Ketosis and height acclimatization - any relationship?

(Elli S) #1

Hi all,
Does anyone know of any relationship between Ketosis and rate of height acclimatization?
I have been invited to take a hiking trek in Yidong, Sichuan, China. I know that it is highly recommended to acclimatize slowly to the height before going to avoid danger due to lower air pressure and relative shortage of oxygen. There are guidelines discussing how long this process takes.

Is there any reason to assume that because I am ketoadapted that this process should take me longer, or shorter, than a “regular” person? Any studies to base myself on?

I am now on a ketogenic diet for some 15 months (52YO male) after being diagnosed with T2 Diabetes. I have reduced my HbA1C from 7 to 5.2 and lost a lot of weight.
I am hoping that I can stay on ketosis while trekking, and wondering whether that gives me an advantage or disadvantage?


@Fiorella has some experience with this.


I can’t remember the details but I think it was on a Tim Ferriss podcast - maybe Dom D’Agostino? - talking about two people doing an intense climb (or bike trip at high altitude?) while keto. I don’t remember too much more than that but it sounded like keto helped them a lot, that they were able to do it without the usual altitude supplements/help.


I have experience going into very high altitudes in ketosis, and can say that being in ketosis was a huge advantage for me.

My ascents were in excess of 4000 metres, and to go where I was going, I needed to get a medical check up with clearance from doctors (I.e. Certified to do high altitude). That’s where they put you on a treadmill, connected to electrodes, and read outs sent to 2 doctors who both have to agree you are ok to go.

The best way is to sleep overnight at a low high altitude, like 2000 or 2500 metres, and then proceed the next day. If you feel bad at 2000, then take it easy, stay another day at lower levels.

You will experience hypoxia (oxygen starvation) at ultra high altitude, but your body will compensate by making more red blood cells. This is why I eat a bit of liver every day for about a week or two before the climb. I make sure I have lots and lots of iron for my body to make hemoglobin (red blood cells). You will also be thirsty a lot (air very dry) which will deplete your electrolytes…so eat/drink lots of broth to restore electrolytes.

People who have a hard time coping at high elevations get massive headaches. If you do, take it easy. To releive the pain of the headache, you can take a bit of oxygen from a bottle…but, be careful. Just do maximum 15 minutes, and go to sleep / lie down and rest. Don’t stay connected to breathing oxygen because you need to teach your body to cope and acclimatize. Oxygen will stop acclimatization. Only in an emergency do you want to continuously feed oxygen supplementation to a person at high altitude.

Dave Asprey got his inspiration for the fatty bullet proof coffee after seeing high altitude natives in Asia drinking fatty tea with yak butter and cream. Like “butter tea” in the Bhutan region. They are in ketosis and eat lots of fat in their diet. It says something when people who are indigenous to high altitude that they eat tons of fat when on high altitude climbs. Dominic Dagostino also did some research on high altitude and benefits of ketosis, too.

Hope this helps!

(Elli S) #5

Thank you all for your responses.
Why should this be so? Is this because in ketosis we need less oxygen?


Just remembered i recently read an article about this.

Spoiler Alert: he did it with keto

(Michele Wilson) #7

I got pretty bad altitude sickness while hiking the Inca Trail, pre-keto. It felt like a very intense keto flu - headaches, inability to sleep, constant thirst (and urination!), and then nausea, followed by food aversion. Also, near the end of the trip I drank some electrolytes, which helped. I can’t help but think this wouldn’t have happened if was fat adapted. I’ve been curious about your question ever since!


The RQ for fat metabolism is around 0.75 vs 1.0 for sugar metabolism . It makes a big difference. Less oxygen is needed for energy with ketosis. Remember it takes 3 months to make a lot of new blood cells … that’s 1% per day.

Ref: That 2KD podcast on the RQ topic.


I think it’s because of more than one thing. Yes, less oxygen is required. But, what I feel during high altitude climbs on keto is greater stability of blood sugar during the day. As you know, it is hard for the body to do exercise at high altitudes, so with better sugar levels in the blood, the body functions better. Also, very high altitudes causes people to lose their appetite. While this sounds good for those who think it will spontaneously make them eat less, it wreaks havoc with their energy levels and metabolism. They lose energy and get tired very easily. With eating keto, you maintain high metabolic rates, and fast spontaneously, because of the fat adapted state. So, you are better equipped to stay active longer during the day at high altitude. I easily outlast my non-keto companions at high altitude.


@Fiorella I have to accept your experience. I have summitted the highest peak in Australia , Mt Koscuiszko. But hey, it’s only about 2000 meters and pretty much like walking across a grassy meadow.

I actually loved reading your high altitude experiences. Sounds like keto was your secret weapon while others were suffering more from the altitude, fatigue and stress.


yeah…keto is definitely a good secret weapon for ultra high altitudes! I’ve done it in the past when not in ketosis and there is a huge difference. The best part is not having the headaches and being able to sleep. This is a massive advantage. The non-keto folks I’ve been with at ultra high altitudes are impossible to talk to…very grouchy, can’t concentrate on what I’m saying and they just want to be left alone (as they suffer in pain). I get up in the morning, all bright-eyed and bushy tailed, smiling, talkative, and so on…and they tell me to shut up…it’s quite funny actually.


Do they also scold you for your ‘unhealthy’ food choices?


oh yes! and of course…I really flaunt the eating as much fat as I want. They see me refuse to eat the bread and so on. And then I get the “but, it is impossible to not eat bread” argument. Such BS. After a while, anyone will forget about bread…I did. I don’t miss it at all!

(kmd) #14

I live near the sierras. I hike there often - generally hikes range from 7 to 11,000 feet. I spent a week at 10 or 11,000 feet earlier in the summer - no real issues. I’d only been in ketosis for about a month, when I hiked (with a 30 lb backpack) from 7,500 feet to about 10K feet. Within the first 15 minutes of the hike I was far behind the group (usually I’m in the front). Within the first 1-2 hours I was breathing heavy, my heart felt constrained, I felt out of shape and eventually I vomited all the snacks and lunch I ate; eventually I couldn’t keep water down and stopped hiking. I think the keto diet was the only difference between this trip and the prior trip. Perhaps my body is not fully adapted - that said that was the worst I have ever felt in my life.


You could also have had a virus.


oh dear - this sounds miserable! I wonder the same thing - whether your hike coincided with a bug.
But from what I’ve read the shift to fully accessing fat can take some time, well past the usual ketoflu weeks. I think the recommendation for athletes is to start it in the off season so that they have several months (4,6) before they need to really rely on ketosis.