Altitude Sickness Is Real — Take It Seriously

Acute Mountain Sickness (AMS) affects trekkers regardless of fitness, age, or experience. It can strike anyone above 2,500m. On our treks, the risk is relevant for EBC (up to 5,545m), Annapurna Circuit (up to 5,416m), ABC (4,130m), Langtang (up to 4,984m), and Mardi Himal (4,500m). Even Poon Hill at 3,210m can cause mild symptoms in sensitive individuals.

Symptoms to Watch For

  • Mild AMS: Headache, nausea, loss of appetite, difficulty sleeping, dizziness. These are common above 3,000m and usually manageable.
  • Moderate AMS: Severe headache not relieved by medication, persistent vomiting, increasing fatigue, shortness of breath at rest. This is a warning sign.
  • Severe AMS (HACE/HAPE): Confusion, loss of coordination, fluid in lungs (coughing, gurgling), inability to walk straight. This is a medical emergency — descend immediately.

Prevention

  • Acclimatize properly: Our itineraries include rest days at key altitudes. Do not skip them.
  • Climb high, sleep low: On rest days, hike to a higher altitude then return to sleep at your current altitude.
  • Stay hydrated: Drink 3-4 liters of water per day at altitude. Dehydration worsens AMS.
  • Do not rush: Walk at a comfortable pace. If you are gasping, slow down.
  • Avoid alcohol and sleeping pills: Both suppress breathing, which worsens altitude effects.
  • Diamox (Acetazolamide): Available in Kathmandu pharmacies without prescription. 125mg twice daily starting 1-2 days before reaching 3,000m. Consult a doctor first if you have medication allergies.

What Our Guides Do

Our guides carry pulse oximeters and check your oxygen levels and heart rate daily above 3,000m. They know the symptoms of AMS and will not let you continue ascending if you are showing concerning signs. If you need to descend, the guide will accompany you. If helicopter evacuation is needed, the guide coordinates with rescue services. This is why having a guide is non-negotiable — and why travel insurance covering helicopter evacuation is mandatory.

The Golden Rule

If you have symptoms of AMS and they are getting worse, descend. Even a few hundred meters of descent can dramatically improve symptoms. No summit, no base camp, no photo is worth risking your life. The mountains will be there next year.