Altitude sickness: how to recognize it and what to do

Above 2,500 metres the partial pressure of oxygen drops enough for the body to notice. From there it is all about the rate of ascent: gain 3,500 m in a day and your head will almost certainly remind you; spread the same gain over three days and you will most likely feel nothing.

How it shows: three stages

Acute mountain sickness — the most common and mildest form: headache, lethargy, poor appetite, shallow sleep in the first days at altitude. With a proper schedule it passes in a day or two.

Cerebral edema — a rare but dangerous development: growing pain that painkillers don't touch, vomiting, loss of coordination (the person cannot walk a straight line), confusion. That is the order for immediate descent.

Pulmonary edema — breathlessness at rest, gurgling breathing, cough, a sharp drop in capacity. Also an immediate descent, oxygen and a doctor.

The core rule: you do not climb with symptoms. Staying the night at the same altitude is acceptable with mild signs; any worsening means down. Descending 300–500 metres works better than any medicine.

Prevention that works

The only reliable prevention is time. All our programs follow "climb high — sleep low": gaining altitude by day, sleeping lower. Look at the altitude chart of any of our programs — it is a sawtooth, and every tooth tells the body to adapt without overload.

What else helps: drinking 3–4 litres a day (dehydration amplifies symptoms), no alcohol during acclimatization, walking slower than you want to, and eating even without appetite. Good fitness speeds up recovery but — contrary to the myth — does not protect against altitude sickness: it fells athletes too.

Drug prophylaxis exists, but that is a conversation with a doctor before the trip, not self-medication on the mountain: the drugs have contraindications and side effects. If you train with our preparation program, this question is covered at the check-up stage.

How it works in the group

The guide checks on everyone daily; the kit includes a pulse oximeter and a blood-pressure monitor. Saturation below the norm for the current altitude means adjusting the plan: a rest day, a smaller gain, or a descent if needed.

The most dangerous mistake a participant can make is hiding symptoms so as "not to let the group down" or "not to lose the money". It works exactly the other way round: an early honest signal is almost always solved by a rest day; a late one — by a helicopter. Honesty with your guide is the safety system.

In short

A headache in the first days at altitude is normal — watch it. Not passing and growing — do not go higher. Coordination problems, vomiting, breathlessness at rest — descend immediately. And the best way never to find out what altitude sickness is like is to choose programs with honest acclimatization rather than a "summit in a weekend".

This article is for information only and does not replace medical advice. Before your first trip to altitude — especially with chronic conditions — see a physician.