And it is all about my genetics. I am a lowlander by heritage, a Sami from Finland, and I carry genetic changes in NOS1AP that lower my ability to make nitric oxide at altitude. But the other factor is polymorphisms in GCH1, a gene linked to altitude adaptation:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5460084/
See GCH1 is the enzyme critically needed to make something called tetrahjydrobiopterin (BH4), and BH4 last at the center of the creation of all the catecholamines, like dopamine and serotonin, but also Nitric Oxide.
https://www.researchgate.net/figure/Fig-1-Tetrahydrobiopteri...
They make a drug called Kuvan which is a BH4 analogue but they only sell it in the EU because they want those of use with mental illness in the U.S. to suffer.
But zinc will increase the activity of GCH1 and alleviate many of these issues for me.
https://www.sciencedirect.com/science/article/abs/pii/S00062...
It has nothing to do with low oxygen, but rather low catecholamines.