Altitude sickness on AT section hikes?

[joshuasdad]

Is this common? I do get altitude sickness at Breckenridge altitude (near 10K), but did not expect it on the AT. Yet on my section hike this weekend (Clingman's to Fontana over 2 days) I had my worst case ever: headache, lack of appetite, decreased hiking ability (especially on downhills), fever, uncontrolled shivering on stopping (of course it was cold...), chills, and even some chest tightness. I had lesser cases of the same on Shenandoah sections, but had attributed that to overexertion.

I have ideas on how to treat it (e.g., ease into hiking, Vitamin I, hydration, food, maybe even Diamox), just seeing if this is common among "weekend warrior" section hikers.

[MuddyWaters]

In my opinion, its unlikely to suffer AMS at such low elevations.
Generally, I think its rare to get AMS below about 8000 ft.
You can be a little more winded or such.
Even my wife, who always has horrible AMS at 9000+ ft and has ended up in hospital with with IV's and oxygen before, has never had the first complaint below about 8000.

[Skidsteer]

Go see your Doctor.

[joshuasdad]

Go see your Doctor.

Definitely will, but trying to get a sense of how common this is.

[joshuasdad]

In my opinion, its unlikely to suffer AMS at such low elevations.
Generally, I think its rare to get AMS below about 8000 ft.
You can be a little more winded or such.
Even my wife, who always has horrible AMS at 9000+ ft and has ended up in hospital with with IV's and oxygen before, has never had the first complaint below about 8000.

Unlikely, but not unheard of. I am popping up from sea level to 6000+ feet and doing 16+ miles in the first day with a heavier pack than usual (for me). I don't think the brain swelling symptom of AMS is coming into play (not that confused...), but many of the symptoms were identical to AMS at high altitude. I definitely did not get enough water in me that day, so that definitely could have some effect. I also became sick when I was 21 in the Smokies (and a whole lot lighter/stronger) on a last day ascent of Clingman's from close to Fontana elevation. Attributed it to overexertion/dehydration, but not so sure now.

[MuddyWaters]

I have had both my wife and a stepson with altitude sickness multiple times, and once so bad, they each had to be hospitalized.
I have never have seen fever, or chest tightness. Vomiting and dehydration can occur, pain right below ribcage is symptomatic of dehydration. Headaches, nausea, etc.

Personally, I can go right from sea level to 12000 ft and hike with skis, and ski all day and just feel a bit not-myself for a day or so.
I did feel a bit unwell at 14,200 + before though, after an hr, I was wanting to get lower.

[Dogwood]

LOL Nah. Probably not below 8000 ft. Breck is at 9600 ft. AT high pt at Clingman's is a little over 6000 ft, a good 3000 ft less than Breck.

[joshuasdad]

Same here on the skiing front. Have gone from sea level to skiing black diamonds at A-basin the afternoon of flying out. That type of altitude sickness sets in the night of sleeping at altitude. If I sleep near Vail, or even Dillon, my altitude sickness is not that bad. If I sleep in Breck or Keystone, I would need Diamox to be comfortable.

There is another mechanism that is affecting me on the AT, probably dehydration. FYI, the chest tightness was pretty short lived, near dawn, could have been from sleeping position or my pack (different than usual). Chest tightness (or even pain) is on the Lake Louise scoring for severity of AMS, so it is a known symptom.

[Feral Bill]

Hypothermia?

[joshuasdad]

I went straight from hiking into a 20 degree bag. Shivering was likely from fever/chills that I commonly get after exertion at some altitude. Cold probably did have some effect though.

I usually can head off the fever with some ibuprofen , but I forgot to check my supply on this trip.

[Dogwood]

Well dehydration can be correlated with AMS. One of the things you DEFINITELY want to avoid is dehydration at altitude. The symptoms of dehydration at altitude are compounded making it even more of a problem.

Instead of seeking out a Diamox(Acetazolamide) prescription I've been using CellFood w/dissolved oxygen drops in my trail water and taking DMG(N,N-Dimethylglycine,) tabs for oxygen utilization while climbing 14 ers and thru-hiking the CT. I think both those have helped me to assimilate to the higher altitudes here in CO faster than without them. Both are available at health food stores. Of course, I take extra notice not to become dehydrated either especially at higher elevations.

Another thing that may be considered is to adapt to a trail diet slightly higher in complex carbs when hiking at higher elevations because these carbs are easier to digest and need less oxygen to assimilate at higher altitudes than fats or proteins. That leaves more O2 to fuel your organs and muscles or to be used elsewhere.

[RED-DOG]

its not common on the AT, this is the first time i ever heard any body getting AMS on the AT.

[leaftye]

I'd think it's due to dehydration. I've noticed on long car trips in the west that I'll get a headache if I'm not well hydrated during big elevation changes, even if I don't go that high. I don't have elevation issues that I know of.

I'm trying to think of examples. I've hiked at or very near 11k a couple times, including once while starting after lunch and gaining 4500 ft, and many times a little over 10k. I've sky dived from 14k. That's all I got.

Anyway, you acknowledged being dehydrated. Go with that explanation for now, and make sure you're well hydrated on trips in the future.

[peakbagger]

Your experience is highly unusual. I do know of a local mountain guide who claims he has minor symptoms as he get older.

Your symptons are similar to the ones that were reported by some hikers who had intolerence to iodine water treatments but this usually was from thruhikers who were on the trail for several weeks.

One thing to be aware of is that some folks are very impacted by electrolyte imbalance which can give a person similar symptoms. I pretty well have to plan to use electrolyte tabs just about every hike these days. They make a big difference if I take them before I think I need them. I use NUUN but there are other similar products.

Good luck

[Snowleopard]

Same here on the skiing front. Have gone from sea level to skiing black diamonds at A-basin the afternoon of flying out. That type of altitude sickness sets in the night of sleeping at altitude. If I sleep near Vail, or even Dillon, my altitude sickness is not that bad. If I sleep in Breck or Keystone, I would need Diamox to be comfortable.
This is altitude sickness. Vail and Dillon are at ~8700'-8800'. Breckinridge is at ~9800'. That extra 1000' makes a difference.

Altitude sickness at 6000' is very unlikely, but not impossible. I suspect that if it happens at 6000' you'd be in serious trouble skiing in Colorado. Other causes are very likely. Dehydration, electrolyte imbalance, cold or flu, allergies, asthma or other respiratory diseases are all possible, as is hiking farther with more weight than you're used to. If it happens again at 6000' after a mild day of hiking when you're sure you're not dehydrated, it would be good to see a doctor.


There is another mechanism that is affecting me on the AT, probably dehydration. FYI, the chest tightness was pretty short lived, near dawn, could have been from sleeping position or my pack (different than usual). Chest tightness (or even pain) is on the Lake Louise scoring for severity of AMS, so it is a known symptom.
Chest tightness might be asthma or muscle strains. It could even be a stomach upset or acid reflux or gas. Depending on the time of year, it could be asthma triggered by the high air pollution levels in the Smokies.

[magic_game03]

I've ran dozens of mountaineering groups from sea level to 14,000 ft in a day and I've never seen anybody get sick from altitude below 8,500 ft. not that it can't happen, but you probably suffered from overexertion.

[Cookerhiker]

...Personally, I can go right from sea level to 12000 ft and hike with skis, and ski all day and just feel a bit not-myself for a day or so.
...

Man, I'm jealous. On every backpacking trip I've attempted in the West, I've had problems acclimating including last year's Colorado Trail thruhike. For that hike, it took me 3 days on the trail to adjust even at the 7,500' level. On Day 4, magic occurred; I was able to get to 10K' with no problems.

[joshuasdad]

Starting to look like situation caused by altitude (for example, body purges water at altitude, causing dehydration and electrolyte issues), as opposed to AMS. I did not feel dehydrated (purging clear water...), but probably was. The more simple answer is that I also get altitude dehydration headaches when skiing the first day, so I naturally thought that I was getting altitude sickness on the AT when having the same symptoms.

Thanks for all of the posts!

[QiWiz]

Definitely will, but trying to get a sense of how common this is.

I would say AMS is impossible at the elevations encountered on the AT. So it either never happens or is very very rare. There is a very big overlap in symptoms between dehydration and AMS. Suggest increasing your fluid consumption and that might make a difference.