Altitude sickness: the part of trekking people get wrong
Every season we meet trekkers who have trained for months, arrive in superb condition, and get turned around at 4,500 m — while somebody twice their age walks past. This surprises them every time, and it should not.
Fitness is not the variable
Altitude sickness is your body reacting to less oxygen. How strong your legs are does not change how fast you produce red blood cells. If anything, fit people are at slightly higher risk, because they can climb faster than their body is adapting — and speed of ascent is the actual variable.
What to look for
- Headache that does not clear with water and rest.
- Nausea or loss of appetite.
- Dizziness, or unusual breathlessness at rest.
- Broken sleep — common, and only a concern alongside other symptoms.
- Loss of coordination, or confusion — this is serious and means descend now.
How to give yourself the best chance
- Ascend slowly. Above 3,000 m, aim to raise your sleeping altitude by no more than 300–500 m a day.
- Take the acclimatisation days. Climb high, sleep low — it works.
- Drink far more water than you feel like drinking.
- Avoid alcohol and sleeping tablets at altitude.
- Tell your guide how you feel, honestly. Playing it down helps nobody.
About medication
Some trekkers take preventative medication. That is a conversation for your doctor before you travel, not for a blog or a guide on the trail — it depends on your history and on what else you take. What no medication does is replace a sensible ascent profile.
The mountain is not going anywhere. Turning around is not failure — it is the decision that lets you come back.
— Dawa Lama
Our guides have the final say
On every trek we run, the guide can call a descent, and that decision is not negotiable. It is made for your safety, it is occasionally unpopular in the moment, and it has never once been the wrong call.