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7 Tips for Altitude Sickness Prevention

Mount Everest and Rongbuk monastery in Tibet
Mount Everest North side in Tibet

HIGH ALTITUDE IN TIBET

White yak on the Yamdrok lake shore in Tibet
White yak on the Yamdrok Lakeshore in Tibet

Tibet, often called the Roof of the World, is situated on the highest plateau on the planet. Many areas you will visit in Tibet are much higher than you might be accustomed to. With the gain in altitude, the oxygen level drops, and you may feel the effects within your first days at high altitude as symptoms of altitude sickness can develop.

The altitude of popular sites in Tibet:

Lhasa: 3658 meters / 12001 feet
Everest Base Camp (Tibet side): 5050 meters / 16568 feet
Mount Kailash area: 4575 meters / 15010 feet

Of course, many people visit Tibet every year and it is safe if you plan your itinerary well and prepare for your visit.

What is altitude sickness

Altitude sickness occurs when you cannot get enough oxygen from the air at high altitudes. Some people can start experiencing symptoms at elevations above 2,500 – 3,000 meters, and the risk increases as you ascend to 3,500 meters and above, where oxygen levels are lower. 

The body’s physiological response to these decreased oxygen levels is hyperventilation, an increased breathing rate to take in more oxygen. Despite this, the overall oxygen intake is still lower than at sea level, leading to reduced oxygen delivery to tissues, which can cause symptoms like headache, nausea, and dizziness. 

The body attempts to compensate by increasing heart rate and blood flow, and over time, it begins to produce more red blood cells to enhance oxygen capacity. However, these adaptations take time, and without proper acclimatization, altitude sickness symptoms can progress, potentially developing into more severe conditions such as high-altitude pulmonary or cerebral edema.

Sacred Namtso lake and Nyechen Tangla mountain on the background
Sacred Namtso Lake at an elevation of 4,700 meters / 15,500 ft

How to prevent altitude sickness

There are effective mechanisms to cope with altitude sickness. Importantly, your body will need some time to acclimatize to high altitudes. Fortunately, this happens naturally within a few days, and you can help speed up the process by following these seven tips:

1. Gain altitude slowly

Aim to ascend about 300 meters (1000 feet) daily and take a one-day break for every 1 km (3000 feet) gained. Gaining altitude at a steady pace is crucial; that’s why it is better to walk or trek to a higher altitude rather than flying or driving.

2. Ascend during the day and descend at night

It is best to go to higher altitudes during the daytime and then descend to sleep at a lower elevation at night. This strategy will not only improve the quality of your sleep but also give your body enough time to adjust to the high elevation.

3. Stay hydrated

Keeping your body hydrated helps it cope better with the lower oxygen levels in the air. Drink plenty of water and other fluids like juices and soups. Avoid coffee and black or green tea, as caffeine can lead to dehydration.

Vegetable Market in Lhasa
Vegetable Market in Lhasa

4. Eat more carbohydrates: chose the ones on the healthier side and unprocessed

A diet rich in carbohydrates helps to acclimatize. The recommended amount of carbs is about 70% of your diet during the time at high altitudes. Good choices include vegetables, whole grains, beans, potatoes, and fruits.

5. Get plenty of rest and sleep

Not getting enough rest or sleep may lead to exertion, increasing your susceptibility to altitude sickness. It’s crucial to take breaks whenever you feel tired and not rush your ascent. Don’t walk too fast. Enjoy the scenery and allow your body to acclimatize naturally.

Getting sufficient sleep can be challenging at high altitudes. If you find it difficult, try sleeping in a seated position to facilitate deeper breathing and prevent headaches.

6. Exercise lightly in the first 2-3 days

Moderate activity can help to acclimatize, while excessive physical activity may worsen the symptoms of altitude sickness. During the first 2-3 days, engage in light to moderate physical activity. That’s why walking during the first few days is recommended, but please, avoid running and jumping.

If you are trekking, consider staying at a campsite for a couple of days and only go on short hikes, allowing ample time for rest.

Stairs leading up to Potala Palace entrance
Going up the stairs to visit Potala Palace in Lhasa

7. Avoid alcohol and depressant/calming drugs, including sleeping pills

Drinking alcohol can cause dehydration and hinder your body’s ability to acclimatize. Similarly, if possible, avoid sleeping pills. They can cause respiratory dysfunction, leading to altitude sickness.

With these simple yet effective tips, you are better prepared to enjoy your tour in Tibet safely and comfortably.

ALTITUDE AND OXYGEN LEVELS

altitude vs oxygen level in Tibet chart

With an altitude gain, the air becomes thinner and the level of oxygen in the air decreases. At the elevation above 3,000 meters, most of the people will need some time to acclimatize to it. The level of oxygen at sea level is 20.9%, at 3,000 meters it is 14.3% and at 5,000 meters it lowers to 11.2%. If you are spending a night at the Everest Base Camp (5,050 m), the oxygen level there is only 11%.

HOW YOUR BODY ADAPTS TO HIGH ALTITUDE

When adapting to high altitudes, your body undergoes several physiological changes to improve oxygen uptake and delivery. One of the most crucial adaptations is the increase in red blood cell production. Increased red blood cell production enhances the blood’s capacity to carry oxygen, thus compensating for the thinner air.

In addition to increased red blood cell production, there’s an increase in the depth and rate of breathing, allowing for more oxygen to be absorbed with each breath. The body also enhances the efficiency of oxygen transport and utilization by muscles and tissues.

These adaptations do not occur overnight and require time to develop fully, which is why a gradual ascent is the best approach when traveling to high altitudes. This gradual approach helps you to acclimatize naturally, reducing the risk of acute mountain sickness and more severe forms of altitude-related health issues.

USING DIAMOX/ ACETAZOLAMIDE TO PREVENT ALTITUDE SICKNESS

Diamox is a brand name of the tablet where the active ingredient is Acetazolamide. It is currently the most widely used medicine, and scientifically proven to work for altitude sickness. It can prevent altitude sickness or reduce its symptoms.  

You generally need a prescription for Diamox, but rules can vary in different countries. It is essential to discuss the dosage with your doctor. The common side effects (especially with higher dosages) are dizziness and lightheadedness. In addition, you have to drink plenty of water when taking Diamox. It often causes dehydration and dehydration can worsen symptoms of high altitude sickness. 

For some groups of people, especially with certain pre-existing conditions (such as asthma, hypertension, and certain heart conditions) taking Diamox can be beneficial

Typical symptoms of altitude sickness

The most common symptoms that travelers experience when they arrive at high altitude are fatigue, headache, dizziness, insomnia, and shortness of breath. All of these symptoms are common in the first days in Lhasa, usually developing within 12 hours of arrival. If the symptoms are mild, they go away as your body adjusts to high altitude. If it gets more uncomfortable, you should talk to your guide and use oxygen or visit a doctor’s office for additional medication.

It is very rare for symptoms to worsen in Lhasa, but if traveling too fast to higher areas in Tibet, such as Everest Base Camp or similar high-altitude areas, symptoms can progress developing into acute mountain sickness. We always recommend only itineraries with gradual ascend to prevent this risk.

TRAVELING TO TIBET BY PLANE VS PLANE FOR EASIER ACCLIMATIZING

Train passing Damshung near Namtso lake, Tibet

Most travelers start their tours in Tibet in Lhasa, the capital of Tibet. While you can travel to Lhasa from China or Nepal overland, most travelers travel by flight or train. Traveling to Lhasa by train versus plane offers an advantage for acclimatizing to high altitudes.

TRAINS TO LHASA

You can travel by train from all major cities in China, including Beijing, Shanghai, Guangzhou, Chongqing, Chengdu, Xian, and Xining. All trains to Lhasa pass through Xining, where you enter the Quinghai-Tibet railway section. If you enjoy riding trains, you can take it from any city, considering the train journey will be quite long. If you are planning to take a train only for better acclimatization to high altitude, the best place to start your journey is Xining.

Xining is located at an altitude of 2,200 meters where you will already start acclimatizing to altitude, while you won’t experience any symptoms. If you have extra time to spend in Xining, it will be even more helpful for acclimatizing. You can explore this city, located in the Eastern Tibetan areas of Amo, visit the Kmbum monastery, or take a day trip to Qinghai Lake.

Train from Xining, on the way to Lhasa, will take you through high-altitude areas, climbing over 5,000 meter passes. The railroad goes through remote areas of the National Park, where lucky travelers can even see wild animals. To make this journey safe for riders, the train is equipped with supplemental oxygen pumped into cabins when the train is traveling through high-altitude areas. With this additional oxygen, the oxygen level in a train is usually close to what you can feel at an altitude of about 3,000 meters. Please, note, that you will only spend a few hours on a train at a higher elevation, and by itself, a train ride is not long enough to fully prepare you for Lhasa altitude. It is slightly better than flying directly to Lhasa, but it won’t make a very big difference. Spending a couple of days in Xining and then taking a train to Lhasa is better than just taking a train, and taking a train is slightly better than flying.

FLIGHTS TO TIBET

Group tour near airport
At Lhasa airport in Tibet

The most popular way to arrive in Lhasa is by flight. You can take a flight from all major cities in China, including Beijing, Xian, Chongqing, Kunming, and others. Chengdu serves as the most convenient hub for direct flights to Lhasa, offering numerous options for travelers. There are 2 international airports, connecting Chengdu with many cities globally, and several direct 2.5-hour long flights to Lhasa daily.

If you are visiting with a private tour and prefer a more gradual ascend you can start your tour in Tibet in Nyingchi, its Eastern area with lower elevation. There is an airport in Nyingchi located at an altitude of about 3,000 meters / 9843 feet. You can fly to Nyingchi from Chengdu and then travel from Nyingchi to Lhasa overland gradually acclimatizing to higher elevation.

Nyingchi view on Niyang River in Tibet

6 Days Tibetan Switzerland Tour from Nyingchi to Lhasa

Nyingchi – Lulang forest – King Cypress – Basum Tso Lake – Lhasa – Potala Palace – Jokhang Temple – Sera Monastery – Drepung Monastery – Barkhor Street

FREQUENTLY ASKED QUESTIONS ABOUT ALTITUDE IN TIBET

Tent camp by the Everest Tibet side
Tent Camp and Everest at 5,050 m / 16568 ft

Genetics plays a significant role in how easily the person will acclimatize, which makes it very difficult to predict who will be affected by high altitude.

Based on scientific evidence, physical fitness, age, or even prior experiences at high altitudes doesn’t predict an individual’s risk of experiencing altitude sickness.

Although young, physically fit travelers might assume they’re less susceptible, taking more risk with rapid ascent without adequate acclimatization may place them at higher risk.

Interestingly, individuals over 55 years old exhibit a slightly reduced risk, challenging common perceptions regarding age and vulnerability to altitude sickness.

Ascending slowly, however, allows for gradual acclimatization and significantly reduces the risk of altitude sickness.

Altitudes are usually classified in the following way:

  • Below 2500 meters. Altitude in Xining. Travelers typically don’t experience any altitude sickness symptoms
  • High altitude: between 2,500 and 3,700 meters. The altitude in Lhasa, Samye, and Nyingchi. Travelers might experience some symptoms of altitude sickness, that typically go away once you acclimatize within the first 2-3 days.
  • Very high altitude: between 3,700 and 5,500 meters. The altitude in Namtso Lake, Mount Kailash area, including Manasarovar Lake. Note, that the highest point on the Mount Kailash trek (5,640 meters) is even higher than this range. You need to acclimatize at lower altitudes to travel to these very high-altitude areas.
  • Extreme high altitude: above 5,500 meters. On your tours in Tibet, the highest point for non-climbers is located on the Mount Kailash trekking route at 5,640 meters. All our tours to Mount Kailash are designed to gradually approach this area, allowing most travelers to acclimatize before reaching it.

Tibetans have over 30 genetic adaptations, helping them cope with lower oxygen levels. In Tibet, you can also find herbal medicine made from local plants to help acclimatize.

In Tibet, you always travel with a licensed guide. All guides know about high altitude symptoms and will be able to offer help. On all tours, we will help you use oxygen to cope with some symptoms. If your symptoms are mild, it is best to give yourself time to acclimatize naturally. Oxygen can be a good short-term remedy, but it can slow down the acclimatizing process. If the symptoms are not going away, your guide might recommend you visit a medical facility.

While no special training is required, it helps to exercise before visiting Tibet. First, you will have more stamina to walk when you are exploring Tibet and trekking (if it is in your itinerary). In addition, regular exercise can improve your cardiovascular health before your trip.

The initial symptoms of altitude sickness can vary from person to person but commonly include headache, loss of appetite, nausea, dizziness, fatigue, shortness of breath, and trouble sleeping.

Recognizing these early signs is crucial for preventing more severe forms of altitude illness, such as High Altitude Pulmonary Edema (HAPE) or High Altitude Cerebral Edema (HACE), both of which require immediate medical attention.

It’s important for travelers to high-altitude areas to acclimatize properly and to ascend gradually to reduce the risk of altitude sickness.

Yes, starting in 2024, high-altitude areas can be restricted to travelers 75 years old and above for their safety. We recommend choosing itineraries in lower altitude areas, such as Lhasa, Gyantse and Shigatse, Samye monastery, and Nyingchi.

Popular Group Tours in Tibet

All our group tours are designed to have enough time for most people to acclimatize to higher altitude areas. There are regular departure dates and fixed prices.

Private tours allowing more time for acclimatizing to high-altitude

Peach blossom - spring views in Eastern Tibet

10 DAYS EASY ACCLIMATIZING TOUR FROM NYINGCHI TO EVEREST

This tour starts in Nyingchi, at an elevation just below 3,000 meters. We will spend two days there, traveling through one of the most beautiful regions in Tibet. It is often called “Tibetan Switzerland” for its forested mountains, river canyons, and alpine lakes.

After that, we will head to Lhasa, where we will spend another two days acclimatizing. We will visit Potala Palace, Jokhang Temple, Sera, and Drepung monastery.

Finally, we will drive to the Everest Base Camp through Gyantse and Shigatse. We make stops at Gyantse monastery and Kumbum stupa, Yamdrok Lake, Karola glaciers and many of the high mountain passes and viewpoints.

Shakyamuni Buddha statue in Sakya monastery, Tibet

10 DAYS EASY ACCLIMATIZING EVEREST TOUR

This slow-paced private tour takes you from Lhasa to Gyantse and Shigatse, where we spend the first few days acclimatizing. We will visit many of the historical and religious places, such as Potala Palace, Jokhang Temple, Gyantse Monastery, and Kumbum Stupa.

We will make stops by the most beautiful natural spots: Yamdrok Lake, Karola glaciers and many of the high mountain passes and viewpoints. Finally, we will reach Everest Base Camp, where we stay for the night.

Samye Monastery the first monastery in Tibet

6 DAYS TIBETAN CULTURAL HERITAGE TOUR

This private tour takes you from Lhasa to Yarlung Valley and Samye Monastery. Yarlung Valley is the birthplace of Tibetan civilization. You can see Yumbulakhang, an ancient fort and the first surviving building in Tibet. After that, you will visit Samye, the first Buddhist monastery in Tibet.

contact us for more information and to plan a safe tour

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