Altitude sickness which is also known as Acute Mountain Sickness (AMS) is a high-altitude condition that affects trekkers and mountaineers who ascend to higher points too quickly. This condition usually occurs due to the lower oxygen level in the atmosphere at higher altitudes. The symptoms do start mildly with symptoms like headache, dizziness and nausea but without proper care, it can also elevate to life-threatening conditions. Many travelers underestimate the dangers of altitude sickness which can lead to this medical condition affecting their overall experience.
There is no risk of High Altitude Pulmonary Edema (HAPE) or High Altitude Cerebral Edema (HACE), which are more serious stages of altitude sickness, in the Everest Base Camp Trek. But, it is still important to understand their symptoms so you can venture into the alpine zones without any stress. In general, some people may experience only mild symptoms while others may face more serious conditions. The good news is that with the right approach altitude sickness can be properly managed and prevented.
Understanding how altitude sickness works and knowing how to prevent it can make a major difference when it comes to deciding the fate of the trek and a dangerous situation. This article provides a comprehensive guide to altitude sickness so you can understand what it is its causes, symptoms, prevention methods, itinerary planning, medication and emergency responses. So if you are planning Everest Base Camp Trek, keep reading to learn hot to stay safe and make most out of your journey.
Understanding Altitude Sickness
What is Altitude Sickness?
Altitude sickness is a condition when the body struggles to adapt to low oxygen levels in the atmosphere at higher altitudes. The air pressure decreases as you climb to higher altitudes which makes it harder for the lungs to absorb enough oxygen for bodily function. This deprivation of oxygen can affect multiple body systems which then leads to various symptoms of altitude sickness. This altitude medical condition usually affects travelers who ascend too quickly to higher points without proper acclimatization.
The likelihood of developing the symptoms of altitude sickness also depends on your fitness level and genetics besides the overall acclimatization period. Adventures who have some prior high-altitude navigation experience also find it easier to adapt to varying oxygen levels at different elevation points.
Different Types of Altitude Sickness
Typically there are three types of altitude sickness. The symptoms trekkers show also differ as per different stages of altitude sickness.
Acute Mountain Sickness (AMS)- This is the most ordinary and relatively mild stage of altitude sickness that trekkers from high altitude journeys. Trekkers who are suffering from this condition start showing symptoms like headache, nausea, dizziness, fatigue, loss of appetite, etc. Even if it is a minor form of altitude sickness ignoring the symptoms can escalate the situation. So, it is necessary to tend to them immediately.
High Altitude Pulmonary Edema (HAPE)- It is a more severe form than AMS, in this condition, the fluid accumulates in the lungs. People suffer from this stage of altitude sickness so symptoms like persistent cough, extreme fatigue, difficulty breathing, chest tightness, etc. If not treated properly this condition can be even fatal.
High Altitude Cerebral Edema (HACE)- A life-threatening condition that is also the final stage of altitude sickness. Due to the low oxygen level in the atmosphere and extreme climate, the brain starts to swell. The symptoms of HACE are confusion, loss of coordination, balance issues, slurring speech, altered consciousness, etc. Immediate descent and medical care are necessary in this condition.
Note: As the trail of the Everest Base Camp Trek doesn’t extend over the alpine snow slopes, there is only a risk of AMS on this trip. As for the HAPE and HACE, primarily only mountaineers doing long Himalayan expeditions have to deal with them.
Common Symptoms to Watch for
Recognizing the symptoms of altitude sickness early will help you manage the risk during your adventure. Treatment at a premature age will also make the treatment much easier and you will be able to continue with your exploration plans without any issues. Here are some of the common symptoms of altitude sickness, if you start showing any of these symptoms make sure to inform your guide or team leader immediately.
Symptoms of Altitude Sickness
- Headache (one of the most common early symptoms)
- Dizziness and lightheadedness
- Nausea
- Vomiting
- Shortness of breath
- Loss of appetite
- Difficulty in sleeping
- Fatigue and weakness
Causes of Altitude Sickness
Quick Ascent and Improper Acclimatization Schedule
One of the major causes of altitude sickness is lack of proper acclimatization. While traversing to the higher part of the trail, it is important to let the body get enough time to adapt. If you push too high too fast, your body won’t be able to adapt to the new atmosphere which will trigger altitude sickness symptoms. Similarly, you will have trek for around 6 to 7 hours trekking days on average.
So, setting up acclimatization days in between will give your body much-needed rest and break. If the walking pace and acclimatization period are not properly managed in your itinerary plan, there is a high risk of you suffering from altitude sickness.
Decreased Oxygen Levels at Higher Elevations
The oxygen level at the sea level is around 21% and that is what people living in normally elevated regions are used to. However, as you move to higher altitudes, the oxygen level in the atmosphere starts to drop gradually which makes it harder for the body to absorb oxygen. At the Everest Base Camp (5,364m/ 17,598ft), the oxygen level is approximately 50 % of what it is at sea level.
Due to this, the body has to work extra hard to function normally. With a gradual climb, your body gets used to the drop in oxygen level as you head toward the foothills of the Himalayas. People who have properly adapted to high-altitude environments may find it easy to adapt to this change. But, people who grew up in sea-level atmospheric conditions may struggle with this deprivation of oxygen in the atmosphere.
Dehydration and Exhaustion
Other primary causes of altitude sickness are dehydration and exhaustion. The dry air of the high-altitude region and the need for long hours of walking lead to fluid loss through respiration and sweat. Trekkers who don’t drink enough water to maintain their body water level have higher risks of getting altitude sickness. Similarly, overexertion during the trek, especially when moving to high altitudes can elevate the risk of altitude sickness even quicker.
It is important to understand that trekking is not a marathon. You will have to follow a steady pace taking short breaks every now and then. Likewise, following a proper hydration and nutrition plan will help to reduce the risks of altitude sickness significantly.
Best Practices to Prevent Altitude Sickness
Acclimatization: Importance of Gradual Ascent and Acclimatization Days
Adhering to a proper acclimatization schedule is the foremost and top preventive measure for altitude sickness. Normally, for the high altitude adventures only traversing 500 meters (1,640ft) in altitude is recommended. Likewise, after crossing an altitude of 1,000 meters (3,280ft), a sufficient acclimatization period should be taken by the adventurers.
As you will follow a gradual pace and climb slowly to the higher points during Everest Base Camp Trek, you will not need to take rest days every time after traversing above more than 1,000 meters. However, two strategic acclimatizations along these mainstream routes are recommended.
Taking acclimatizing days at Namche Bazaar (3,445m/ 11,302ft) and Dingboche (4,360m/ 14,304ft) will help your body adapt to a new atmosphere before pushing even further. This will also give you ample rest period so you don’t have to overexert yourself, making your journey comfortable and enjoyable.
Hydration: Staying Well-hydrated to Prevent Dehydration-related Symptoms
Dehydration increases the risk of altitude sickness during the trek. During the long hours of walking, your body will lose a major water level. This is due to dry air conditions and sweating. So, in order to keep the water level balanced, you should meet the daily hydration quota which is about 3 to 4 liters. You don’t necessarily have to keep drinking water but you can also opt-out for other alternatives like herbal tea, fresh fruit juice, lemon tea, etc.
Just make sure that you avoid caffeine which will contribute to the cause of dehydration. Besides drinking the recommended volume of fluid, it will also be beneficial if you avoid smoking cigarettes and drinking alcohol during the trek. Caffeine, alcohol and smoking are known to make the acclimatization process much more complicated.
Proper Nutrition: Importance of a High-carbohydrate Diet at Altitude
For the long hours of walking in each trekking day, you will need a good amount of fuel. If you don’t plan a nutritious and healthy diet, it can significantly affect the energy level in your body and can lead to exhaustion. Furthermore, if you are not your best self, it will also affect your immune system and you might be vulnerable to other general illnesses as well.
That’s why for this high-altitude trek, you should focus on eating healthy and carbohydrate-rich food. As carbohydrate requires less oxygen level to metabolize than other food sources like fat and proteins, they are the ideal energy source for trekkers.
Slow and Steady Trekking: the Role of a Steady Pace in Prevention
Moving along at a manageable pace helps to prevent exhaustion. Normally, in a mountain trek, you will need to traverse across rugged and steep terrain. You will also be carrying a backpack with significant weight. As you ascend to higher altitudes, doing even small tasks can be more physically straining.
That’s why it is important to move along with a steady pace and take enough short breaks along the way to get rest. You should avoid over-physical exertion and not rush too fast to the higher points just because you can.
Medication and Supplements
Using Diamox (Acetazolamide) for Prevention
Diamox (Acetazolamide) is a commonly prescribed medication for high-altitude adventures. This medication helps your body to adjust to the lower oxygen level in the atmosphere. Diamox is most effective when taken 24 to 48 hours before trekking on the high-altitude part of the trail. After taking this medication trekkers will need to continue taking it throughout the trek.
However, travelers have reported side effects like frequent urination and tingling sensation in hands and feet. So, before taking the medication, you should consult your doctor first about it.
Natural Remedies Like Garlic Soup and Herbal Tea
If you are not comfortable taking medication, there are also natural remedies that are known to heal and prevent altitude sickness. Garlic soup and herbal tea are believed to be the top natural remedies to counter altitude sickness. In particular, garlic is known to improve the oxygen circulation by increasing the blood flow. Some of the herbal teas are also packed with similar properties.
Make sure to include them in your daily food and hydration options during the trek. Besides the altitude sickness-preventing qualities, garlic also reduces inflammation and boosts antioxidant levels in the body. Having garlic tea will also help you with digestion and reduce nausea.
Note: Before taking medicine or natural remedies you need to consult your doctor. Self-medication may lead to unwanted side effects and having and if you are on any prescribed medication, the natural remedies may also have negative impacts.
Acclimatization Stops and Itinerary Planning
Recommended Acclimatization Days (E.g., Namche Bazaar and Dingboche)
Typically two days of acclimatization is enough for this high-altitude base camp exploration. Standard itinerary plans also set two resting periods along the route, one at Namche Bazaar (3,445m/ 11,302ft) and another at Dingboche (4,360m/ 14,304ft). These two acclimatization days with slow-paced exploration will be sufficient for trekkers with basic fitness (recommended for this trek).
However, if you are trekking with seniors or children, you will need to plan an extensive acclimatization period. You will also have to set the walking pace according to the physical capabilities of such a group. The rest day at Namche will prepare your body for the alpine atmosphere and the one at Dingboche will make you ready for the trans-Himalayan zone.
Note: It is advised that you should take part in short hikes around the region which will make the acclimatization much more effective.
Ideal Itinerary to Minimize Altitude Risks
A well-planned itinerary needs to follow a steady and manageable walking pace, sufficient rest breaks along the route and an ideal acclimatizing period. Following the climb high and sleep low strategy also works best to minimize the symptoms of altitude sickness during the trek. That’s why it is advised that you should do some short hikes after reaching your destination which will make resting and sleeping easier.
Everest Base Camp Trek Itinerary Outline (With Strategic Acclimatization)
Day 01: Flight from Kathmandu (1,400m/ 4,593ft) to Lukla (2,800m/ 9,186ft) and Phakding (2,610m/ 8,562ft) trekking: 30 minutes flight and 4 hours trekking
Day 02: Trekking from Phakding to Namche Bazaar (3,445m/ 11,302ft): 6 hours
Day 03: Acclimatization day and exploration at Namche
Day 04: Namche Bazaar to Tengboche (3,860m/ 12,664ft): 5 hours
Day 05: Trekking to Dingboche (4,360m/ 14,304ft): 4 hours
Day 06: Acclimatization day in Dingboche
Day 07: Trek from Dingboche to Lobuche (4,930m/ 16,174ft): 5 hours
Day 08: Lobuche to Gorakshep (5,160m/ 16,929ft) to Everest Base Camp (5,364m/ 17,598ft): 7 hours
Day 09: Hike to Kalapatthar (5,545m/ 18,192ft) and trek to Pheriche (4,820m/ 15,813ft): 7 hours
Day 10: Trek to Namche (3,445m/ 11,302ft): 6 hours
Day 11: Namche to Lukla (2,800m/ 9,186ft): 8 hours
Day 12: Flight back to Kathmandu (1,400m/ 4,593ft): 30 minutes
Note: This is the standard 12 Day Everest Base Camp Trek of Nepal Eco Adventure. We also offer a complete customization option. You can adjust the overall walking distance, resting period, quality of services, side detours, etc as per your preference with us. For booking and further enquiry connect with us using the details on our Contact Page.
What to Do If Symptoms Appear?
Recognizing Mild, Moderate, and Severe Symptoms
As we have already discussed there are several phases of altitude sickness and the symptoms at each stage vary. That’s why it is very important to identify the symptoms and take necessary precautions immediately. Even if you just have to worry about the risk of AMS in this base camp route, it will be best if you understand the symptoms of other forms as well. Even if the symptoms are mild to moderate you shouldn’t overlook them.
Remember, if you can understand the symptoms before the situation gets worse, it will be much easier for you to deal with altitude sickness. Be on the lookout for general symptoms like headache, nausea, dizziness, vomiting, insomnia, etc. As for the extreme stage, confusion, chest pain, disorientation, bluish skin or lips, slurred speech, seizures, etc are the primary symtoms.
Immediate Steps to Take (Descending, Resting, Oxygen Therapy)
After recognizing the symptoms, there is a set of procedures that you have to follow. This step is crucial to determine your safety and well-being. Thus, after identifying the symptoms inform the guide or team leader as soon as possible.
Immediate Steps After Identifying Symtoms
- The first step you need to take after identifying symptoms of altitude sickness is to stop ascending and get some rest
- Keep yourself hydrated and don’t panic, you can also eat some carbohydrates
- Take altitude sickness medication that has been pre-approved by the doctor (make sure to pack them for trek)
- If the symptoms persist and the situation gets worse, you should descend to at least 500 to 1,000 meters below immediately
- There is supplementary oxygen at different stations request your guide to arrange it if necessary
- Keep yourself warm and drink some hot beverage
- Don’t drink alcohol or use a sleeping pill
- Monitor your oxygen level using the pulse oximeter
When to Seek Medical Help?
If the situation doesn’t change after a long period and the symptoms start to get worse, it is necessary to seek medical assistance. Normally, AMS can be treated with rest and hydration but in case of other severe forms of altitude sickness, it is best to seek medical help immediately. Your guide will arrange the helicopter rescue that will take you to the hospital in Kathmandu or a nearby city.
Health posts on the mountain are not able to provide extensive care that’s why emergency evacuation by helicopter is the only option in this remote mountain. Make sure that your insurance plan for the trek also includes helicopter evacuation if necessary.
Conclusion
Although altitude sickness is serious, it is a preventable condition. By following a gradual ascent plan, staying hydrated, eating well, keeping yourself warm and recognizing the symptoms early on can help trekkers mitigate and deal with this issue immediately. As a trekker, it is important for you to understand the symptoms of altitude sickness and take immediate action if necessary.
So, always listen to your body and prioritize safety over ambition. Many trekkers make the mistake of ignoring mild symptoms like dizziness or headaches thinking that it will go overtime. However, symptoms can get worse if you overlook them at their premature stage. It is crucial to stop ascending and take appropriate measures. In serious situations, immediate descent and medical attention are the only life-saving option.
Final Tips for Safe and Enjoyable Everest Base Camp
- Plan a gradual ascent and stick with a well designed itinerary plan that has a sufficient acclimatization period
- Stay hydrated and drink plenty of fluid but avoid alcohol and caffeine
- Eat carbohydrate-rich diets to maintain your energy level
- Listen to your body, if you start experiencing symptoms of altitude sickness don’t ignore them
- Take rest and short breaks when necessary don’t push yourself too hard
- Carry a pulse oximeter to check your oxygen level at different altitudes
- Bring altitude sickness medication with you after consulting about it with your doctor
- Make preparations for emergency situation and get an insurance plan that has coverage for helicopter rescue
