Altitude Acclimatization 10 Golden Rules

High-altitude treks, such as Everest Base Camp, Annapurna Circuit, and Manaslu Circuit, come with the inherent risk of altitude sickness. Though it is impossible to completely eradicate the chances of catching altitude sickness at high elevations, here are some ways to minimize the chances.

 

1. Increase altitude gradually and stick to a set climbing regime

The best way to avoid altitude sickness is to increase altitude gradually and systematically. You can safely travel up to 2,700 – 3000 meters without acclimatizing. Popular mountain airports in Nepal, Lukla and Jomsom, lie in this altitude range. If you are traveling to these airports, we advise you to spend the night at an altitude comparable to these airports.

After reaching 3,000 meters, you must stick to a set climbing regime. You should only gain a height of 3,00 to 400 meters a day. Accordingly, you should sleep at an altitude only 300 – 400 meters higher than your previous night. After gaining an altitude of 1,000 meters, you must acclimatize for a day and stay overnight at the same altitude.

 

2. Consume lots of liquids while trekking

In the mountains, atmospheric pressure falls as the altitude increases, affecting your body. Respiration increases, and with a higher respiration rate, your body loses water faster. Therefore, when trekking in the mountains, you must take lots of liquids such as tea (green) tea, juices, soup, and clean water. We recommend you drink at least 3 -4 liters of liquids per trek day. You can buy bottled water from teahouses along the trek routes. 

However, you should avoid drinking too much black tea or coffee because these drinks can induce heart palpitations and create additional pressure on your heart.

 

3. Avoid alcohol, smoking, and using sleeping tablets

You must categorically avoid alcoholic drinks, sedatives, or sleeping pills while gaining elevation. Smoking or sedatives artificially reduce oxygen flow to the brain, in mountainous regions, where oxygen concentration is already low. Moreover, alcohol deprives the body of water and dehydrates it.

 

4. Use preventive medicines while trekking

There are several medicines that aid the acclimatization process and reduce the side effects, such as sleepless nights. Many trekkers on popular trek routes, such as the Everest Base Camp, Gokyo, and Annapurna Circuit trek, take these medicines.

Acetazolamide and Diamox

The most popular medicine for altitude sickness is Diamox. It contains an active chemical called Acetazolamide. You can buy Diamox without a prescription in Kathmandu, Lukla, and Namche Bazaar. One strip of Diamox contains ten 250 mg tablets and costs around 150 – 200 rupees.

Possible alternative names (trademarks) for Acetazolamide include Acetamox, Acetazolam, Ak-Zol, Apo-Acetazolamide, Atenezol, Cidamex, Dazamide, Defiltran, Dehydratin, Diacarb, Diakarb, Diamox, Didoc, Diluran, Diuramid, Diureticum-Holzinger, Diuriwas, Diutazol, Donmox, Duiramid, Edemox, Eumicton, Fonurit, Glaupax, Glupax, Natrionex, Nephramid, Nephramide, Phonurit, Storzolamide, and Vetamox.

You should start taking Diamox 24 hours before your ascent, and once while trekking, you should use Diamox twice a day (once in the morning and once in the evening) in doses of either 125 or 250 mg, depending on your body weight. 

The optimum Diamox dose for children is 2.5 mg per kg of body weight twice a day. It’s important to take Diamox before sleeping because it deepens the depth of inhalation during sleep, thus improving the body’s supply of oxygen. Diamox is an effective means of preventing pulmonary edema.

Diamox can cause side effects, such as light tingling of the hands and fingertips, blurred vision, etc. It can also induce allergic reactions. Therefore you should consult your doctor before using it. You should stop taking Diamox on the second or third day after reaching the maximum height in the trekking route. Some experts advise against using Diamox for longer than 3 -5 days in a row. 

In traditional medicine, Acetazolamide is also used to treat epilepsy and glaucoma.

Ginkgo Biloba Extract

Studies on the effectiveness of Ginkgo biloba extract during the altitude acclimatization process are continuing, but, so far studies have shown that it is effective in helping to reduce symptoms of altitude sickness during trekking. Ginkgo biloba functions as an antioxidant, reducing stress and increasing the oxygen supply to the brain.

We recommend you start using Ginkgo biloba in doses of 80 – 120 mg twice a day for five days before heading to the high elevations.

Ginkgo biloba extract is a natural product made from ginseng and may be used for prophylactic purposes to improve brain functions. You can buy Ginkgo biloba in pharmacies as a nutritional supplement without a prescription.

Garlic Soup

One of the best natural recipes for aiding altitude acclimatization is garlic, and you can get garlic soup throughout lodges and teahouses in trek regions in Nepal. At first, you might find the taste strange, but as you get used to it – you might even love it. Garlic soup is widely available in lodges/hotels along the Everest Base Camp trek route.

 

5. Avoid overexertion from carrying overly heavy rucksacks 

Trekking with a heavy load will lead to overexertion. So we advise you to use professional porters instead. You can hire Sherpa porters to carry your bags cheaply.

 

6. Don’t trek alone

You must take a guide with you while trekking in the mountains. When altitude sickness symptoms show up you might panic so you need a person with you who can help you in such a situation. Typically, altitude sickness symptoms get worse at night as the body struggles to acclimatize at the new altitude gained during the day. In case, you get seriously affected, you might have to descend immediately. Hence, you must take a guide with you. 

 

7. Don’t climb higher as your body shows mild altitude sickness signs

If you begin to experience mild altitude sickness symptoms, you must not climb higher. Instead, you must remain at your current altitude and monitor your symptoms. Usually, altitude sickness symptoms begin to appear 6 -12 hours after reaching a new altitude. Symptoms may start appearing in the form of a mild headache, which may disappear in a few hours, or, on the contrary, get worse and you find yourself panicked, with a loss of appetite, and nauseated. Other symptoms include difficulty falling asleep, bad dreams, and even mild hallucinations. 

Even if you lose your appetite, you must drink lots of liquids and eat properly. We advise you to take garlic soup, Diamox, and pills that improve blood flow: Paracetamol, Aspirin, Tylenol, or Ibumetin.

 

8. Descend immediately if altitude sickness symptoms get worse

If the usual painkillers for headaches (Aspirin, Tylenol, Ibumetin, etc.) don’t help and your headache doesn’t go away, this indicates that the altitude sickness is getting worse. If the symptoms of altitude sickness don’t pass as you reach high altitude, you must descend immediately, even during the night. However, you shouldn’t descend alone, take your guide with you along with your essentials. 

If you must descend, you should descend to an elevation where you were not affected while spending the night. You will feel a sense of relief when you reduce your altitude by 500 to 1000m. We advise you to take medicines, additional oxygen, and your compression bag or Gamow bag if available.

 

9. Never leave anyone with signs of altitude sickness

Do not leave anyone showing signs of altitude sickness alone because the conditions might deteriorate further, and the affected person might need urgent evacuation to lower regions. If the situation is critical, helicopter rescue might be necessary. Hence, if you are trekking to high elevations, you must purchase adequate insurance that also covers high-altitude helicopter rescue.  

 

10. Dress warmly, and don’t overexert yourself

You must keep your body warm at all times, particularly during the first stage of altitude acclimatization. Make sure that your clothing is always dry. In the mountains, the air is dry and windy. As sweat evaporates, it cools the body rapidly, narrows arteries, and reduces the supply of blood and oxygen reaching your organs. It leads to a situation that deteriorates altitude sickness. There are technical clothes available in the market that are manufactured especially for trekking in the mountains. You should consider buying them.

If you follow the above rules, your chances of catching altitude sickness decrease substantially, and you can enjoy your trek to the fullest.