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Health Info

  • AMS


Ultimately it is your responsibility to ensure that you are fit enough to join an adventure holiday. In line with this, please complete the relevant section of our booking form fully and honestly. You should also have a thorough medical and dental check-up before the holiday in particularly if you intend to climb 6000m+ peak.

Typically asthma and high blood pressure are conditions, which may affect your performance at high altitude, however these can be controlled with medications and as general rule they should not prevent you from trekking or climbing at high altitude unless your doctor advises otherwise. If you have such condition you need to declare them and seek your doctor opinion. We as service providers need to be aware of any such conditions, so in case of emergency we can act accordingly with the best to your welfare and well-being.

You may need specific vaccinations when visiting some remote areas and this is explained in the information that we send to you when you book. For recommended and compulsory health requirements, please talk to your doctor or visit a specialized travel medical clinic.



Although every trip carries a medical kit, it is advisable to bring a supply of first aid items for your own personal use. Base this on the following list, plus any special medications you may require.

  • Antiseptic cream (Betadine).
  • Sunbloc SPF 30+.
  • Throat lozenges.
  • Painkillers and anti-inflammatory such as Aspirin,Paracetamol, Ibuprofen etc.
  • Band-aids, bandage, compression bandage and 'Second Skin' for blisters.
  • Re-hydration salts. (Gastrolyte).
  • Dextrose glucose tablets.
  • Water treatment tablets.
  • Your prescription medichations
  • Antibiotics for longer climbing and expedition style trips
  • Diamox for high altitude biking, climbing and expedition style trips


For many tourists this will be your first trip to high altitude. You will be affected by high altitude environment and you should be familiar with the effects, symptoms and the basics of physiology. This page has been designed to give you basic information in a short form to enable you to prepare for the trip and enjoy your experience.

The altitude has some important beneficial effects on the human body and our trips have been designed to enable these. Please familiarize yourself with the information on AMS (Acute Mountain Sickness) and understand how to avoid it and read on benefits of high altitude and take advantage of these to improve your body' metabolism.


Altitude sickness is the reaction of the body adjusting to decreasing amounts of oxygen. Normally, the higher the altitude, the less oxygen is available for the body to carry on normal functions.

Altitude sickness most commonly occurs from above 2,800 metres (9,200ft) but this is different for everyone - there is simply no way of knowing your own susceptibility prior to being at altitude thus it is vital you monitor your own health. Symptoms may be mild and subside/go away after a day's rest, or if it is ignored it could lead to death.



Symptoms can appear within 1-2 hours although most often appear 6-10 hours after ascent and generally subside in 1-2 days as the body adjusts to altitude. They may reappear as you continue to go higher. Symptoms of AMS usually occur gradually and can be one or a combination of the following:

  • Headache
  • Difficulty sleeping
  • Shortness of breath
  • Loss of appetite
  • Disturbed sleep or drowsiness
  • Irritability
  • Fatigue
  • Nausea/vomiting
  • Dizziness
  • Rapid pulse
  • Swelling of hands, feet & face

Symptoms generally associated with more severe Acute Mountain Sickness include:

  • Bluish discoloration of the skin (cyanosis)
  • Chest tightness or congestion
  • Confusion
  • Cough
  • Coughing up blood
  • Decreased consciousness or withdrawal from social interaction
  • Grey or pale complexion
  • Inability to walk in a straight line, or to walk at all
  • Shortness of breath at rest

At high altitude all people will experience some of the above symptoms in a mild form. If the body is unable to adjust to altitude these symptoms will persist and, if they are left untreated, altitude sickness may progress to High Altitude Cerebral Edema (HACE) or High Altitude Pulmonary Edema (HAPE). Edema means simply fluid accumulation in your interstitial body tissues. Both HACE and HAPE can be fatal if ignored.


WHAT ARE THE SYMPTOMS OF HAPE (fluid in the lungs)?

  • Breathlessness
  • A dry cough, developing to a wet one with blood-tinged discharge or saliva
  • Tightness in the chest & blueness/darkness of face, lips & tongue
  • Low fever up to 38°C/100°F
  • Severe fatigue, progressing to coma

WHAT ARE THE SYMPTOMS OF HACE (fluid in the brain)?

  • Severe headache symptoms not relieved by painkillers or lying down
  • Confusion, disorientation & drowsiness
  • Nausea/vomiting
  • Loss of balance or coordination
  • Blurred or double vision/retinal hemorrhage


Certain medical conditions (such as respiratory disease) or medications (such as sleeping pills) can increase the risk of altitude sickness - it is important that you inform your guide of any medical conditions or medications before ascending to altitude. You can help your body to acclimatise and avoid altitude sickness by:

  • Avoiding alcohol, tobacco and substances that can interfere with good delivery of oxygen to the body or cause dehydration
  • Eating small, frequent meals high in carbohydrates
  • Drinking plenty of water – the test of sufficient amount of water intake is ability to urinate colourless urine
  • Taking it easy or have a rest. Walk at a slower pace than you would at sea level and avoid over-exertion
  • Climb the mountain gradually and stop for a day or two of rest for every 600m/2000ft above 2,400m/8000ft
  • Sleep at a lower altitude when possible
  • Learn how to recognize early symptoms of mountain sickness


Most travelers are able to successfully acclimatise by following the previously mentioned guidelines. However, there are instances where medical treatment is required. Ultimately, the best treatment for acute mountain sickness (AMS) is to descend to a lower altitude and rest. Early diagnosis is important. Acute mountain sickness is easier to treat in the early stages.

The guide we book for your party has training and experience in AMS symptoms recognition, prevention and treatment. The guide will monitor your all the time for symptoms and will pace you appropriately to minimize your exposure to AMS.

We ask you to cooperate with the guide by reporting any above described symptoms and allow your guide to undertake appropriate and timely action such as take a rest and have a drink or snack, help you to carry your day pack or change a pace, take extra day rest or descent if necessary.

Your Guide will carry some medications in First Aid Kit and may suggest medication such as Ibuprophen, Paracetamol, combination of them or specific AMS medication. Standard and effective medication for prevention of AMS is Acetazolamide (Diamox) and it may be given to help improve breathing and reduce mild symptoms. This drug can cause increased urination. Ensure you drink plenty of fluids and avoid alcohol when taking this drug.

With severe cases of AMS our guide will contact our office in Kathmandu and arrange your evacuation by helicopter. Before we accept you on the trek we will require that you purchase health and travel insurance including helicopter rescue and hospitalization.


The human body operates in its own ‘goldilocks’ range being most comfortable at the sea-level and tolerating rapid ascent to about 3100m or 10,000ft. This is due the pressure differential between your internal and external pressure. External pressure, being higher than internal pressure in the body’ cells including your lungs, keeps the body fluids within body cells.

If the external pressure drops below the critical pressure the body fluids break the cell’s barrier and leek outside the body. This critical pressure occurs above 9km above the sea-level; above this altitude human body is not able to survive without a spacesuit. Mt Everest, 8848m high, is very close to this magic point yet still below, allowing humans to summit however there is a price to pay.


The human body is wonderful and adaptive system and with time we can adapt (acclimatize) to high altitude; we are able push our bodies within a certain range of oxygen deprivation and the body will respond positively to it; it will immediately adjust internal processes to cope within a short term and within it will start to produce additional red blood cells to carry more oxygen internally. Your lungs absorb oxygen based on pressure differential and therefore you need more blood cells to compensate for lower pressure differential. Naturally there is only a narrow adjustment window limiting adaptation.


While climbing higher and higher we must keep the system in fine balance pushing the body to increase production of the red blood cells and at same time resting the body to keep healthy body cells and to maintain the system integrity. The body is in anoverdrive and as long as its system integrity is intact, the body system slowly adapts. The higher we go the longer it takes to adapt. One can climb to 4500m in three days form the sea level without developing AMS; it takes 7 days to climb to 6000m, about 10 days to summit 7000m and it takes 5 weeks to acclimatize for Everest climb.

The body cooperates if one follows appropriate acclimatization sequence and timing and there is a fine balance; high altitude above 7500m is very exhausting and the longer one stays at this altitude, the longer it takes to recover; the climbing window of 8000m mountain is very short, sometimes less than one week; so one needs to time the acclimatization to be ready for the climbing window.

Lower altitude acclimatization below 6000m is a very nice and comfortable process and the most beneficial adventure from metabolic and sensory aspect with stunning vistas, often great weather, pleasant temperatures and no AMS problems if approached correctly.


With the access of red blood cells one becomes a super human being able to climb to almost 9000m. The benefit of these red blood cells is increased metabolism after returning to lowlands with increased energy and system metabolic capabilities. It doesn’t last too long before blood count returns to normal within less than 30-60 days depending on altitude and time spent but here is the opportunity. One can support maintenance of the increased metabolic processes with cardiovascular exercise for extended period of time. This applies to any high altitude above 3000m and all is a function of the time and altitude.

The most beneficial altitude is 5000-6000m because at these levels the balance between exhaustion and metabolic gain is optimum and the acclimatization process is not destructive to the tissue and sustainable by most healthy and fit persons. Climbing above 8000m requires long recovery times and most of people lose the benefits before they recovered and unable to maintain metabolic gains.


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