Elevation conditioning

Hydration, hydration, hydration. Also, adequate rest and maybe a little more caffeine than usual. There are claims that conditioning doesn't have much to do with tolerance for elevation. That's true in the sense that well-conditioned people can still suffer symptoms, however, I'm convinced that good aerobic conditioning helps most people. According to the Fitbit, my resting heart rate increases by 3-4 beats/minute at 8,000 feet, and heart and respiration rates increase more rapidly with activity. Conditioning enables you to withstand higher rates for longer periods. Even on my acclimation days, I do as much walking around as possible.

Going to echo those more experienced here, and as a fellow flatlander add a bit of weight to what they say. Appropriate acclimation, hydration, rest, and conditioning to prep for altitude all seemed to help, but never completely solve the problem. I used to run until I could feel the edge of fatigue, then start my stairs. It never really seemed to matter how far or fast I could run when I got around 12,000', what mattered was that I was used to feeling fatigued but still moving forward and up under that extra strain. That said, don't ignore the signs of altitude sickness if you ever get to altitude no matter how in shape you think you are.

The elliptical trainer is a great substitute for running if you have bad knees (like me).   I can withstand the same intensity and distance as when I was running without the impact.  If you really want to just walk, find the longest, steepest hills available and do repeats on them.   There's a half-mile loop near me that gains over 200 feet in 200 yards.  I aim for 8-12 laps every weekend.

Caffeine isn't important, but it helps some people.  If you don't drink coffee or caffeinated soda, I wouldn't suggest changing.  Just take an aspirin or two if you feel a headache coming on.

First of all, be aware of symptoms just don't fret about it too much.  After all, almost all who hike to altitude in USA come from within 600 feet of sea level.  Your chances are you will only notice you can't go as fast and you are winded by just tying your boots.  Within two days you will most likely forget you are where you are. 

The only way you can acclimate (quickly) to high altitude hiking is in a high altitude simulator - you just live in it for a couple of weeks. Ok not everybody has access to that. Reducing your intake of oxygen at sea level will only turn you blue. It is not the lack of oxygen it is the difference in partial pressures between your insides and your surrounds.  A graphic example is to wave your hand in front of your face - now.  You should feel a slight breeze.  While stopped to take in the scenery on a 11,000' pass, try the same experiment.  More than likely you will not feel a breeze.  You really have to beat the air around you to get a waft.  At 14,000' you need somebody fanning you with a wide brimmed hat to get cool.   You just don't have as many molecules up there.  It gives new meaning to the speed of those high altitude winds that flip you on your kiester.

Generally it takes about 2 weeks for your body to accept the lower pressure of Denver (6000' about). At 8000' it takes 4 weeks; 10,000' about 4 months and 14,000' most of a year. So this means you probably will not adapt to altitude during your trip. BUT the body is resilient and will catch up for altitudes under 10,000' quickly - a few days.

There is a caution in being extremely fit and goal driven and going to altitude (with a lot of testosterone working on you). It means you can probably get MUCH higher and MUCH faster than your body can handle. Fitness keeps you going even when you are having problems keeping up. Being fit aerobically is a good thing.

You can experience AMS (Acute Mountain Sickness) as low as 8,000'. If you have a headache that won't reduce with a couple of aspirins, you can't keep food down, you are feeling a bad case of malaise and flu like symptoms, then the only cure is go back down hill aways. Trying to tough out AMS is a fools errand and can be dangerous.

The 'rule' is sleep a lot lower than you hike each day; Don't exceed 1000' daily altitude gain. All that said, it would indicate that it would take more than a week to hike up a 14,000' peak. The actual experience is probably closer to three days.

I feel the affects every time. Rather than waste a few days feeling rotten 'getting acclimated' before starting out, I figure I will feel the same if I just start out very slowly the first few days. I don't try to muscle up extraordinary heights, unless I will be down to a much lower altitude to sleep.

The trail up Mt Witney in California accepts all those from near sea level (most of us) puts you on a trail that starts above 9,000 feet and plops you down at a camp spot that is close to 12,000'. It then expects you to climb 2500' feet more up the next day. Most can but others have moderate to severe AMS.

Surprisingly those who can walk the 22 mile round trip trail and spend that night near 6,000' (Lone Pine), only have really sore feet and very few have AMS symptoms. Its the overnight too high that can give you some AMS symptoms. If you can get the body up and down before the body knows it (sleeping) you might get around AMS.

The prime candidate for AMS is one who spends all night packing his packbag and catches a plane at 6am - not having slept. A few drinks along the way seems right to celebrate the freedom and the chance to do something he has planned for a very long time. Upon landing he picks up the rental car and others (perhaps), having not eaten in 20 hours, they all grab fast food full of salt, grease and sugar on the way to the trail head. A couple of beers is appropriate for the camp that night. A greasy pizza serves as supper and a very late night because they are full of excitement.  The next morning a few hits of coffee and an instant breakfast poured on top of instant oatmeal serves as breakfast.

The odds of that group being uncomfortably affected by high altitude at first camp in the Sierra or Rockies, is almost a certainty.

Get plenty of rest. You will be stressing your body. You don't need salt to survive a few days. You DO need to pound water down you and stay hydrated from three days before you hit the trail head. Start the sugar and carbo loading right after you hit the trail. Keep the nutrition coming all day long and keep sipping the water bottle.

Ok, if all else fails and you are not feeling very good at 10,000' and you can't sleep, have a prescription filled for Acetazolamide (Diamox®) 250mg/12hrs. Check a few days ahead of time if a day's dosage affects you. It is a diruretic - means you will need to drink more.


ismm.org/index.php/treating-ams.html?expandable=1&subexpandable=2

This is all good advice, and I would only offer a potential counter to one point. I will also preface this with another statement regarding the importance of conditioning, and a quick story.
Statement: conditioning helps you to get to know your own body.
Now the story: in the best shape of life I was running 3 miles a day running minimum at an 8 mile and hour pace, with alternating days of upper body and intense cardio of 100 story of stairs then elliptical after that, but I also was intermittently crashing and getting massive headaches. I found out why when I got married and my wife not in as good a shape started having the same problems. It was salt, or more accurately salts, in other words electrolyte balance.

Doesn't seem to matter if I run 3, walk 8, or climb stairs for a couple of thousand feet. In the end I loose, and need, salt. Table salt, pickle juice (the product or straight up out of the jar), or electrolyte salt pills. I know this now and usually head it off, if I forget I pay for it.