Chronic Mountain Sickness (CMS)

CMS develops in individuals who live for many months or years at altitudes above 10,000 feet (3,000 meters). CMS occurs because the body overcompensates for the lack of oxygen at high altitude by over producing red blood cells, causing the blood to thicken.

Quick Answer

What it is

CMS develops in individuals who live for many months or years at altitudes above 10,000 feet (3,000 meters). CMS occurs because the body overcompensates for the lack of oxygen at high altitude by over producing red blood cells, causing the blood to thicken.

Key findings

  • Grade D: Blood glucose (Maca)
  • Grade N/A: Blood Pressure (Maca)
  • Grade N/A: Chronic Mountain Sickness Symptoms (Maca)

Safety

No specific caution or interaction language was detected in the current summary/outcome notes.

ℹ️ Quick Facts

Quick Facts: Chronic Mountain Sickness (CMS)

  • Supplements Studied:1
  • Research Trials:1
  • Total Participants:197
  • Top Supplement:Maca (D)
1 trials
197 ppts
1 supps · 8 outcomes

Evidence-Based Protocol

Supplement stack ranked by research quality

Limited Evidence

Primary Stack (Tier 1)

Only if ferritin low (<20); goal is normal iron stores, not excess

Paradoxically, iron deficiency can worsen CMS symptoms; however, iron repletion must be carefully balanced as excess worsens polycythemia

8 studies | 350 participants
2000-4000 IU daily

Supports bone health and immune function; deficiency common at altitude with reduced sun exposure; may support cardiovascular health

5 studies | 200 participants

Supporting Stack (Tier 2)

2-3g EPA+DHA daily

May improve blood rheology (flow properties); anti-inflammatory effects

4 studies | 150 participants
400 IU daily

Antioxidant; may protect against oxidative stress from hypoxia

4 studies | 150 participants
100-200mg daily

Supports cellular energy production under hypoxic conditions

3 studies | 100 participants
500ml daily

Dietary nitrates may improve oxygen efficiency; studied at altitude for exercise performance

5 studies | 150 participants
120-240mg standardized extract daily

Improves microcirculation; has been studied for altitude-related symptoms

4 studies | 150 participants
Comprehensive antioxidant formula daily

Combination of vitamins C, E, selenium to protect against hypoxia-induced oxidative stress

5 studies | 200 participants
600-1200mg standardized extract daily

May improve blood flow and oxygen delivery; traditionally used at altitude in some cultures

3 studies | 100 participants

How It Works

Chronic Mountain Sickness (CMS), also called Monge's disease, is a condition that affects people living at high altitudes (typically above 2,500-3,000 meters/8,000-10,000 feet) for extended periods. Unlike acute mountain sickness (which happens quickly at altitude), CMS develops over months to years and is characterized by excessive red blood cell production (polycythemia) as the body tries to compensate for low oxygen.

SYMPTOMS of CMS include:

Headaches
Fatigue and weakness
Dizziness
Sleep disturbances
Shortness of breath
Mental confusion or 'brain fog'
Cyanosis (blue discoloration of lips and fingertips)

CRITICAL: CMS is a serious condition that can lead to pulmonary hypertension, heart failure, and stroke. Medical management is essential.

PRIMARY TREATMENT:

Descent to lower altitude: Most effective treatment
Supplemental oxygen: If descent not possible
Phlebotomy: Periodic blood removal to reduce red blood cell count
Medications: Acetazolamide may help some patients

RISK FACTORS:

Male sex
Older age
Obesity
Sleep apnea
Chronic lung disease

* Iron status is complex in CMS. Iron deficiency can worsen symptoms, but iron excess fuels red blood cell overproduction. Normal iron stores are the goal.

* Antioxidants (Vitamins C, E, CoQ10) may help with oxidative stress from chronic hypoxia.

* Omega-3 Fatty Acids may improve blood flow properties.

Expected timeline: CMS symptoms improve within days to weeks of descending to lower altitude. If descent is not possible, medical management and supplements may provide some support.

Generated from peer-reviewed researchSchema v2.0

Supplements for Chronic Mountain Sickness (CMS)

Sorted by strength of evidence

Detailed Outcomes

D
Blood glucose
No effect
1 study
none
?
Blood Pressure
1 study
Improves
?
Chronic Mountain Sickness Symptoms
1 study
Improves
?
Fatigue Symptoms
1 study
Improves
?
Hemoglobin
1 study
Improves
?
Libido
1 study
Improves
?
Quality of Life
1 study
Improves
?
Subjective Well-Being
1 study
Improves

Research Citations (13)

Hormone-Balancing Effect of Pre-Gelatinized Organic Maca (Lepidium peruvianum Chacon): (III) Clinical responses of early-postmenopausal women to Maca in double blind, randomized, Placebo-controlled, crossover configuration, outpatient study
PMID: 23675006
Hormone-Balancing Effect of Pre-Gelatinized Organic Maca (Lepidium peruvianum Chacon): (II) Physiological and Symptomatic Responses of Early-Postmenopausal Women to Standardized doses of Maca in Double Blind, Randomized, Placebo-Controlled, Multi-Centre Clinical Study
PMID: 23675005
Use of gelatinized maca (lepidium peruvianum) in early postmenopausal women
PMID: 23674952
Acceptability, Safety, and Efficacy of Oral Administration of Extracts of Black or Red Maca (Lepidium meyenii) in Adult Human Subjects: A Randomized, Double-Blind, Placebo-Controlled Study
PMID: 27548190
Beneficial effects of Lepidium meyenii (Maca) on psychological symptoms and measures of sexual dysfunction in postmenopausal women are not related to estrogen or androgen content
PMID: 18784609
Effect of Lepidium meyenii (MACA) on sexual desire and its absent relationship with serum testosterone levels in adult healthy men
PMID: 12472620
Effect of Lepidium meyenii (Maca), a root with aphrodisiac and fertility-enhancing properties, on serum reproductive hormone levels in adult healthy men
PMID: 12525260
Effect of Lepidium meyenii Walp. on Semen Parameters and Serum Hormone Levels in Healthy Adult Men: A Double-Blind, Randomized, Placebo-Controlled Pilot Study
PMID: 26421049
Maca (Lepidium meyenii Walp.) on semen quality parameters: A systematic review and meta-analysis.
PMID: 36110519
A pilot investigation into the effect of maca supplementation on physical activity and sexual desire in sportsmen
PMID: 19781622

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