem, leaves, flowers, and seeds all have adaptogenic and antioxidant properties and have long been considered a panacea. Rhodiola enhances physical and mental energy and performance, improving mental acuity, memory and concentration and increases blood supply to brain and muscles. It combats the effects of excess adrenaline causing raised blood pressure and blood lipids.

Ginkgo biloba has a remarkable ability to increase blood flow throughout the body, in particular to the brain, enabling it to cope better with decreased atmospheric oxygen levels. The leaf extracts have antioxidant properties, increase vasodilation and peripheral blood flow rate in capillary vessels, decrease blood viscosity and helps regulate cerebral energy metabolism. Gotu kola (Centella asiatica) also improves blood flow to the brain, benefits the microcirculation and capillary permeability, and relieves oedema. Hawthorn (Crataegus monogyra) flowers, leaves, berries are adaptogenic, enhance blood circulation and have antioxidant, vasodilatory, cardiotonic, and nervine properties. They regulate blood pressure and viscosity and help prevent blood clots.  

Reishi mushroom (Ganoderma lucidum) is used in the high altitudes in Asia to prevent altitude sickness. The 'mushroom of immortality', Reishi has been used for centuries as a longevity tonic to increase energy and increase resilience to physical, mental and environmental stressors. It has antioxidant properties, reduces blood pressure and viscosity, increases oxygen levels in the blood[5]  and aids oxygen utilization.

Eugenol, a component of the volatile oils in cloves, allspice, basil, cinnamon, bay, wild carrot seeds and marjoram decreases blood viscosity, and aid the retention of fluids in the blood. Horsebalm, (Monarda spp), and various related species including thyme, mints, wild bergamot, winter savory,  contain blood thinning compounds including thymol, menthol or menthone. Foods such as garlic, ginger, tomatoes, dill, parsley, chillis, celery, onions and fennel also possess blood thinning compounds.[6]

Failing all of these, the traditional and most popular remedy in Ecuador and other parts of South America for altitude sickness is of course coca leaves which are available in pharmacies in tea bags!

References

1. Maakestad K, Leadbetter G, Olson S, Hackett P. Ginko biloba reduces incidence and severity of acute mountain sickness.(Abstract) Proceedings Wilderness Medical Society Summer Conference, Park City, Utah. August 9-12, 2000.
2. Clostre, Neurologic Psychiatrie, speciall issue1, 33-41: 1989.
3. Spinnewyn, et al.  Recent Results in Pharmacology and Clinic.  Springer-Verlag Berlin, 143-52: 1988.
4. Artmann, et al.  Hemorheology.  9:44, 1989.
5. Barnett, R. Tonics. HarperCollins. New York. 1997.
6. Patti Stafford. Herbs for Altitude Sickness May 25, 2006. www.associatedcontent.com/article/33373/herbs_for_altitude_sickness.html?cat=5