Supplements For High Altitude Hiking

When it comes to high altitude hiking, there are many supplements out there promising the world.

From 'enhancing bioavailability of oxygen', to 'increasing lung capacity' to 'increased blood volume' - many of these supplements seem too good to be true.

And in most cases, that is exactly the case.

So before you fork out your hard earned money, you need to ask yourself 'Does it actually work?"

This article will explore some of the few supplements that have been proven to work (and not just empty your wallet).

Ginkgo Biloba

Ginkgo biloba is a tree native to China and has been used in traditional medicine for centuries. It has commonly been used for cognitive enhancement and it has a long history of being used to prevent altitude sickness.

But looking at the evidence, it's ability to prevent altitude sickness has been often questioned. 

On one hand, there have been there have been numerous studies suggesting that Gingko is effective at preventing altitude sickness symptoms.

Though not completely understood, it is theorised to do this through either:
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• 'Scavenging' nitric oxide (which is suggested to play a role in altitude sickness)
• Improving blood oxygen saturation
• Acting as an antioxidant and reducing 'free radical' production
  
  

However on the other hand, there have been many studies which have shown no real effect...

While these conflicting results are confusing, it has been suggested that this can be explained through  a number of shortcomings in these studies (such as dosage/quality of gingko extract, duration of supplementation before ascent).

It also should be noted that there have been studies which have identified 'non responders' to Gingko Biloba. Meaning on an individual basis, it may or may not work for you. 

Conclusion:
Looking at evidence on the whole, Gingko Biloba extract can be effective at reducing the symptoms of altitude sickness. It should be taken 1-5 days before ascent. However because of its unreliability and the potential of you being a 'non responder' it should not be relied upon solely as a preventative for altitude sickness.
​

Iron 

When we are at Altitude our iron requirements increase. Iron is essential for the acclimatisation process and if we do not have enough of it, the process will be hindered. This can directly effect the potential for altitude sickness.

Unfortunately while at altitude, it can be difficult to reach these increased iron requirements. Reasons for this include a reduced appetite at altitude and a reduced availability of meat in remote conditions.

To counter this, iron supplementation has been used by high altitude athletes and mountaineers for many years to aid the acclimatisation process. 

This is backed up with evidence which shows that iron supplementation showed a significant increase in haemoglobin production at altitude (particularly for those who were already low in iron).

It should be noted that this is not appropriate for everyone. These studies specifically excluded people who already had 'overly high' iron levels, as excess iron stores in vital organs is associated with an increased risk of a number of conditions including cancer, liver disease and heart failure. 

So while iron supplementation can be an effective aid at altitude, it should always be guided by a doctor. 

* Read here for more details on why Iron is essential for altitude performance (and how to get more of it).

Conclusion:
​Iron supplementation can be an effective aid to the acclimatisation process (and hence reduce the possibility of altitude sickness). However due to the dangers of overly high iron levels, self 'prescription' is not recommended and should always be guided by a doctor.

​Caffeine

Conventional wisdom is that coffee should be avoided at altitude.

The idea behind this is that caffeine is a diuretic (meaning that it increases our urination). And an increased urination rate can lead to dehydration (which is a major issue at altitude).

The problem with this assumption is that is missed one crucial point. And that is caffeine only acts as a diuretic when you first start drinking it. So if you are a regular coffee user, this is not an issue.

And when it comes to preventing altitude sickness, it is theorised that it may help speed acclimatisation because of its effects as a 'respiratory stimulant' - however there has been no studies to back this theory up.

Saying this caffeine is a well known performance aid.

It can:

• Improve endurance performance
• Improve cognitive function
• Improve mood
  
  

And while none of these will directly effect altitude sickness, they will be beneficial for trekking performance.

One final point, is that if you are a regular coffee drinker - it is recommended you don't stop you intake while on the mountain. This is because symptoms of caffeine withdrawals can be very similar to early symptoms of altitude sickness...

Conclusion:
​Caffeine is safe to use at altitude and will be beneficial for performance. But while there are some promising theories on caffeine preventing altitude sickness, there is no direct evidence to back this up. 

​Magnesium

Magnesium is a mineral that is crucial for a number of functions in the body. It is naturally found in many foods.

Supplementation of magnesium has often been suggested as an aid for altitude sickness.

However when looking at the studies, there is no real evidence of magnesium helping prevent altitude sickness. 

This does not mean it is completely useless at altitude...

It can help improve peripheral factors such as:
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• Improving sleep quality 
• Reducing muscle cramps 
• Aiding muscle recovery 
• Reduces stress and anxiety

Conclusion.
While magnesium supplementation can be beneficial for some things at altitude, there is no evidence it is effective at preventing altitude sickness. 

Final word:

Talk of supplements are always a controversial topic. It is a billion dollar industry where ethics are often very questionable. And while you might find plenty of articles claiming particular supplements are 'the best' at altitude, when you look a bit deeper you will very rarely see evidence backing up these claims.

The aim of this article was is to give some evidence backed information on some popular supplements for altitude trekking. I would like to be clear that I am definitely not a dietician or a doctor and this article in no way should substitute for professional medical advice. There is always potential for supplements to interact with other medications . And I highly recommend anyone going to altitude to consult a travel doctor.

While there are many supplements touted as a cure for Altitude Sickness, there are very few with direct evidence to back this up. Gingko Biloba and Iron are the only supplements that have direct evidence to support them, however if you do choose to use one, ensure that it is guided by a travel doctor.

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