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Read MoreAltitude Headaches: Causes, Symptoms, Prevention and Treatment
Medically reviewed by Oghenefejiro Okifo | MD, Harvard Medical School | Henry Ford Hospital - Detroit, MI on November 20th, 2023.
Key Takeaways
- High-altitude headaches strike at elevations above 8,500 feet when oxygen levels drop to roughly 75% of sea level concentrations, triggering cerebral vasodilation and increased intracranial pressure.
- The characteristic bilateral throbbing pain worsens dramatically with coughing, sneezing, or bending forward, distinguishing it from typical tension headaches or migraines.
- Rapid ascent increases risk exponentially—climbing more than 1,600 feet per day above 8,200 feet can trigger symptoms in up to 25% of travelers, even those who are physically fit.
- Descent to below 8,200 feet provides relief within 24 hours, while ibuprofen 600-800mg every 8 hours or acetazolamide 125mg twice daily can manage symptoms at altitude.
- Dehydration amplifies oxygen deprivation effects, requiring 12+ cups of water daily at elevation, while alcohol dilates blood vessels and worsens cerebral swelling.
If you're planning a trip to the mountains for skiing, hiking, or sightseeing, it's important to be aware of a condition called altitude headache. This is a common symptom of altitude sickness, which can occur when you travel to higher elevations, typically starting at around 8,500 feet above sea level.
What Causes Altitude Headaches?
The exact cause of altitude headaches is not fully understood, but it is thought to be related to the lower levels of oxygen available at higher elevations. When your body doesn't get enough oxygen, a condition called hypoxia, it can lead to various symptoms, including headaches.
Several factors can increase your risk of getting an altitude headache, such as:
Living at sea level and traveling to high elevations quickly
Going up in elevation too rapidly (e.g., via ski lift instead of hiking)
Engaging in strenuous activities like running, climbing, or skiing at high altitudes
Symptoms of Altitude Headaches
The most common symptom of an altitude headache is moderate pain on both sides of the head, which may worsen with coughing, straining, or bending over. The headache typically starts when you reach around 8,500 feet and should go away within 24 hours of descending below 8,200 feet.
Other symptoms of altitude sickness may include:
Fatigue
Weakness
Dizziness
Nausea
Difficulty sleeping
Preventing Altitude Headaches
The best way to prevent altitude headaches is to ascend gradually, allowing your body time to adjust to the change in elevation. Experts recommend limiting your daily ascent to no more than 1,600 feet per day, especially if you're engaging in physical activity.
Other prevention tips include:
Staying well-hydrated by drinking at least 12 cups of water per day
Increasing your carbohydrate intake to around 75% of your daily calories
Avoiding tobacco, alcohol, and certain medications like barbiturates and sleeping pills
Treating Altitude Headaches
If you develop an altitude headache, the best treatment is to descend to a lower elevation. In more severe cases, supplemental oxygen may be necessary until you can reach a lower altitude.
Over-the-counter pain relievers like ibuprofen or aspirin may help alleviate headache pain, and some people find relief with the migraine medication sumatriptan. If you're prone to altitude headaches, your doctor may prescribe medications like acetazolamide (Diamox) or corticosteroids to help prevent them.
Remember, if you plan on traveling to high elevations, it's always a good idea to consult with your healthcare provider to discuss prevention and treatment options that are right for you.
The Bottom Line
Immediate descent remains the most effective treatment when headaches develop above 8,500 feet, though gradual ascent and aggressive hydration prevent most cases. The key is recognizing that bilateral head pain worsening with movement at high altitude signals your body's oxygen distress. If you're experiencing concerning symptoms at elevation, Doctronic can help you determine whether descent is necessary or if other treatments might be appropriate.
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