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Altitude sickness, mountain sickness or AMS. You don’t want to experience it while trekking in Nepal. For years you have dreamt of your upcoming adventure to Everest Base Camp, Annapurna, the Dolpo region or the Manaslu Circuit. It doesn’t matter where you go in the Nepali Himalayas, you will experience some serious altitude. That attitude, although exciting, can be extremely dangerous. Let us tell you what altitude sickness is and, most importantly, how you can prevent it.* You are on your way to Everest Base Camp and you have been having the best of times. Everything has been going smoothly, you are enjoying the endless vistas and can’t wait to hit Kala Pattar. If you get there. All of a sudden you are overcome with nausea and you feel like you have to vomit. You had heard about it, but you didn’t think it would happen to you. Altitude sickness. It’s real.

What is Altitude Sickness?

Altitude sickness is pretty self-explanatory. Aso know as Acute Mountain Sickness (AMS) or simply Mountain Sickness, it is the health effect that kicks in when exposed to low amounts of oxygen at high altitude. Altitude sickness isn’t exclusive to the Himalayas, it can also occur when trekking on Mount Kenya, Kilimanjaro or when discovering the Inca Trail. At a lower altitude, up to 1,500m (5,000ft) you met experience breathlessness, but AMS usually only shows at 2,400m (8,000ft) and above. Left untreated, AMS can progress to more severe conditions like high altitude pulmonary edema (HAPE) or even high altitude cerebral edema (HACE). Although HAPE and HACE can be deadly, it happens to less than 1% of exposed unacclimatized trekkers. Although our itineraries are designed to allow for adequate acclimatization, you are likely to feel some sickness and can be short of oxygen while trekking. Altitude Sickness can happen to anyone, regardless of age or physical fitness.

Altitude Sickness Symptoms and Diagnosis

Symptoms of AMS start to show within a few hours after arrival at high altitude and include nausea, shortness of breath, headache and inability to exercise. An overall feeling of fatigue will take all the joy away that you were experiencing until things got bad. You may struggle to fall asleep, experience dizziness and have a severe headache. You may also lose your sense of coordination, have trouble walking and have a tight chest. If things progress to HAPE or HACE, you might get confused, have a shortness of breath at rest and you will likely be unable to walk at all. The higher the altitude, the more severe your symptoms can be. If you have watched Everest the movie, you know what we are talking about. But those guys were climbing and we are only trekking. There is a number of scoring systems for determining altitude sickness. Guides are trained in these systems and are experienced in immediate treatment. Although many people will experience some symptoms of altitude sickness, it doesn’t have to escalate. When aware of the symptoms, you can do a lot to make sure you stay healthy at high altitude.

Prevent Altitude Sickness while Trekking

There are a few rules of thumb that you need to take very seriously when being out there in the Himalayas. Your body is working hard to get accustomed to the new surroundings and it will let you know when it needs to take things easy.

Prepare Carefully

Consult your medical professional about 6 months before your trip. Have a full medical checkup and tell your practitioner what you are up to. Purchase medication recommended by your doctor. If you plan to be trekking with children, make sure you take their preparation just as carefully. Do you have any pre-existing medical conditions? Make sure you consult your doctor about this as well.

Get Fit

If you want to enjoy your trekking experience, make sure you do all you can to get physically fit. Do a lot of walking and try and cover some elevation if you can. Exercise about 3 to 6 hours a week with a backpack of 10kg to simulate an average day out in the Himalayas. Read here about what else you can do to get fit for trekking in Nepal.

Listen to Your Body

Your body tells you when it needs rest. Listen to it carefully. Be aware of the symptoms of Altitude Sickness and talk about it. Let your friends, your guide, your porters know how you feel and press pause when your body wants you to. Don’t let things get worse.

Climb High, Sleep Low

An unwritten law for trekkers and climbers alike is to climb high but to sleep low. That’s why those mountaineers on Everest take a long time to get to the peak, they go up and down a few times before they push for the peak. They climb high, but they sleep low. That’s why you sometimes see a descent in the middle of your itinerary. This is being done to ensure you that you acclimatize carefully after having tackled elevation.

More Food

Eat. Eat as much as you possibly can. Never skip a meal in a teahouse, even if you don’t like what you see on your plate. Your body is working hard and needs plenty of carbohydrates to go the extra mile and to be able to handle more elevation. Forget your diet and buy that extra candy bar. Trekking is hard work and easily makes you burn over 4,000 calories a day. Replenish, your body will be grateful.

Hydration is Key

Before and after food comes water. After that comes water again. Seriously, you will have to up your water intake. This is a lot easier when it’s warm and you transpire, but you have to be disciplined. Drink 3 to 5 litres a day and have another cup of tea. You are trekking and not partying - So leave the alcohol for after the trek. Alcohol stimulates AMS, not just because you are dehydrating while consuming alcohol.

Choose the right Itinerary

You have been dreaming about trekking in the Annapurna or Everest region for years and now you decide to cut your budget and basically run to that Base Camp. Why? Take it easy. Book the 15 instead of 12 days and treat yourself in the Namche Bazaar. There is plenty to do and spending more time on the same altitude will definitely help you acclimatizing.

Keep Note of Urination

Drinking more and being on a high altitude should inevitably lead to you having to make a leak more often. Take note of this. Simply, make sure that you are urinating more frequently than normal. If that is not the case, then you know what to do: Hydrate.

Travel Insurance

It doesn’t prevent you from experiencing altitude sickness, but it of importance in case you need medical assistance. Make sure your insurance provider covers you while traveling and also check if you are covered on high altitude. Insurance providers usually demand you to make an upgrade as soon as you intend to travel to high altitude destinations.

Feeling Sick. What now?

You are starting to feel sick and you fear that you are suffering from Altitude Sickness. What do you do? Communicate. Let the people in your group, your guide or your porter know that you are not feeling well. Guides and Porters are trained to spot the symptoms and can help you on the spot. Descend if you or your guide fears that you might be suffering from HACE or HAPE: The only way to increase your oxygen intake is to descend to a lower altitude. There you rest till you feel better. Acclimatize and come back stronger. *The information provided is a collection of tips and tricks collected from various sources. It is under no circumstance intended to replace the advice of medical professionals.

If you want to find out all you need to know about trekking in the Himalayas, don't forget to read our long-read article about Nepal trekking!

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