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02 April 2012

Ibuprofen may help prevent altitude sickness

A new study suggests that taking ibuprofen before a trip to high elevations may help some people avoid the headaches and nausea that come with altitude sickness.

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A new study suggests that taking ibuprofen before a trip to high elevations may help some people avoid the headaches and nausea that come with altitude sickness.

A new study suggests that taking ibuprofen before a trip to high elevations may help some people avoid the headaches and nausea that come with altitude sickness. But even with ibuprofen, "there are still a lot of people who do have symptoms," said Dr Robert Roach, head of the Altitude Research Center at the University of Colorado Denver School of Medicine.

Because the body's response to high altitudes varies person-by-person, there may be some people who do better with ibuprofen than with prescription drugs, including acetazolamide – which increases the amount of oxygen in the blood – and dexamethasone, he said. But the opposite is also true. "There are for sure going to be some people where ibuprofen doesn't do much," Dr Roach, who wasn't part of the study team, said.

Dr Jeffrey Gertsch from the University of California, San Diego School of Medicine and his colleagues had healthy adult volunteers drive and hike a few miles from an altitude of about 4 000 feet to over 12 000 feet in the White Mountains of California.

Half of them were given 600 mg of ibuprofen three times during the day, starting six hours before the ascent. The other half took a placebo. Participants stayed overnight at the high altitude. Forty-three percent of those given ibuprofen developed acute mountain sickness, with a severe headache and at least one other symptom, compared to 69% of those on the placebo pills instead.

Eight volunteers had symptoms serious enough to warrant treatment – six with ibuprofen and two with placebo, the researchers reported online in the Annals of Emergency Medicine.

Does ibuprofen relieve symptoms?

The authors calculated that four people would need to take ibuprofen before and during a high-altitude trip to prevent one from getting sick.

Dr Gertsch said one big question his study can't answer is whether ibuprofen is just easing altitude symptoms by providing pain relief or if it's really getting at the underlying causes of those symptoms, including inflammation and changes in blood vessels.

If it's only easing pain, he said, that could actually be worrisome for climbers. "You could have a false sense of security... and get yourself into real trouble" at higher altitudes with low oxygen, Dr Gertsch said. Researchers will need objective ways to measure altitude sickness before they can try to answer that question, he added.

Ibuprofen an option for altitude sickness 

The researchers agreed that ibuprofen is an option for people who'd rather not take prescription drugs. Acetazolamide comes with a risk of nausea and fatigue – symptoms of altitude sickness itself – and dexamethasone may raise blood sugar levels and disturb sleep. And ibuprofen costs pennies per pill.

"People would be welcome to try it... and see how it works for them," Dr Roach said – assuming they realise ibuprofen can also have side effects, including stomach problems. "If people want to use this to prevent altitude sickness, I'm not going to say that's bad, they just need to be very careful," Dr Gertsch added. When it comes to high-altitude climbing, he said, "there is no substitute for careful planning, which is staged ascent, just going slow."

(Reuters Health, Genevra Pittman, March 2012)

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