Protocol · Respiratory Health
Chronic Mountain Sickness Support Protocol
Iron and Vitamin D are the core of this stack, with 7 supporting supplements. Each row gives the amount the protocol lists and the grade our evidence database holds for that supplement in Chronic Mountain Sickness Support.
We are re-verifying the studies cited on protocol pages; only confirmed citations are shown.
The stack
9 supplements · none graded yet
| Grade | Supplement | Amount listed | Why it’s in the stack | Evidence on file | Shop |
|---|---|---|---|---|---|
| Primary stackThe core of this protocol | |||||
| Iron | Amount listed: 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 | Not graded yet | ||
| Vitamin D | Amount listed: 2,000–4,000 IU daily | Supports bone health and immune function; deficiency common at altitude with reduced sun exposure; may support cardiovascular health | Not graded yet | ||
| Supporting stackListed as additions to the core | |||||
| Omega-3 Fatty Acids | Amount listed: 2–3 g EPA+DHA daily | May improve blood rheology (flow properties); anti-inflammatory effects | Not graded yet | ||
| Vitamin E | Amount listed: 400 IU daily | Antioxidant; may protect against oxidative stress from hypoxia | Not graded yet | ||
| CoQ10 | Amount listed: 100–200 mg daily | Supports cellular energy production under hypoxic conditions | Not graded yet | ||
| Beetroot Juice | Amount listed: 500 ml daily | Dietary nitrates may improve oxygen efficiency; studied at altitude for exercise performance | Not graded yet | ||
| Ginkgo Biloba | Amount listed: 120–240 mg standardized extract daily | Improves microcirculation; has been studied for altitude-related symptoms | Not graded yet | ||
| Antioxidant Complex | Amount listed: Comprehensive antioxidant formula daily | Combination of vitamins C, E, selenium to protect against hypoxia-induced oxidative stress | Not graded yet | ||
| Garlic | Amount listed: 600–1,200 mg standardized extract daily | May improve blood flow and oxygen delivery; traditionally used at altitude in some cultures | Not graded yet | ||
Shop the evidence-backed picks
Support alongside medical care. These supplements are not a treatment for Chronic 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
Each opens third-party tested products, matched to the dose above where we can.
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How this protocol works
In plain language
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.