How to Prevent Altitude Sickness on Your First 14er

Altitude sickness is the most common reason people fail to summit a 14er. The good news is that with proper preparation and awareness, you can significantly reduce your risk and enjoy a successful summit day.

What is Altitude Sickness?

Altitude sickness, also called Acute Mountain Sickness (AMS), occurs when you ascend to high elevation too quickly. At 14,000 feet, the air contains about 40% less oxygen than at sea level. Your body needs time to adapt.

Common Symptoms

• Headache (often the first sign)
• Nausea or vomiting
• Fatigue and weakness
• Dizziness or lightheadedness
• Difficulty sleeping
• Loss of appetite
• Shortness of breath during exertion

Prevention Strategies

1. Acclimate Before Summit Day

Spend at least 1 to 2 days at elevation before attempting your 14er. If you are flying in from sea level:

• Arrive in Denver or Colorado Springs 2 days early
• Take a day hike at 9,000 to 11,000 feet on Day 1
• Rest and hydrate on Day 2
• Summit on Day 3

2. Hydrate Aggressively

Dehydration makes altitude sickness worse. Your hydration strategy:

• Drink 3 to 4 liters of water the day before your summit
• Start hydrating 2 days before, not just the night before
• Bring 3 to 4 liters of water for summit day
• Drink before you feel thirsty
• Your urine should be clear or light yellow

3. Climb High, Sleep Low

If possible, sleep at a lower elevation than you will be hiking. For example:

• Sleep in Breckenridge (9,600 feet) before summiting Quandary (14,265 feet)
• Sleep in Leadville (10,200 feet) before attempting nearby peaks

4. Ascend Slowly

The "climb high, sleep low" principle applies during your hike too:

• Take breaks every 30 to 45 minutes
• Move at a pace where you can hold a conversation
• If you feel symptoms, stop ascending immediately
• Consider turning back if symptoms persist

5. Avoid Alcohol and Sleeping Pills

Both interfere with your body's ability to acclimate:

• Skip the beer the night before
• Avoid sleeping pills at altitude
• These depress your breathing and reduce oxygen intake

6. Consider Supplements for Acclimation

Consider whether to start taking supplements to help with acclimation. Always check with your primary care physician before taking any supplements.

Baby Aspirin OR Ginkgo Biloba (NOT both)

• May help improve blood flow and oxygen delivery
• Choose one or the other, never take both together
• Start taking 2 to 3 days before your summit
• Continue through summit day

Rhodiola Rosea

• May help your body adapt to high altitude stress
• Start taking 2 to 3 days before your summit
• Continue through summit day

Remember: These supplements are not a substitute for proper acclimatization, hydration, and listening to your body. Always consult your doctor before starting any new supplement regimen.

7. Eat Carbohydrates

Your body uses carbs more efficiently than fats or proteins at altitude:

• Eat a carb heavy dinner the night before
• Pack carb rich snacks for summit day
• Eat even if you are not hungry

What to Do If You Feel Symptoms

Stop ascending immediately. This is the most important rule.

Mild symptoms (slight headache, minor nausea):

1. Stop and rest for 15 to 30 minutes
2. Drink water and eat something
3. Take ibuprofen for headache
4. If symptoms improve, continue slowly
5. If symptoms persist or worsen, descend

Moderate to severe symptoms:

1. Descend immediately
2. Even 1,000 feet of descent can help significantly
3. Do not continue to summit
4. Seek medical help if symptoms do not improve with descent

When to Seek Emergency Help

Call 911 or get emergency help if you experience:

• Severe shortness of breath at rest
• Confusion or inability to think clearly
• Loss of coordination or stumbling
• Severe persistent headache despite medication
• Fluid in the lungs (crackling sound when breathing)

These are signs of High Altitude Pulmonary Edema (HAPE) or High Altitude Cerebral Edema (HACE), which are life threatening.

The Bottom Line

Altitude sickness is preventable with proper preparation:

1. Acclimate for 1 to 2 days before your summit
2. Hydrate aggressively (3 to 4 liters daily)
3. Ascend slowly and take frequent breaks
4. Listen to your body and descend if symptoms appear
5. Consider supplements after consulting with your doctor

Remember: The mountain will always be there. There is no shame in turning back. A successful summit is one where you return safely.

Additional Resources

• Talk to your doctor about altitude sickness prevention
• Practice your training plan at elevation if possible
• Read our guide on best foods for high altitude hiking
• Learn more about Colorado weather patterns for 14ers
• Review the complete 13 week training plan

Stay safe out there.