Green Valley Nepal Treks
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High Altitude Sickness

Altitude acclimatization rule - Altitude sickness in Himalaya – Altitude sickness on trekking – high altitude sickness - Acclimatization

Acclimatization is very important to do a trekking on high altitude area. Nepal Trekking routs planned specially a gradual to get use in altitude with many of our trekking trails having extra days to allow time for acclimatization. Green Valley Nepal Treks offer advice about acclimatization and with the sensible approach we take on all of our treks, anyone who is fit and healthy should have few problems. On our trekking, climbing trips in Nepal and trekking trips in Tibet we carry a portable altitude chamber as an extra safety precaution.

To make sure that you return from trekking in the Himalayas in Nepal with a lot of happy and unforgettable memories, it is very important that you are aware of the altitude acclimatization required by the human body in mountain conditions. By observing a tried and tested altitude acclimatization regime about which I’ll tell you below, you’ll succeed in avoiding altitude sickness which can not only provide you with unpleasant moments, but could also force you to change your trekking plans.

Green Valley Nepal Treks suggest 10 golden rules for successful altitude acclimatization to way from high altitude sickness:

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

The most important and best way of avoiding altitude sickness whilst trekking in Nepal is to increase altitude gradually and systematically. In Nepal a safe altitude to which you can climb rapidly and straight away is: 2,700 – 3000 m. The most popular mountain airports in Nepal are located in this altitude range: Lukla and Jomsom. On the day of your arrival, you must definitely spend the night at the same altitude.

Afterward you must stick to a set climbing regime: 300 – 400 altitude meters a day. Having climbed a total of 1,000 altitude m, you must have one whole day to altitude acclimatization and stay overnight at the same altitude. In Nepal, you will not find it possible to stick to exactly this climbing rule on all trekking routes in the Himalayas, therefore altitude acclimatization days are individually planned for each trekking route.

2. Consume lots of liquids while trekking

In the mountains, atmospheric pressure falls as the altitude above sea level increases and this affects your body. Therefore, when trekking in the mountains it’s very important to consume a lot of liquids by drinking lots of tea, juice, soup and clean water. You should drink at least 3 -4 litres of liquid a day. You can buy a liter of bottled water in teahouses along all the most popular trekking routes in Nepal.

3. Avoid alcohol, smoking and using sleeping tablets

When trekking in the mountains, particularly during your ascent you must categorically avoid the use of alcoholic drinks and sleeping pills. Like smoking, calming unnaturally reduce the flow of oxygen to the brain, particularly in mountain conditions in which the concentration of oxygen is already reduced. In turn, alcohol has the heightened effect of depriving the body of water or dehydrating it which is a similarly undesirable process when trekking in the Himalayas in Nepal.

4. Use preventive medicines whilst trekking

Mountain medicine has discovered a range of medicinal products that improve the altitude acclimatization process and reduce the side effects of altitude acclimatization in the mountains such as sleepless nights. These products are widely used by trekkers on popular trekking routes in Nepal like the Everest Base Camp trek, Gokyo trek, Annapurna Circuit trek, etc.

Acetazolamide or Diamox
Of all the medicinal products use to aid altitude acclimatization and treat altitude sickness the most popular is Diamox, whose active substance is Acetazolamide. On the Everest Base Camp trek Diamox is widely on sale without prescription in Kathmandu, Lukla and Namche Bazaar.

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.

Before trekking it is advisable to start using Diamox 24 hours before your ascent and once you’ve started trekking you should use Diamox twice a day in doses of 125 – 250 mg depending on your body weight in the late morning and in the evening. Kids should be administered a Diamox dose of 2.5 mg per kg of body weight twice a day. It’s important to take Diamox before going to bed, 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 oedema.

It’s true that Diamox can cause some side effects of which the most common are light tingling of the hands and finger tips, blurred vision, etc. Diamox can also induce allergic reactions; therefore it is recommended that you consult your doctor before use. According to some sources, you should stop taking Diamox on the second or third day after reaching the maximum height on your trekking route, while others say that it is not recommended to use Diamox for longer than 3 -5 days in a row.

Garlic soup
One of the best natural recipes for aiding altitude acclimatization that is often recommended by trekking guides in Nepal is garlic and the popular garlic soup served in Nepal’s trekking lodges and teahouses. At first it is likely to taste quite strange, but as you get used to it – you’ll begin to get a taste for it. Garlic soup is also widely available along the Everest Base Camp trek route.

5. Avoid overexertion from carrying overly heavy rucksacks whilst trekking

Bearing in mind the physical strain and changes in mountain conditions, whilst trekking you would be well advised to avoid overexertion and leave the carrying of your heavy bags to bearers. This doesn’t cost much and you can a hire a Sherpa to carry your bags. If you still plan to carry your own rucksack; optimally its weight should not exceed: 10 -12 kg.

6. Don’t go trekking alone

You should always take a guide with you when trekking in the mountains. Altitude sickness symptoms can induce panic or wild behavior so you must have somebody alongside you who can help you at any time you find yourself in trouble. Typically, altitude sickness symptoms get worse at night due to problems acclimatizing to the new altitude reached during the day. If symptoms of altitude sickness force you to depart and descend at night, you simply must have your guide with you at all times!

7. Don’t climb higher even if you are only suffering from mild symptoms of altitude sickness


If, after reaching a new altitude on your trekking route, you begin to experience mild symptoms of altitude sickness, you must not climb higher under any circumstances! 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 start appearing in the form of a mild headache which may disappear in a few hours, or, on the contrary, get worse, accompanied by panic, loss of appetite and nausea. Trying to fall asleep you experience wild dreams and mild hallucinations.

During this period, even though you’ve lost your appetite, it’s very important to drink a lot of fluids and to eat, if you haven’t already done so. Garlic soup is recommended as well as Diamox or some headache tablets which liquefy blood and improve blood flow: Paracetamol, Aspirin, Tylenol or Ibumetin.

8. Descend immediately if your altitude sickness symptoms get worse

If the usual painkillers used to treat headaches (Aspirin, Tylenol, Ibumetin, etc.) don’t help and your headache doesn’t pass, this indicates that the altitude sickness is getting worse. In the event that upon reaching a new altitude along the trekking route the symptoms of altitude sickness don’t pass and get worse; the most effective treatment is to descend without delay to a lower altitude. You must descend without delay even at night. You must be accompanied by your guide and take everything with you that you need for the journey. Under no circumstances should you descend alone.

In such circumstances you should reduce your altitude to at least the altitude at which you made your previous overnight stay where you didn’t notice any signs of altitude sickness and, if possible; descend even lower. You will feel the benefits after reducing your altitude by 500 – 1,000 altitude metres. You should use medicines, additional oxygen and your compression bag or Gamow Bag if you have them available.

9. Never leave anybody alone with signs of altitude sickness

Never leave a person showing signs of altitude sickness alone. He/she could begin to experience rapidly deteriorating altitude sickness symptoms and it may be necessary to urgently evacuate him to a lower place.

10. Dress warmly when trekking and don’t overexert yourself

You should keep warm at all times when trekking and prevent your body from cooling, particularly during the first stage of altitude acclimatization. Check to make sure that your clothing is always dry. In the mountains the air is dry and it’s usually windy. As sweat evaporates, it increasingly cools the body, narrowing arteries and reducing the supply of blood and oxygen reaching your organs, thus creating conducive conditions for altitude sickness to get worse. Special technical clothing has been invented for trekking in the mountains, which ensures that the body breathes and gets rid of sweat as effectively as possible.

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Green Valley Nepal Treks

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