The Ultimate Guide to Hiking Colorado's Fourteeners

Fifty-four peaks. More than 140 routes. And hundreds of thousands of feet in elevation. Here, the ultimate beginner’s guide to climbing Colorado’s famous fourteeners.

June 2013

—Photos by Jeff Nelson

Dr. Peter Hackett, the founder of Telluride’s Institute for Altitude Medicine and one of the world’s leading experts on high altitude–related illness, talks about reducing the risk of altitude sickness and who shouldn’t climb fourteeners. —LBK

Can Denverites get AMS while hiking a fourteener? Yes, but it is usually mild: Headaches, heaviness in the legs, and shortness of breath are normal when going to 14,000 feet. Some folks will also get nauseated. Denverites will have about half the incidence of AMS compared to lowlanders.

What can peak baggers do to combat AMS? Hike at a steady but moderate pace. Avoid dehydration by drinking enough to maintain clear urine. If you’re accustomed to caffeine intake, be sure to have your usual amount the day you’ll be climbing. And stay fit—although AMS is not directly related to fitness, being fit makes the hike more enjoyable and a touch of AMS easier to tolerate. Take ibuprofen with you on the hike, and either use it at the first sign of a headache or take it preventively. As long as the hike is a day-trip, and you will be returning to a lower altitude within hours, there is no danger of serious illness, so immediate descent is generally not necessary when AMS develops. That is, it is safe to push on to the summit with some symptoms.

What don’t most people understand about physical exertion at high altitudes? That exercise capacity is markedly reduced, and that intensity of exercise needs to be reduced to avoid exhaustion. Also, the greater the exertion, the more likely they’ll experience symptoms of AMS.

Are there any pre-existing conditions that may make climbing a fourteener a bad idea? Yes. Most doctors recommend not going over 11,000 to 12,000 feet during pregnancy, but this is not based on data, and it’s unlikely that a one-day exposure to high altitude would cause problems. Since we’re dealing with day-trips, most problems such as high blood pressure, diabetes, and atrial fibrillation are not a concern. But in terms of impacting performance, lung disease is at the top of the list. People with chronic obstructive pulmonary disease or cystic fibrosis will not generally do well. Neither will those with heart failure or pulmonary hypertension. However, it is not necessarily dangerous to go to altitude for these folks; it’s more that they won’t be comfortable and might have to turn around. The most important advice relates to exercise ability at low altitude: If a person can exercise with moderate to high intensity and/or duration at low altitude, they will generally do fine at high altitude.

Is there anything available over the counter that helps combat AMS? People always want to know about herbs, supplements, and vitamins. The only such products ever shown to help with AMS are ginkgo biloba—about 100 mg twice a day for one to three days before climbing—and ibuprofen at 600 mg three times a day on the day of your hike.


—Model apparel generously provided by Patagonia Denver