The view is beautiful from the top of the world.
Everest is like a friend. Everest is God.
-- Babu Chhiri
KATHMANDU, NEPAL - The great Himalayan mountaineer Babu Chhiri, a Sherpa guide whose exploits are the stuff of legend, fell to his death in a crevasse on Mount Everest in April 2001, at the age of 35. He had reached the summit of Everest ten times before, had once stayed there for 21 hours without oxygen bottles (most climbers stay, with oxygen, only long enough to have their picture taken), and once blazed up the last 12,000 feet solo in only 17 hours (most climbers take two to four days of agonizing effort). Mr. Chhiri is survived by his wife and children.
One can only marvel at such phenomenal achievement by an actual human being, made of the same flesh and blood as our own. Well, not exactly the same, because there was a degree of high-altitude conditioning and aerobic capacity that probably exceeded that of any other human being who ever lived. Just try to imagine Chhiri's cardiorespiratory fitness, his metabolic efficiency, his sheer strength . . . . The mind boggles.
ANTIOXIDANTS ON EVEREST
By now you are surely wondering what this has to do with our subject. Nothing, except that it would have been fascinating to have had Chhiri as a kind of ultra-reference point against which to assess the physiological condition of a group of far less accomplished mountaineers - but Everest climbers nonetheless, which isn't too shabby - in a recent study of the effect of antioxidant vitamins and lipoic acid on acute mountain sickness (AMS).1 Lipoic acid (technically, alpha-lipoic acid) was once thought to be a vitamin, but we now know that it's not. It is, however, regarded as the ideal antioxidant by Dr. Lester Packer of the University of California, Berkeley, one of the world's leading authorities on the subject.
Lipoic acid has protective effects on the brain, the heart, and much more.
It's possible to experience some degree of AMS, also known as altitude sickness, even in the United States, if one goes high enough into the Rockies or the Sierra Nevada, or especially the Alaska Range, which is much higher. The chief symptom of moderate to severe AMS is cerebral edema, a swelling of the brain, which you definitely don't want to have. To say that it can be incapacitating is an understatement, and many a highly conditioned mountaineer has been defeated by it on the slopes of the world's great peaks. Some have been killed by it. The irony is, they don't know whether they will fall prey to it until they get there. It can be a very expensive and frustrating way to learn about one's limitations.
ASKING FOR TROUBLE
All the more reason, then, to try to find a remedy - a better remedy than the currently used drugs, which are not very effective and have adverse side effects - that might prevent or alleviate the swelling and allow the climbers to push on toward their lofty goal. That was the goal of this study, which involved a group of 18 physically active, apparently healthy mountaineers (16 men and 2 women, average age 35) who were embarking on an Everest expedition.
These climbers were judged to be likely candidates for AMS on the mighty mountain, because all of them were permanent lowland residents with limited Himalayan experience. (The study was conducted by a pair of physiologist-climbers from the Health and Exercise Sciences Research Laboratory at the University of Glamorgan in South Wales, so most or all of the subjects were presumably from Great Britain.)
A WELL DESIGNED STUDY
The study, despite its highly unusual circumstances, was conducted in classic fashion as a randomized, double-blind, placebo-controlled trial, to ensure that the results would be meaningful and not tainted by the placebo effect, which would cause the subjects to feel better simply because they believed (desperately, perhaps) in the power of the pill to achieve this, even if the pill was in reality ineffective.
The climbers were randomly divided into two groups of nine each. For three weeks at sea level, and then during the ten-day ascent to the base camp in Nepal, at 17,000 ft (5180 m),* they took, in pill form four times a day, either a placebo or a combination of vitamin C (1000 mg/day), vitamin E (400 IU/day), and alpha-lipoic acid (600 mg/day). To prepare their bodies as "clean slates" for the study, they had been requested not to take any antioxidant vitamins or food supplements for four weeks before it began, and during the climb they were not permitted to take any anti-AMS drugs, which would have invalidated the study.
*The authors didn't mention whether the group ever got beyond the base camp, where the study came to an end. One presumes that they didn't.
ANTIOXIDANTS ARE EFFECTIVE
The effectiveness of the antioxidants was evaluated by subjecting the climbers periodically to a battery of functional and clinical tests to assess their physical condition - which turned out to be not too good, especially for the control group. All nine of them suffered from AMS, whereas only five of the nine antioxidant test subjects did. This difference, however, was not statistically significant, according to accepted methods for evaluating such things. What was statistically significant was the difference in physical symptoms between the two groups. These were summarized through the Lake Louise Consensus scoring system, which assigns overall numerical values based on the physiological test results.
The worse the symptoms, the higher the score.
And here are the results: the control group scored about 50% higher in symptoms than the antioxidant test group. The researchers concluded that ". . . dietary antioxidant vitamin supplementation . . . is an apparently safe and potentially effective intervention that can attenuate AMS and improve the physiological profile of mountaineers at high altitude." The authors could not, of course, determine what the relative contributions of the three different ingredients were, but it's safe to say that lipoic acid played a major role.
LIPOIC ACID CAN BENEFIT EVERYONE
Well, so what, you might be thinking - I'm not planning to climb Mount Everest anytime soon, so what good does this do me? The simple answer is: if lipoic acid can alleviate the symptoms of AMS in the Himalayas, it can probably help with the stresses your body is subject to - particularly if you get a lot of exercise (which you should). Paradoxically, although exercise is undoubtedly the single most important factor in maintaining good health, it is also known to be a source of oxidative stress caused by the generation of free radicals, those highly reactive molecules that are strongly implicated in the aging process.2
But whether you exercise a lot or not, you can benefit greatly - as everyone can - from the versatile antioxidant action of lipoic acid, which manifests itself in so many ways that it will take another article to give an overview of them.** Stay tuned - and stay on top of your world with the power of antioxidants.
1.Bailey DM, Davies B. Acute mountain sickness; prophylactic benefits of antioxidant vitamin supplementation at high altitude. High Alt Med Biol 2001;2(1):21-9. 2.Bailey DM, Davies B, Young IS. Evidence for reactive oxidant generation during acute physical exercise and normobaric hypoxia in man. J Physiol 2000;C27:47P.