Trekking in Altitude

Would you know what to do if you were trekking at high altitude and you got Altitude Sickness/Acute Mountain Sickness (AMS)?

Do you worry more than most people?

Are you the optimist who dives in head first believing it will never happen to me?...or somewhere in between?

One thing we know for sure about trekking is that you will always be taken by surprise and worrying doesn’t help. Good surprises happen, like when the clouds part to reveal a glowing snow-capped mountain peak just as you emerge from your ice-covered hiking tent. Facing the not so good surprises like a dose of unexpected altitude sickness on a high peak, is not so easy.

On a recent trek in the Himalayan Mountains in Bhutan the dreaded nausea and headache that signal the onset of AMS (very common and not life threatening) began just below our first high pass of 4850m. The urge to roll up in a ball and find a quiet spot by yourself under a blanket is strong but not so helpful. As you submit to let others help you, it is important for you to look for ways to cope. Controlling your emotions and negative self-talk is essential to a good outcome. Knowing the facts beforehand about AMS and your own body can help you to stay relaxed and keep your mind strong. Accepting the situation and looking for solutions is critical. Number ONE is to Communicate to those around you exactly what you feel and need. For example, you may need to slow your pace, breath slowly to lower your heart rate, receive oxygen from the guides, take medication, recite a steady mantra, stop and rest, have someone carry your pack or move to a lower altitude. So many choices!!!!

With trekking experience, you get to know your body better and how to manage such situations. Without previous experience you will need to rely on others, your own instincts and simulating similar situations in training where you might feel a bit out of control. Training allows YOU to practice this important piece of advice, so embrace those unexpected situations in training, and fine tune your response.  


AMS Prevention Strategies – your body needs to acclimatise when you ascend to altitudes over 2500m and this takes time. Rates of acclimatisation vary from one person to the next and are not determined by fitness level. 3 things that slow the process are ALCOHOL, OVER EXERTION & DEHYDRATION

·       Trek high and sleep low and gain altitude slowly (no more than 300m per day)

·       Maintain good hydration with water or electrolyte drinks and avoid caffeine

·       Rest, relax and keep your heart rate steady especially on acclimatisation days before the trek

·       Consult your doctor about prevention medications like DIAMOX.

·       Have a buddy who can keep an eye on you – for example, vivid dreaming may be a sign that you are getting AMS

·       Use a pause step when ascending to keep your heart rate down and practice it in training

·       Don’t ignore symptoms like headache, nausea, loss of appetite and extreme fatigue – tell someone


AMS Management Strategies

·       Stop and rest until you feel better – don’t go higher.

·       Move to a lower altitude

·       Use medications for headache and nausea

·       Listen to your guides – they will have experience and training in managing AMS

Jo Vartanian