How to prepare myself physically for a road trip vacation to Colorado
February 25, 2022 9:55 AM   Subscribe

The last time I went to Colorado for a vacation, I had horrible headaches from the altitude. This summer we're going again and I’d like to avoid those if there’s a way to do that. I would also like to have more athletic stamina for hiking at a high elevation. So I have a two-part question: what can I do now to prepare myself so that I minimize headaches from the altitude and that I’ll be ready to hike? We live at 500’, and we are staying in an area of Colorado around 9000’.

I had a friend tell me that I should avoid dairy for the week before my trip and during my help with the headaches. Does anyone know about that?
posted by allison00 to Travel & Transportation around Colorado (18 answers total)
It kind of depends on the nature of your headaches. The two biggest headache risks at that elevation are dehydration and sinus pain (which can present basically all over your head including in your teeth and jaw, even lower teeth and jaw). If dairy gives you the runs, or exacerbates your sinus issues, I suppose cutting it out would help.

I use ibuprofen and sudafed prophylactically, starting the morning of my trip so I am fully-loaded before ascent begins. I also have to do this to fly or I get vertigo, and while I do it for any elevation change over 2000' now it's mostly anything at 4000+ that really gets me. For longer trips I can taper down after ascent (though I do continue to take the sudafed at bedtime and I'll take Mucinex in the day if there's any sign of congestion) and then re-prep before descent. If you use an inhaler, even just for rescue, make sure you have sufficient supplies with you.

Cardio is largely the thing that's going to help stamina, but also know that there seem to be some additional variables that science hasn't entirely sorted out. A fit professional athlete training for high elevations can be at the top of their game one trip and just not on another, with no obvious change in conditions, they just don't seem to have as good O2 sats on the second trip.
posted by Lyn Never at 10:07 AM on February 25 [1 favorite]

Drink lots of water and not alcohol of caffeine is typical advice. Dairy's entirely new to me, but I don't know that it's wrong. Muña tea is another folk remedy that may or may not actually do anything.

I've seen Diamox do astonishing things when taken by people who are already experiencing non-life-threatening symptoms. (There can be serious side-effects that you should read about or talk to a professional about.) Getting a prescription for a few pills to bring with you just in case isn't a terrible idea.
posted by eotvos at 10:14 AM on February 25 [2 favorites]

If you're able to spend a night or two somewhere in between 500' and 9000', that can help. Many people plan ski trips so that they spend a night in Denver around 5200' first, before heading all the way up to the mountains.

Once you're at 9000', I'm not sure there's a magic formula besides taking it easy the first day or two and staying very well hydrated, which for many people involves avoiding alcohol. Sleeping with a humidifier can also help a lot.

Ultimately, my experience over the past 15 years or so is that how well a person handles altitude is not really tied to general physical fitness / stamina, though of course that won't hurt.
posted by rachelv at 10:16 AM on February 25 [6 favorites]

Regarding athletic stamina, make sure your blood iron levels are good. I live at sea level and when I visited Colorado it felt exactly like how I felt when my ferritin was super low. Anything physical felt harder than normal and it was way easier to get winded.

You should get tested now to see if you need to increase your iron consumption since it takes a few months to make a difference in your blood iron levels.
posted by burntflowers at 10:22 AM on February 25 [1 favorite]

Ask your doctor to give you drugs.

I take a high daily dose of acetazolamide (generic Diamox, as mentioned above) to manage the symptoms of a neurological condition I have. My use is off label. What is acetazolamide actually used for? Altitude sickness. (Well, and glaucoma.) It can be taken an advance as a preventative to lessen the symptoms.

Call your doctor, explain that you have previously experienced terrible symptoms from altitude sickness, and that you'd like to try to treat this with drugs in addition to [other good altitude habits]. This is a very reasonable request and your doctor probably will have heard it before.

If you go this route, know that it's a diuretic, so make sure you're staying extremely well hydrated--that's water and salts--or you're going to experience problems of a whole different sort.
posted by phunniemee at 11:13 AM on February 25 [3 favorites]

the only answer is acclimatize. 9k is no joke from sea level. you could even (it's rare at 9k) get hape or hace.
  • cardio might help, a little.
  • staying hydrated is critical. given the delta altitude, it might help a little.
  • acclimatize. a night in denver, a night somewhere higher (breck?), a partial hike up to, say, 7k.
this is way more than what you're trying, but a good caveat for higher attempts:

i was doing a winter 14k (quandary), and some dumbass group of coloradans took their friend (who flew in from sea level the day before). the trailhead is at 10.8k. by the time this dude was at 12.5, headache, puking, blurred vision, a little incoherent, difficulty standing.

i had to get up in their faces: take this guy down now, he is seriously ill. took like four tries before they agreed.
posted by j_curiouser at 11:34 AM on February 25 [5 favorites]

I forgot to note: hydration does not just mean "water" or "liquids" but you should specifically be using rehydration solution that has appropriately-balanced electrolytes, up to the daily max recommended amount. I use a product called lyteshow which has no sugar and the faintest citrus flavor, it disappears in soda or iced tea or cocktails, and the 4oz bottle comes with a handy purse-size travel bottle so you can just spike every beverage with it and spread out your electrolyte consumption across the whole day.
posted by Lyn Never at 11:43 AM on February 25 [2 favorites]

Spend a couple days at 5000 feet.
posted by medusa at 12:19 PM on February 25 [3 favorites]

I used to have a job that required me to spend Monday - Friday at 7000 feet, and my weekends at sea level. For the first several months I always had massive headaches on my first day back at the mountain until I realized I need to just hydrate, hydrate, hydrate. Problem solved. For the stamina I think it's kind of inevitable that you'll be struggling to adjust but the stronger you can make yourself cardiowise beforehand, the better off you'll be.
posted by BlahLaLa at 12:53 PM on February 25

Do take care and notice if whatever you’re doing isn’t working. 9,000’ is borderline for altitude sickness, and that is NOT something to fuck around with. If you develop symptoms, get down to a lower altitude (7-8,000 should do it), quickly. Symptoms should resolve fairly quickly then. And yeah - NO alcohol your first few days at altitude, and half your “normal” amount if you decide to drink.
posted by dbmcd at 1:19 PM on February 25

Strongly recommend a Diamox prescription as well. I've backpacked the same high elevation hiking route with and without it, and it made such a difference for headaches, endurance, and sleep quality.
posted by soleiluna at 1:56 PM on February 25

I live at sea level and am usually out of shape. I was able to prepare OK for 9000'-14000' hikes in Colorado by going on AllTrails and looking for the highest possible hikes near me (for me this means driving up to three hours sometimes) and hiking them. The steeper and longer the better, done as often as you can. For me the highest trails within that three-hour radius were like 2000-2500', nowhere near CO, but when I did that routine the hikes were a lot easier than they were when I didn't. I ended up paying for a premium AllTrails subscription and it was definitely worth it (and it was really helpful for some of the poorly-marked hikes I went on in CO!).

Also, if you don't have a workout program that incorporates lifting as well as HIIT/intervals/metabolic conditioning for cardio then I recommend it, that will also help a lot.
posted by Anonymous at 2:03 PM on February 25

Response by poster: Thanks so much, everyone! There are so many suggestions here that I hadn't considered. I really appreciate all of the advice! I'll keep checking in case there are more comments later. I hope this advice can help others too!
posted by allison00 at 2:32 PM on February 25

Not to scare you but absent the drug mentioned (and staying hydrated) there is little you can do to prevent the possibility of altitude sickness or feeling terrible. Acclimation can help and using a humidifier can help (the high attitude air is wickedly dry in winter). No amount of cardio capacity will prevent the possibility of you getting sick. Super fit people get put on their butt along side the proverbial couch potato that is perfectly fine.

Personally I thankfully have never gotten sick but after many trips I know I don't sleep well at high altitudes so I know not to overdo it and try to get rest in where I can.
posted by mmascolino at 3:24 PM on February 25

The importance of staying hydrated isn't just a "you get dehydrated in the cold dry air" thing:

When you're at altitude, your body compensates for the relative lack of oxygen in each given breath by increasing your respiratory rate so you breathe faster, which results in something called a respiratory alkalosis, meaning your blood is a little more alkaline than usual. Then your kidneys have to adjust the pH of your blood back to normal by, essentially, peeing out more bicarbonate than usual and allowing your pH to come back to its usual 7.4 or so. The respiratory alkalosis is fast, taking about 6 hours, and the kidney compensation takes about 24 hours in healthy people.

Staying well hydrated facilitates your kidneys' ability to excrete bicarbonate ions by, well, creating a lot of pee to excrete the ions in. Diamoxx helps this process along as well.

If you can stay a night on the Front Range in Denver or Colorado Springs before heading up to the mountains, you will probably be happier because the adjustment can be a little slower and more gradual. Avoiding alcohol will also help.
posted by The Elusive Architeuthis at 3:56 PM on February 25 [1 favorite]

Omeprazole (Prilosec) is also a carbonic anhydrase inhibitor (that inhibition is how Diamox decreases CSF production and treats altitude sickness), and according to the first linked article, replaced Diamox in the treatment of peptic ulcers because it has fewer side effects.

Omeprazole does also decrease CSF production when injected directly into the ventricles of the brain, but I didn’t find any studies of its efficacy in humans when taken orally. However, oral omeprazole has been shown to be effective in treating hydrocephalus in dogs.

And it is available over the counter.
posted by jamjam at 4:32 PM on February 25

I get asthma at altitude, and it is the one time I keep my Proventil inhaler around. I used to get injured skiing and get terrified, the last ski injury, I just passed out and woke up because my shoulder was separating. So, I use my inhalor to take exercise at or about 10,000 ft. Then I don't get altitude sickness or headaches. It is rare, I mean years go by in which it sits around, except for high altitude. I paid some dues not knowing this about my physiology. My blood iron levels are great, there is just some response that makes me woozy.
posted by Oyéah at 8:04 PM on February 25

And in an interesting coincidence I don’t immediately see how to connect with my previous answer, high altitude stomach problems are surprisingly common:
High altitude associated dyspepsia is a common phenomenon and some studies done in high altitude population have recorded high incidence of antral gastritis and mucosal atrophy on histo-pathological evaluation. This is also supported by high incidence of H. pylori infection.
So having some omeprazole on hand might be a good idea anyway.
posted by jamjam at 3:06 AM on February 26

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