Tag Archives: mountains

Sharing at the Chateau: 23rd International Hypoxia Symposium in Lake Louise

I attended the 23rd International Hypoxia Symposium in Lake Louise, Canada to present some of the research on altitude I’ve been conducting in Colorado. The conference has been going on since 1979, and for the past 26  years the organizers have been Robert Roach and Peter Hackett, world-renowned medical researchers from Colorado. Meeting most of the famous altitude researchers from all over the world was an inspiration.  Personal talks and sharing information were equally important to imbibing the latest knowledge about hypoxia and hemoglobin.

A slide is projected onto a screen over the heads of conference participant, depicting statistics showing infant birthweight in mammals decreasing over increasing elevations.
From Jay Storz’s presentation at the 2025 International Hypoxia Symposia in Lake Louise, Canada

Antarctic Icefish: Life Without Hemoglobin, was presented by Kristen O’Brien, expanding the concept of oxygen distribution in living beings and introducing us to varieties of fish we have never heard of. Her talk was followed by our “Mice and Men” guy, Jay Storz (and colleague Graham Scott), who along with Jon Velotta mentioned in our blogpost on the show “This Podcast Will Kill You” collect the large eared deer mice from peaks such as Blue Sky Mountain to study adaptation to hypoxia in their labs. The talk recognized for first prize was on Altitude Headaches, including a discussion of migraines, by Andrew Charles.

Every evening there was a banquet and speaker.  Astronaut Jessica Meir spent 210 days aboard the space station.  She shared a wide range of challenges such as exercising without gravity, choosing a compatible crew, getting boxes of treats from home, and effects of prolonged weightlessness on your eyes and muscles.

A slide projected onto a conference room screen before participants depicts results for six minute walks on and off oxygen.
Silvia Ulrich presented on Pulmonary Circulation of Central Asian Highlanders at the 2025 International Hypoxia Symposium at Lake Louise, Canada.

The research I would like to see duplicated in Summit County was from Kyrgyzstan, where Silvia Ulrich studied the hearts and lungs of the permanent residents at 9000 feet using the six minute walk as one of her tools.  They did not score higher when studied at sea level! She ran tests for pulmonary hypertension, which could be important here.

Of course, there was a talk on Sleep Disordered Breathing (sleep apnea) by Esther Schwarz, something we pay a great deal of attention to in our own clinic in Frisco, Colorado and have several research projects on the improvement we see with supplemental oxygen. The role of mitochondria in cellular function in hypoxia was presented by Dr. Christian Arias-Reyes, a researcher at Seattle Children’s Hospital who is originally from La Páz, Bolivia.  I met him at the Chronic Hypoxia conference in 2019 when he was a graduate student in Quebec and again in La Páz at this year’s conference. 

A line of people pose in front of a cafe with signs and plants hanging above a stone-tiled street lined with buildings
Altitude experts Dr. Zubieta Calleja, Dr. Christian Arias-Reyes, Dr. Michele Samaja and Dr. Christine Ebert-Santos with colleagues of the Hypoxia Symposia in front of a pizzeria in Coroico, Bolivia.

A deep dive into how our neurons react to hypoxia in the brain by releasing nitric oxide to dilate blood vessels and preserve circulation reenforced the counseling I do here in my clinic to parents whose children have breath holding spells or babies with dips in their oxygen on home monitors. Along with all the millions of children and adults living at 12,000 feet in Bolivia, we can witness that hypoxia does not cause brain damage. (Not to be confused with anoxia, a complete lack of oxygen.)

Lastly, Nobel prize winner and fellow pediatrician Gregg Semenza spoke on research to find a blocking compound against HIF- hypoxia inducible factor, as a cure for some cancers. Gregg’s work was described in our blog on the Nobel prize being awarded to scientists working on hypoxia. HIF deserves its own blogpost! More about cancer and hypoxia at altitude from the Chronic Hypoxia Conference in La Páz.

I was selected to give my presentation, “Colorado Kids Are Smaller” to both conferences. I have been working on this for 20 years. You can read more on our blog where it is titled “Mountain Kids Are Smaller”.  My goal is to get a unique growth chart for children under age two at altitude, to save parents and providers anxiety and money trying to get our kids to “be the same” as those at sea level.

The most useful tidbit of information came on the bus ride back to Calgary. Dr Heimo Mairbaurl, PhD shared that a quarter dose of acetazolamide was sufficient for his acute mountain sickness symptom prevention, 62 mg for a guy over 6 feet tall. Although there was a study on a new possible preventive treatment, prochlorperazine, done on Mount Blue Sky last fall, I still swear by the old drug formerly known as “Diamox”.

A Query on Mt Quandary

A personal story of acute mountain sickness (AMS)

Disturbing the “Locals”

“Race ya down”, my friend Liz took off from the summit of Mt. Quandary. Ahead of us stood a 2 mile scrabble through a boulder field with a 1 mile decent down a winding trail through the forest where we would descend from 14,265’ to 10,850’. In my experience, a 6 mile hike with 3,400 vertical feet was no feat. However, something was different as we approached the cars at the end of the hike. I noticed the start of a headache and I held onto the car to keep myself from swaying while taking off my boots. Thinking this was merely dehydration I finished my 3 liters of water – but that did not help. Once in the car my head continued to throb as we drove over Hoosier pass. Incoherently I mentioned that we should stop for Gatorade but the 64 oz of Gatorade did not abate my symptoms. In fact they worsened, my symptoms included severe dizziness, nausea, and a pounding headache. While my memory was hazy I knew this was not dehydration, maybe this was acute mountain sickness? But how could it be? I was in shape, lived at 5,400’, and this was my 5th 14er that summer. Was it possible to have AMS on the same peak I had climbed just weeks prior?

Standing on the summit of Mt. Quandary

My name is Chris Whitcomb and I am a 3rd year PA student at the University of Colorado. This story is all too familiar for anyone who spends time at elevation. Thankfully by the time we hit Idaho Springs, 7,526’, my symptoms dramatically improved. After reviewing my case and talking it over with my peers I believe that I developed AMS with some elements of HACE mixed in. A quick calculation of the Lake Louise Score came in at 6, which would classify this episode as “severe AMS”.

Who is most susceptible to AMS?

A prospective study analyzed a total of 11,182 workers on the Quighai-Tibet railroad in Tibet. This study identified 6 independent risk factors for AMS such as: rapid ascent to elevations above 3500 m (11482’), sea-level or lowland newcomers, young people of age, heavy physical exertion, obesity, or SaO2 below 801 Another study in 2013 looked into various other predictive indexes for AMS and found that the level of activity (higher activity) and sex (male>female) lead to increased odds of AMS 2. A quick review of the above criteria showed that I was the perfect demographic for AMS. I am a young male who was exerting myself physically at altitude.

Will this stop me from hiking at elevation?

Not one chance! Last summer alone my wife and I backpacked and hiked over 250 miles in Colorado. Since the incident I now make sure that I have the ability to seek lower elevation if needed during all our outdoor adventures. I also pay close attention to how I am feeling as we ascend.

Should I take acetazolamine/Diamox before backpacking trips because of my past AMS episode?

A meta-analysis in 2015 looked at 7021 individuals to see if a past episode of AMS warranted medication to prevent future AMS episodes. Interestingly enough they found that the literature did not support it. This was in part due to the sporadic nature of AMS 3I personally do not take a prophylactic medication before hiking at elevation, but this would be a great conversation to have with your medical provider if you are at all concerned.

Chris Whitcomb, PA-S3
University of Colorado
Class of 2018

References

  1. Wu TY, Ding SQ, Liu JL, Jia JH, Chai ZC, Dai RC. Who are more at risk for acute mountain sickness: a prospective study in Qinghai-Tibet railroad construction workers on Mt. Tanggula. Chin Med J. 2012;125(8):1393-400.
  2. Beidleman BA, Tighiouart H, Schmid CH, Fulco CS, Muza SR. Predictive models of acute mountain sickness after rapid ascent to various altitudes. Med Sci Sports Exerc. 2013;45(4):792-800.
  3. Macinnis MJ, Lohse KR, Strong JK, Koehle MS. Is previous history a reliable predictor for acute mountain sickness susceptibility? A meta-analysis of diagnostic accuracy. Br J Sports Med. 2015;49(2):69-75.

The air is thinner up here!

More and more people of all ages travel to  and reside in the mountains. Scientists and health care providers are just beginning to discover the effect of high altitude on health.

I have practiced medicine in Frisco, Colorado at 9,100 feet since 2000. Before that I worked on Saipan at sea level for 20 years. The difference has made me aware of special considerations when caring for people from newborns to retirees at high altitude. Simple measures can be taken to save a vacation or preserve an active life style in the mountains.  All visitors who are not pregnant should consider taking Diamox (acetazolamide) starting two days before travel. Tourists and residents should buy an inexpensive home pulse oximeter to monitor oxygen levels.  Anyone staying for more than a week should pursue testing for night time hypoxia and pulmonary hypertension when experiencing difficulty sleeping, fatigue or trouble breathing

Read articles on the Ebert Family Clinic Website for more information. I will add new information, discuss symptoms and diagnoses, and respond to questions. We have a power point available to interested groups. Personal evaluations and consults can be scheduled at Ebert Family Clinic with myself for children and Laura Amedro FNP for adults or children

Hi altitude Conference- peoples final.