The Basics: What Happens at Altitude?
The higher you go, the thinner the air gets. At altitude, there’s less oxygen, meaning your body has to work harder to function. For many, this can lead to altitude sickness (also known as Acute Mountain Sickness or AMS) which can range from mild headaches and nausea to more serious symptoms if not properly managed.
The key to staying healthy is acclimatisation—giving your body time to adjust to the lower levels of oxygen. But even with careful acclimatisation, everyone reacts differently to altitude. Here’s what’s worked for us:
1. Go Slow
This can’t be stressed enough: pace yourself. We know you’re excited to see those epic mountain views or hit the next milestone, but moving too quickly at altitude is one of the easiest ways to get into trouble. Listen to your guide’s advice on pacing—they’ve done this before, and their experience is invaluable.
In countries like Nepal, you’ll often hear guides say, “pistade, pistade” (slowly, slowly), or in Tanzania, “pole, pole.” Take it to heart—this mantra is the best way to avoid getting sick.
2. Drink Lots of Water
Dehydration happens fast at altitude, and it can make altitude sickness worse. You’ll need to drink more water than you would at sea level. Aim to keep sipping throughout the day rather than waiting until you’re thirsty. Some trekkers find it helpful to use hydration salts or electrolyte tablets to keep balanced.
Pro tip: Drink water at regular intervals, even when you don’t feel thirsty. Your body will thank you later.
3. Eat Plenty (Even If You Don’t Feel Like It)
Altitude can suppress your appetite, but you need to keep your energy levels up. Carbs are your friend at altitude—your body burns through them quicker in low-oxygen environments. Even if you’re not feeling particularly hungry, try to snack regularly and eat well at meal times.
Our favourites on the trail: Dal bhat in Nepal, hearty soups in Tanzania, and high-energy snacks like nuts and dried fruit are perfect for keeping you going.
4. Listen to Your Body (And Talk to Your Guide)
No one knows your body better than you. Pay attention to how you’re feeling and don’t ignore any early signs of altitude sickness. Headaches, nausea, dizziness, and shortness of breath are all warning signs. If you start to experience any of these, talk to your guide straight away.
Your guides are trained to spot the signs of altitude sickness, and it’s crucial to keep them in the loop. Don’t push through feeling bad—resting, hydrating, or descending a little could make all the difference. And, if you’re not able to continue there’s no shame in coming down. One of the first rules of mountaineering is that it’s not making it up to the top that counts but about getting back down safely.
5. Make Use of Porters
Altitude is tough enough without a heavy pack on your back. Don’t be afraid to use a porter if one’s available (as they are on all of our trips). Lightening your load can help conserve energy, which you’ll need more of at altitude. Keep a daypack with your essentials (water, snacks, layers), and let the porter carry the rest.
Remember, porters are skilled professionals who know how to handle the terrain and altitude, so don’t feel guilty about using their services—they’re an important part of trekking culture in many regions. They’ll make your life easier but you’ll also be helping with employment in an area where that income is an invaluable and respected way to earn a living.
6. Sleep at Lower Altitudes (If Possible)
If you’re on a multi-day trek, try to follow the “climb high, sleep low” rule. This means ascending during the day but descending to a lower altitude to sleep. It’s one of the most effective ways to acclimatise and help your body adjust to altitude.
While it’s not always possible on every trek, your guide will generally build in rest days or lower sleeping altitudes to help the process.
7. Carry Essential Medications
If you’ve got concerns then it’s worth chatting to a doctor about what medications are available to help with the effects of altitude. Many trekkers swear by taking Diamox to help with acclimatisation but you shouldn’t take medication without speaking to a medical professional.
Also, packing basic over-the-counter remedies for headaches, nausea, and digestive issues is always a smart move.
8. Use Trekking Poles
Trekking poles aren’t just for balance—they can help take the strain off your legs and conserve energy as you ascend. This might not seem important at lower altitudes, but once you get higher up, you’ll be grateful for anything that makes the climb easier.
Make sure you’ve had a dry run with them though – they take a bit of getting used to and aren’t for everyone. Click-clack!
9. Dress in Layers
The weather can change rapidly at altitude so having the right clothing is key. There’s no such thing as bad weather, only the wrong clothes! Wear layers that you can easily adjust as temperatures shift. Staying warm helps prevent exhaustion and conserves your energy for the ascent. Make sure your layers are moisture-wicking and quick-drying to avoid getting cold if you sweat.
10. Avoid Alcohol and Caffeine
At altitude, alcohol and caffeine can dehydrate you quickly. While that post-trek beer might be tempting, it’s best to wait until you’re back at lower altitudes. Stick to water, tea, or electrolyte drinks instead to keep your hydration levels up. You might also notice the difference to your waistline on a longer trek after abstaining for 2-3 weeks!
Final Thoughts: Know When to Turn Back
The mountains will always be there. If you’re struggling with altitude sickness and it’s not improving, turning back isn’t a failure—it’s a smart decision. Safety is always the priority, and there’s no shame in descending to recover or regroup.
At Earth Dog Travel, we’ve built in plenty of acclimatisation days and rest breaks into our itineraries, but ultimately, each person’s experience at altitude is different. The best advice? Listen to your body, take it slow, and don’t be afraid to ask for help. It’s all part of the adventure!
Quick Checklist: How to Stay Healthy at Altitude
- Go slow and let your body adjust.
- Stay hydrated—drink water frequently, even if you’re not thirsty.
- Eat plenty, especially carbs, even if you don’t feel hungry.
- Communicate with your guide—don’t ignore symptoms.
- Use porters to lighten your load.
- Take rest days and sleep at lower altitudes where possible.
- Consider medication like Diamox (consult a doctor first).
- Keep warm, but not too hot—dress in layers.
- Avoid alcohol and caffeine to prevent dehydration.
Safe travels, and we’ll see you at the summit!