24th Aug, 2025

Altitude Sickness

- Magnificent Himalayan Treks

Acute Mountain Sickness, sometimes known as altitude sickness, is by far the most serious concern to anyone walking in Nepal's higher (above 3000m+) routes. This potentially lethal illness is caused by a combination of decreased oxygen and lower air pressure interacting with the body.

Almost everyone who treks beyond 3000m will have moderate symptoms such as dizziness, headache, and difficulties sleeping. Other symptoms of altitude sickness include fatigue, nausea, shortness of breath, and loss of appetite. Difficulty sleeping is another sign, however many people experience it even if they don't have any other symptoms.

Mild altitude sickness usually lasts a short time and is a result of your body adjusting to the decreased oxygen levels at altitude. If you have these mild symptoms, rest and drink plenty of water or ginger tea; they should disappear fast.

If symptoms persist or worsen, and a strong headache and vomiting occur, moderate or severe altitude sickness is likely. This is far more serious, and the best thing to do is get to a lower level as soon as possible, even if it's in the middle of the night.

Normally, you don't have to drop very far (a few hundred meters of elevation reduction should suffice) for the symptoms to begin to improve. You may need to hire a porter to help transport the sufferer down the mountain swiftly. Ignoring AMS can swiftly progress to grave issues, even death.

When a person has a severe case of altitude sickness, fluid accumulates in the lungs. This is referred to as high altitude pulmonary edema (HAPE), or HACE if it affects the brain rather than the lungs. 

Symptoms include dyspnea even while the person is resting, coughing, severe headaches, loss of coordination, erratic behavior, and severe vomiting.

If you suspect someone is suffering from severe altitude sickness, ask them to walk in a straight line with the heel of the front foot against the toe of the rear. HACE occurs when a person is unable to walk in a straight path, stumbles, and falls.

If a person becomes breathless while sitting still (give it ten minutes if you've just climbed uphill), they are getting HAPE. In any scenario, the next steps are the same.

Get down that mountain swiftly and rapidly. The sick person is probably only a few hours away from being unconscious.

There is no rhyme or reason behind how AMS strikes. We chatted with a Sherpa who has summited Everest several times without incident but once developed severe AMS at merely 3500m.

And it doesn't always strike the elderly or infirm first. In fact, some data suggests that younger individuals have it easier than older people.

How to Avoid Altitude Sickness While Trekking in Nepal.

Altitude sickness is typically caused by ascending too high and too quickly. The golden guideline of high mountain trekking is to move slowly and never ascend too high or too quickly.

Above 3000m, most experts agree that you should not ascend more than 300-500m each day. You should also allow for one acclimatization day for every 1000m of height gain (a rest day does not necessarily imply rest).

On these days, it's best to hike to a higher elevation and then descend again to sleep).

The vast majority of treks in Nepal are designed to avoid rapid ascent, but there are one or two exceptions (the routes to the Gosainkund Lakes in the Langtang region and the Makalu Base Camp trek are both notorious altitude sickness hotspots) where daily height gain is greater than recommended.

If you have altitude sickness-related symptoms when trekking in Nepal, do not disregard them.

When traveling in a group, it is common to try to mask your symptoms and push on in order to avoid slowing down the group as a whole. Doing so could cost you your life (and impede the group even further!). Inform your trekking partners right away if you are feeling ill.

Although many trekkers in Nepal are concerned about altitude sickness, following the simple measures stated above will significantly lessen the chance of complications.

Medication for altitude sickness.

Some visitors to Nepal bring Diamox (acetazolamide) medication with them. This can be used to prevent and treat altitude sickness, and it may be effective if you will only stay at altitude for a day or so and do not have time to thoroughly acclimate.

However, for general hiking in Nepal, we do not recommend using drugs as an alternative to ascending slowly and carefully. Taking such substances might give you a false sense of security, which can lead to major problems if you stay high for an extended period of time.

Other Health Issues While Trekking in Nepal

Although altitude sickness is the most common health concern among walkers in Nepal, there are a few other potential hazards.

Hypothermia

Hypothermia is not as widespread as you might think on a hike in Nepal, but it is a risk for those who are not properly suited and prepared.

Symptoms are comparable to those of AMS, with slurred speech, lack of focus, and weariness being major indicators. Get the victim into a warm environment (wrap them in sleeping bags and utilize your own body heat if required) and provide them with hot liquids and food.

Sunstroke and Heat stroke

Sunstroke and heat stroke are both prevalent. Many potential trekkers are surprised to learn that they are more common than hypothermia.

This is especially true while walking all day in the sunlight through the hottest, lowest valleys and slopes. At such times, try to rest in the shade, drink plenty of water (at least 3 liters per day), eat salty foods, and always wear a wide-brimmed hat and sunglasses.

Blisters

Although not life-threatening, blisters are a condition you can do without on a Nepalese trek, and a serious case of blisters can completely ruin your walk or possibly prevent you from continuing at 

all. Blisters are typically caused by wearing ill-fitting boots or ones that have not been properly broken in before venturing out on the mountain trails.

Always acquire the greatest quality boots you can afford from a dedicated trekking shop, and break them in before arriving in Nepal by taking walks around your house. This helps to loosen the material and mould it to your feet better. 

Some people hire boots from trekking stores in Kathmandu or Pokhara. We strongly advise against it. Almost inevitably, the boots will not fit properly, and unusual lumps and bumps inside will cause blisters. 

Dedicated trekking socks might help you avoid blisters. It's also a good idea to bring a roll of Second Skin, which is similar to a sticking plaster and can be applied to any tender places on your foot. The substance ultimately looks to blend in with your skin, preventing blisters from forming.

Tummy Troubles

Food poisoning and other stomach problems aren't as common in the hills and mountains as they are in Kathmandu, Pokhara, and the Terai lowlands (be careful what you eat in these locations before starting on a trek; the last thing you want is to start trekking with a bad stomach).

Even so you should still choose your food carefully. It’s best to stick to simple vegetarian food such as dhal bhat, momos or fried noodles. Bring anti- diarrhea medications with you as you trek just in case.

Insurance

Perhaps the most critical health precaution you can take while hiking in Nepal is to get a solid travel health insurance policy before leaving your home country.

Before purchasing any policy, thoroughly read the fine print.

Many insurance policies (including those given by well-known 'adventure' travel insurance companies) do not cover trekking over 2500-3500 metres, rendering them ineffective for many Nepalese climbs. It's also important to ensure that your policy covers helicopter evacuation from the mountains.

Finally, double check that any policy you might buy does actually cover Nepal.

Sadly, due to the high number of cases of insurance scams and general corruption within the Nepalese trekking and medical industry, a growing number of international travel insurance companies are simply refusing to insure anyone travelling to Nepal for any reason.

And finally, if you’re presented with the opportunity to partake in one of these scams then you should report the company offering it to the Nepalese Tourist Board in Kathmandu. 

Agreeing to participate in such a scam is a criminal offense, diverts valuable resources away from where they are most needed, and makes it much more difficult for future travelers to obtain insurance for Nepal. It also identifies you as a selfish idiot!

Conclusion

Altitude sickness is a threat to your life. Take all the necessary precautions and follow the tips above. We ensure your safety and care for your adventures. Feel free to text on whatsapp or visit Magnificent Himalayan for more details.