Viagra in the mountains?

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Why do we need Viagra in the mountains, or how can medications help in the prevention and treatment of "Acute Mountain Sickness"?

There is a point of view that certain pharmacological drugs can help in case of the mountain sickness, as well as for its prevention. The most famous of them are Hypoxene, Sildenafil (Viagra), Diamox (Diacarb), Mildronate (Meldonium).

Briefly, the effect of these drugs can be described as follows:

1. Hypoxene provides an increased level of tissue respiration and aerobic processes, reduces the negative effects of hypoxia, improves the ability to physical and mental stress.

Side effect: Allergic reactions, individual intolerance.
There is no information on the side effects of use at the critical altitudes (*).

2. Sildenafil (Viagra). Improves the cardiovascular system and increases the degree of saturation of arterial blood with oxygen.

Side effects: headache, dizziness, nasal congestion, visual impairment, increased sensitivity to light, impaired vision.
There is no information on the side effects of use at the critical altitudes.

3. Diamox (Diacarb). Diuretic. Reduces high levels of carbon dioxide and bicarbonates in the blood. Reduces the activity of carbonic anhydrase in the brain, which provides anticonvulsant activity of the drug. Reduces intracranial and intraocular pressure.

Side effects: disorientation, impaired touch, drowsiness, nausea, vomiting, diarrhea, allergic reactions.
There is no information on the side effects of use at the critical altitudes.

4. Mildronate (Meldonium). For this drug, there is no qualitative evidence of its effectiveness, Meldonium is not included in any recommendations recognized by the international community for the treatment of any disease.

Meldonium increases working capacity, reduces the symptoms of mental and physical stress, helps to increase endurance, and eliminates withdrawal symptoms in chronic alcoholism.
Side effect: digestive problems, agitation, tachycardia, sometimes critical decrease in blood pressure, skin itching.
There is no information on the side effects of use at the critical altitudes.

Before you choose the drug you like from the list above and go on a trip to the mountains, you should deal with some fundamental issues. To begin with, what exactly we will try to “treat” with the help of the above drugs of wide and strong action.

The natural reaction of our body to an external stimulus - altitude, colloquially called "AMS – acute mountain sickness." However, many people do not understand the fact that this phenomenon is not a disease. In a special article in this section, I explain in detail the causes of "acute mountain sickness" and way to prevent it.

With regard to the issue of the drug effect on the symptoms of “mountain sickness,” it can be said that this “disease” can be effectively treated only in one way - excluding the reason to which the body has reacted painfully – the altitude. All other methods come down to masking the symptoms and tricking the body, which in turn can lead to unpredictable consequences.

For comparison, you can take drinking an antipyretic for calming down the fever - high temperature. By raising the temperature, our body fights against various processes threatening it - this is a natural reaction, and our desire to forcefully lower the body temperature with the help of the drugs can lead to aggravation of the processes that our body tried to fight.

“Mountain sickness” is the body’s reaction to a sharp decrease in the level of oxygen in the air that we breathe. Our body has all the means to adapt to various environmental conditions, including the lack of oxygen, even at very high altitudes, where the percentage of its content drops to 40% of the norm. As you progress through the acclimatization schedule, metabolism gradually changes, blood circulation accelerates, and the corresponding rhythm of the heartbeat is developed. But all these processes do not happen fast, they require a certain time for initiation, which, in turn, depends on the individual characteristics of the organism, preparation, and high-altitude experience.

Without touching on the intricacies of the acclimatization process, I want to say that a number of medical drugs presumably have the ability to accelerate the acclimatization process and reduce the effect of altitude on an unprepared body. The most famous among them are listed above, these are Diamox (Acetazolamide), Hypoxene, Meldonium, Viagra. The mechanism of action of these drugs is quite different, but in general, the effect of their use is expressed in certain physicochemical changes at the cellular level, as a result of which blood circulation improves and stimulates, and oxygen metabolism in tissues improves.

However, with the contraindications revealed and the side effects of the use of these drugs, no one conducted in-depth studies of the effects of these drugs on the serious altitudes, under critical physical, climatic and psychological stresses. In such a situation, our body works to the limit, and any extraneous push can lead to loss of a balance and unpredictable consequences.

Before looking for a cure for “mountain sickness,” answer to the question - what tasks do you pursue in the mountains, trying to solve the problem of altitude with medications? How critical is it for you to continue to climb, despite the obvious signs of insufficient acclimatization? Of course, in a situation where a person’s life depends on the use of chemicals, in case of need to keep working by any means for a short time (for example, in the conditions of some military or rescue operations, etc.), regardless of further health consequences. But it is like an amphetamine ampoule in the pocket of a suicide bomber...

But if you just relax in the mountains? If for you the mountaineering is a form of active leisure, a source of positive and vivid impressions? Is it worth it to risk your health and ignore the obvious signals that your body gives to you? Moreover, the signals are quite obvious - an immediate descent and restoration is necessary. Is it worth to rely on the drugs of broad and powerful action?

Many generations of climbers who have done the most serious ascents at high altitudes give us a good example of the fact that the best “cure” for “mountain sickness” is proper acclimatization, and the best prevention is adequate motivation, clear mind and common sense. A gradual altitude gain, regular descents from the altitude camps for a good rest - all this allows us to prepare smoothly letting to our body good time for acclimatization and normal functioning at sufficiently high altitudes.

In 2002, the author of this article was preparing an international climbing expedition to Mount Ushba - it was a memorial climb dedicated to the 70th anniversary of the famous Georgian mountaineer Mikhail Khergiani. Since this expedition was given very close attention at a high level, the event was broadcast on TV channels in Russia and Georgia, it was necessary to do everything to minimize a chance of possible failure. At the preparation stage, I received an offer from the representative of a pharmacological company to test some drug to accelerate acclimatization of the climb participants.

Experienced climbers, members of the expedition, who had the experience of numerous ascents to Everest and other highest peaks, unanimously opposed the use of any chemicals that violate the natural way of the acclimatization process. As the youngest participant in the expedition, I accepted the point of view of older and more experienced comrades and abandoned the idea of using any chemicals during acclimatization and the main ascent.

I have not changed this point of view so far - the best doctor is our own body. And many problems, including in the mountains, happen because we interfere in the complex natural processes of its functioning.

* critical altitudes - above sea level from 3000m to 6000m, the level at which the human body can function only under the condition of full acclimatization and special training.

The author of the text and photos - Alex Trubachev

MCS EDIT 2023