Protocol · Environmental & Performance
Acute Mountain Sickness Prevention & Relief Protocol
Ginkgo Biloba and Iron (if deficient) are the core of this stack, with 6 supporting supplements. Each row gives the amount the protocol lists and the grade our evidence database holds for that supplement in Acute Mountain Sickness Prevention & Relief.
We are re-verifying the studies cited on protocol pages; only confirmed citations are shown.
The stack
8 supplements · 1 graded
| Grade | Supplement | Amount listed | Why it’s in the stack | Evidence on file | Shop |
|---|---|---|---|---|---|
| Primary stackThe core of this protocol | |||||
| Ginkgo Biloba | Amount listed: 80–120 mg standardized extract twice daily, starting 5 days before ascent | Improves cerebral blood flow and oxygen utilization; mixed evidence but some studies show AMS prevention benefit
| Grade B for Acute Mountain Sickness Symptoms6 studies · 818 people | ||
| Iron (if deficient) | Amount listed: Check ferritin before trip; supplement if <50 ng/mL with 30–60 mg elemental iron daily | Essential for hemoglobin synthesis and oxygen carrying capacity; deficiency impairs altitude adaptation | Not graded yet | ||
| Supporting stackListed as additions to the core | |||||
| Rhodiola Rosea | Amount listed: 200–600 mg standardized extract daily, starting 1–2 weeks before ascent | Adaptogen that may improve oxygen utilization and reduce fatigue at altitude | Not graded yet | ||
| Beetroot Juice / Nitrates | Amount listed: 500 mL beetroot juice or 400–800 mg nitrate daily | Dietary nitrates convert to nitric oxide, improving oxygen efficiency and blood flow | Not graded yet | ||
| Coenzyme Q10 | Amount listed: 100–200 mg daily | Supports mitochondrial energy production which is challenged at altitude | Not graded yet | ||
| Vitamin E | Amount listed: 400 IU daily starting before ascent | Antioxidant that may protect against oxidative stress increased at altitude | Not graded yet | ||
| Vitamin C | Amount listed: 500–1,000 mg daily | Antioxidant; high altitude increases oxidative stress | Not graded yet | ||
| Electrolytes | Amount listed: Electrolyte supplement with sodium, potassium, magnesium during ascent | Replace losses from increased urination and respiration at altitude; prevent dehydration | Not graded yet | ||
Shop the evidence-backed picks
Support alongside medical care. These supplements are not a treatment for Acute Mountain Sickness. If you are being treated for it, talk to your clinician before adding one: supplements can interact with medicines.
The collection holds the supplements we grade A or B for its theme, in third-party tested products where the catalog has them. It opens in our Fullscript store. You can look through it without signing in; Fullscript asks for a free account to order.
Or shop one supplement
The supplement in this protocol graded A or B. Each opens third-party tested products, matched to the dose above where we can.
- Grade B
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How this protocol works
In plain language
Acute mountain sickness (AMS) occurs when you ascend to high altitude (typically above 8,000 feet/2,500m) faster than your body can acclimatize to the reduced oxygen. Symptoms include headache, nausea, fatigue, dizziness, and sleep disturbance. AMS can progress to more serious conditions: high-altitude pulmonary edema (HAPE) or high-altitude cerebral edema (HACE), which can be life-threatening. The best prevention is gradual ascent, but supplements may help support acclimatization.
CRITICAL: The most effective prevention for AMS is gradual ascent (climb high, sleep low), allowing your body to acclimatize. Above 10,000 feet, increase sleeping altitude by no more than 1,000-1,500 feet per day. Acetazolamide (Diamox) is the gold-standard medication for prevention and treatment. If symptoms worsen despite rest - especially if you develop severe headache, confusion, ataxia, or breathing difficulty - DESCEND IMMEDIATELY and seek medical help. These supplements may support acclimatization but don't replace proper ascent protocols or medication.
Ginkgo Biloba* improves blood flow and oxygen utilization. Some studies show it can reduce AMS incidence, though results are mixed. Start 5 days before ascent for best effect.
Iron* status is crucial for altitude adaptation because iron is needed for hemoglobin production. If you're iron deficient, your body can't make enough red blood cells to carry oxygen. Check ferritin before high-altitude trips.
Rhodiola Rosea* is an adaptogen traditionally used in high-altitude regions. It may improve oxygen utilization and reduce fatigue, though direct AMS prevention evidence is limited.
Beetroot Juice* provides dietary nitrates that convert to nitric oxide, improving blood flow and oxygen efficiency. Studies show benefits for exercise at altitude.
CoQ10* supports mitochondrial energy production, which is challenged when oxygen is limited at altitude.
Vitamins E and C* provide antioxidant protection. Oxidative stress increases significantly at altitude due to higher UV exposure and metabolic changes.
Electrolytes* are important because you lose more fluids through increased urination (altitude diuresis) and increased respiration. Proper hydration with electrolytes helps maintain performance.
Expected timeline: Start ginkgo biloba 5 days before ascent. Iron: 4-8 weeks if deficient. Other supplements: 1-2 weeks before and during ascent. Acclimatization takes 2-5 days at each significant altitude gain.