the average health care provider knows a smattering about high altitude, Diamox, and for that matter, a lot of wilderness medicine. They often did not get the training (you can't take every course, or see every condition) or if they did they don't get the ongoing experience to stay proficient. High altitude medical care is a niche. High altitude illnesses rank from headache to death. I've seen the gamut.
not much to add to what has been said. Some need or tolerate tiny doses, some more. The patient is the one who has to learn the individualization.
I have a friend who in 2012 took 1,000 mg daily plus a nuclear weapon dose of steroids (16 mg dex)daily for 3 weeks when he went to 18,000 ft in Nepal. There are legitimate studies that say this helps for altitude of that sort (not Whitney). Claims he had no side effects from either drug. Others might have had a bleeding ulcer or gone into steroid-psychoses with that.
125 mg twice daily is a common compromise dose for Diamox.
It is not a panacea.
