Can Chinese Herbs Treat Altitude Sickness?
I remember the first time a patient walked into my clinic and said, “Doctor, I can’t breathe, and it’s not getting better.” She wasn’t asthmatic. She wasn’t sick in any conventional sense. She had simply been sent to work in Lhasa — and her body was paying the price.
Altitude sickness is one of those conditions that Western medicine handles reasonably well in acute settings, but struggles with when it becomes chronic or subclinical. Acetazolamide helps some people. Supplemental oxygen helps more. But for the long-term high-altitude worker, the expat who never quite acclimatizes, or the mountaineer who develops symptoms despite prophylaxis — there’s a gap. And that’s where Chinese medicine has something genuinely useful to offer.
Ms. Wang was 28 years old, a software engineer from Chengdu, assigned to a six-month project in Lhasa. She had taken acetazolamide during her first week and felt fine. But by the third week, as the medication wore off, a different set of problems crept in.
She couldn’t sleep. Not the usual difficulty falling asleep — she would lie awake with a racing heart, feeling as though the air were thin even though she was breathing normally. Her appetite had disappeared. A dull, heavy pressure settled in her head. Her face became slightly puffy, her lips dusky. Climbing a single flight of stairs left her winded.
She went to the local hospital. Her oxygen saturation was 82% — low, but not dangerous enough to warrant urgent intervention. She was given supplemental oxygen and told to “rest and wait for acclimatization.” Three more weeks passed. Nothing changed. Her project deadline was approaching, and anxiety was setting in.
That’s when she came to see me.
Her pulse was thin and wiry, slightly rapid. Her tongue was pale with a bluish-purple tinge at the tip and edges, and slightly swollen.
In TCM, we see altitude sickness as a condition of qi deficiency with blood stasis. The reasoning runs like this:
“When qi is sufficient, blood circulates. When qi is deficient, blood stagnates.” — Ling Shu, Spiritual Pivot
At high altitude, the body encounters what the ancients called “thin qi” — a concept that maps remarkably well onto what we now know as reduced partial pressure of oxygen. The lungs receive less atmospheric qi, generating less qi for the body. Over time, a state of systemic deficiency takes hold.
When qi is deficient, it cannot properly propel blood. Blood stagnates — visible in Ms. Wang’s dusky lips and purplish tongue. This stasis in turn blocks the generation of fresh qi, creating a vicious cycle. Meanwhile, the spleen, weakened by deficiency, fails to transform food into nutrients, leading to appetite loss and fatigue.
I prescribed a modification of Bu Zhong Yi Qi Tang (Tonify the Middle and Augment Qi Decoction) — Li Dongyuan’s famous prescription from the Pi Wei Lun (Treatise on the Spleen and Stomach) — combined with blood-invigorating herbs:
Bu Zhong Yi Qi Tang addresses the root by tonifying spleen and lung qi. The genius of Li Dongyuan’s formula lies in Sheng Ma and Chai Hu — used in small doses for their lifting, raising quality. In altitude sickness, this lifting quality is particularly meaningful: we are literally trying to raise the body’s energy upward to compensate for the thin atmosphere.
To this base, I added Dang Gui, Chuan Xiong, and Dan Shen to break the blood stasis. Dan Shen deserves special mention — it improves microcirculation and has mild anti-hypoxic properties, making it especially well-suited for altitude-related conditions.
I also taught Ms. Wang a qigong breathing exercise: inhale slowly through the nose for a count of four, hold gently for a count of two, exhale through pursed lips for a count of six. Ten minutes, three times daily.
This is a simplified version of Tu Na breathing from the Dao Yin classics. The prolonged exhalation activates the parasympathetic nervous system, calming the anxiety and palpitations. Pursed-lip breathing creates positive end-expiratory pressure that improves oxygen exchange in the alveoli — a principle well-established in Western pulmonary medicine. Two traditions, one technique.
Within one week, Ms. Wang reported real improvement. She was still waking once or twice at night, but she could fall back asleep. The heavy sensation in her head had lifted. Her appetite returned. She had more energy.
By the second week, her oxygen saturation had risen to 89% — still below sea-level normal, but a meaningful jump. She was managing stairs without gasping. Her work performance had recovered.
At four weeks, she described herself as “90% normal.” She still felt the altitude during exertion, but her resting symptoms had largely resolved. I reduced the dose — halving Dan Shen and Chuan Xiong — for another two weeks as consolidation.
I have since used variations of this approach for several other patients with altitude sickness, including a group of mountaineers preparing for a Cho Oyu expedition. The results have been consistently encouraging.
But I want to be clear: Chinese herbs should never replace proper acclimatization protocols, supplemental oxygen, or descent when symptoms are severe. What they can do is fill the gap — the space between “not sick enough for hospital” and “not well enough to function.”
The TCM understanding of altitude sickness — qi deficiency leading to blood stasis — offers a framework that complements the Western physiological model. Where Western medicine sees hypoxia triggering compensatory mechanisms, TCM sees the body’s qi being depleted faster than it can be replenished, with blood stagnating as a consequence. Both are describing the same reality from different angles.
For practitioners working with patients at high altitude, my suggestion is straightforward: tonify the middle jiao to generate qi, add blood-invigorating herbs to break stasis, and teach simple breathing techniques to support the whole process. The combination is more powerful than any single intervention alone.
Professor Zhao Hanqing is a senior TCM practitioner at Beijing Heniantang, one of China’s oldest and most prestigious traditional pharmacies, established in 1405 during the Ming Dynasty. With decades of clinical experience, Prof. Zhao specializes in the integration of classical formula therapy with modern respiratory and altitude-related conditions, drawing on generations of accumulated medical wisdom from the Heniantang tradition.
Disclaimer: This case is presented for educational purposes. Individual results may vary. Always consult qualified healthcare providers before beginning any treatment.
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