The Himalayas of Nepal captivate hikers around the globe with world-renowned Everest Base Camp (EBC), as well as more off the beaten path Upper Dolpo, Manaslu, and Nar-Phu. These breathtaking treks, many surpassing 8000 feet (2400 meters) in altitude, come with the perilous threat of high altitude sickness, also referred to as acute mountain sickness (AMS). For those planning to undertake the challenging treks in the Nepalese Himalaya, knowledge of the AMS symptoms along with causes, treatment, and preventative measures is essential. This blog focuses on high altitude sickness specifically in relation to hiking the Himalayas, making the experience safer, easier, and more delightful when visiting the Nepalese mountains.
What is High Altitude Sickness?
High altitude sickness develops when the body cannot adjust to the lack of oxygen and lower air pressure above 8000 feet. “How high does altitude sickness start?” This is a question many trekkers have. Symptoms may be present as low as 8000 feet. Treks in the Nepal Himalayas such as EBC (Everest Base Camp trek) with a height of 17598 feet, Upper Dolpo (up to 16700 feet), Manaslu circuit (16752 feet at Larkya La Pass), and Nar Phu (up to 17400 feet) pose this risk for trekkers.
AMS can be as mild as discomfort to as severe and life threatening as high-altitude pulmonary edema (HAPE) or high-altitude cerebral edema (HACE) which makes monitoring and responding to high altitude sickness symptoms vital while trekking in the Himalayas in Nepal.
Locals helping trekkers cross a Himalayan stream
Who is at Risk in Nepal’s Himalayas?
Whenever a person undertakes Himalayan trek, such as Everest Base Camp (EBC), fitness levels, age, perceived trekking experience doesn’t come into play as factors. What does come into factor is high altitude sickness. In Nepal’s Himalayas, certain factors enhance the probability of being encountered with high altitude sickness:
- Quick Increase of Height: Flying to Lukla (9,383 feet) for EBC or the lesser known airstrips such as Juphal (Upper Dolpo) results in sudden boosts in elevation.
- Remote Routes: Treks like Upper Dolpo and Nar-Phu lack immediate medical facilities, making treatment difficult.
- Prior AMS Diagnosis: Trekkers that have suffered from AMS in the past are predisposed to recurrence.
- Health Issues: Patients with heart and lung health problems carry the greatest risk.
Travelers to the Nepal Himalayas, irrespective of being a novice or a seasoned mountaineer, should exercise caution against AMS, especially on high passes such as Thorong La (Annapurna) or Larkya La (Manaslu).
Symptoms of High Altitude Sickness
High altitude sickness symptoms usually worsen up to 6-24 hours after reaching higher elevations. Symptoms experienced include:
- Mild: Headaches, nausea, lightheadedness, fatigue, decreased appetite, and insomnia.
- Moderate: Recurrent headaches, vomiting, difficulty breathing, and extreme fatigue.
- Severe: Confusion, difficulty with ambulation, chest constriction, coughing up frothy fluid, or bluish skin and lips (Signs of HAPE or HACE).
Understanding the early warning signs of high altitude sickness is pivotal in remote regions such as Nar-Phu or Upper Dolpo due to lack of treatment options.
High-Risk Areas in the Himalayas of Nepal
Trekking in Nepal’s Himalayas has routes that vary in remoteness and difficulty but requires caution for the following high altitude treks:
- Everest Base Camp: Climbing to 17,598 feet via Castle Rock includes steep elevation jumps from Lukla.
- Upper Dolpo: Very remote with Kang La Pass standing at 17,700 feet and sparse medical aid.
- Manaslu Circuit: Larkya Pass crossing at 16,752 feet which has extensive stretches in the high altitude zone.
- Nar Phu: Remote with high passes like Kang La (17,400 feet) in isolated areas.
Other difficult treks are the Annapurna Circuit (Thorong La 17,769 feet) and Langtang’s Gosainkunda (15,092 feet) which are extremely high risk for altitude sickness without sufficient planning or hematopoiesis.
Rescue Helicopter in Nepal Himalayas
Preparation for Treks in the Himalayas Nepal
In the Himalayas of Nepal, being well-prepared lowers the risk of getting high altitude sickness:
- Gradual Ascent: Choose itineraries that are geared for acclimatization, such as rest days at Dingboche (14,469 feet) or Namche Bazaar (11,286 feet). For treks such as Manaslu or Dolpo, add additional days at mid-altitude.
- Physical Training: Having a healthy heart helps you use oxygen more efficiently.
- Hydration: To prevent dehydration in the arid Nepal Himalayan air, drink 3 to 4 liters of water per day.
- Medications: Ask your doctor about medications that prevent high altitude sickness, such as acetazolamide (Diamox). Keep dexamethasone on hand in case of an emergency; it is a well-known medication for high altitude sickness.
- Gear: For routes such as Nar-Phu, bring lightweight oxygen packs and proper outfit.
- Guides and Insurance: Make sure your insurance includes high-altitude helicopter evacuation and hire knowledgeable guides.
Also check our recent blog on Trekking in Nepal with Kids: Is It Possible?
Remedies and Cure for High Altitude Sickness
If you develop high altitude sickness symptoms, you should ensure:
- Halt Ascent: You do not climb higher until symptoms subside.
- Rest and Hydrate: Ensure proper rest and hydration as it helps to alleviate mild symptoms.
- Medications: Use ibuprofen for headaches. Acetazolamide can enable swifter altitude adjustment when taken beforehand. In severe cases, and under supervision, dexamethasone is used. These are all part of the standard cure for high altitude sickness.
- Oxygen: Portable oxygen is a crucial asset for remote trekkers venturing into Upper Dolpo.
- Descend: Descend immediately by 1,000 – 2,000 feet if symptoms worsen. For HAPE or HACE, immediate descents are critical. Evacuation and helicopter transport from EBC or Manaslu is common in the Nepal Himalayas. In more remote areas like Nar-Phu, descending to lower villages like Phu at 13,320 feet may be helpful.
Note: The Himalayan Rescue Association(HRA) runs aid posts in Manang and Pheriche staffed with professionals who actively treat and give educational lectures on the prevention of high altitude sickness—offered free of charge—which greatly benefits trekkers in the Nepal Himalayas.
Final Thoughts
From the busy tracks of Everest Base Camp to the remote areas of Upper Dolpo, Manaslu, and Nar-Phu, high altitude sickness poses a threat to anyone trekking in the Himalayas of Nepal. If trekkers know the symptoms of high altitude sickness, its prevention methods, and the proper treatment, they can safely appreciate the magnificence of the Himalayas in Nepal.
When traveling across the mountains, make sure to respect them and your body. Pay special attention to acclimatization; that will allow you to make your journey through the Nepal Himalayas safe and memorable.
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Frequently Asked Questions (FAQs)
Are there clinics and hospitals along the popular trekking routes in Nepal?
Yes, in Pheriche and Manang, regions supported by the Himalayan Rescue Association, along with several trekking routes have medical posts and clinics which assist with altitude sickness and other medical complications.
How do local high-altitude residents and Sherpas manage with low oxygen levels?
Sherpas and other high-altitude populations reportedly possess unique enhanced features which make them exceptionally adapted to high elevations, such as efficient oxygen usage and greater-than-usual production of Nitric Oxide, allowing them tremendous capability at high elevations without significant altitude sickness.
Are there any herbal methods or traditional ways to avoid altitude sickness that are practiced in Nepal?
Some trekkers resort to herbal alternatives such as ginkgo biloba alongside conventional ones like acetazolamide. Nevertheless, there’s not much scientific proof backing the claimed benefits of these herbal alternatives.
