Thousands of people travel to Tibet every year to experience the unique culture and visit some of the highest and most remote areas of the world. Whether you are there to see the monasteries and unique culture or to trek around the high mountains and lakes, one thing you need to concern is the hugely increased altitude on the Qinghai-Tibetan Plateau. Then for many travelers, altitude sickness is most concerning part of a Tibet tours and few of them may give up the once in a life experiences in Tibet just because of the altitude concern, honestly speaking, it is a natural effect of being on a high altitude, and more important is to know about the altitude sickness and have prepared how to prevent the altitude sickness.

What is Altitude Sickness?

Altitude sickness is a disorder caused by going to high altitude, where oxygen levels are low, without gradually getting used to the increase in altitude. In other terms, it is also known as Acute Mountain Sickness (AMS), altitude illness, hypobaropathy, Acosta disease, puna, and soroche.

Our bodies are used to working at our usual environment. When we travel higher they need time to adapt. Altitude starts to have an effect when you ascend around 1,500m – 2,000m or 4920 feet – 6560 feet. Our body will start to behave differently as it tries to adapt for the change in the new environment and low oxygen levels. If you go up too fast to above 2500m or 8200 feet, then mild altitude illness and symptoms are very common.

Some very strange things can happen to your body when you go high! Most people who have been to altitude can tell you about having headaches, being out of breath, sleeping badly and lost appetite. These are symptoms of AMS, AMS is uncomfortable, not life threatening. If the AMS symptoms become severe and you keep going higher, then it will lead to worse situation. So, it is very important to concern it when you plan your Tibet tour and booking your tour with an experienced local Tibetan tour company will make your tour different by concerning these issues.

How to arrange your Tibet tour by concerning altitude in Tibet?

Generally, if you give enough time to acclimatize, then most of the people can adjust to altitude between 5,000m (Mt Everest Base Camp) and 5,500m (Mt Kailash Trekking). Above 5,500m few people can adjust easily, and it would take longer time for acclimatization or may need special altitude trainings to adapt. So, what is different about travel at altitude? The main difference is that as you go higher the air pressure gets lower (the air gets thinner), and this means for any single breath that you take there will be less oxygen for your body. Oxygen is needed to give you the energy to move but is also needed simply to keep your body alive and many other biological things your body does normally without you knowing about it.

As your body gets less oxygen it adapts. You breathe faster and deeper. It makes more red cells to carry more oxygen in the blood and changes take time to happen.

Therefore, acclimatization is very important while you arrange your Tibet tour itinerary, normally we advise to ascend no more than 300m – 400m (980feet – 1300feet) higher at the end of each day, going higher during the day is ok if you go down to sleep at lower altitudes. Always remember “go high and sleep low”.

It is crucial to at least spend two full days in Lhasa which is 3650m or 11975feet, it will allow your body to acclimatize correctly and make it easier for you to acclimatize when you go higher up to Shigatse and Everest Base Camp slowly.

Best Practices of Acclimatization in Tibet.

When the body slowly adapts to lower oxygen levels the process is called acclimatization. Different people acclimatize at different speeds, so there is no certain rule or method that works for everyone, but there are good guidelines that works for everyone effectively. Over 3000m, ascend slowly and make sure you have at least two full days in the same altitude to adapt and examine yourself how you feel, sleeping no more than 300m – 400m higher at the end of each day. Going higher during the day is ok if you go down to sleep (walk high – sleep low). If you go up higher and can’t descend – take a rest day to allow your body time to catch up.

If your time allows, a rest day scheduled after every 2 to 3 days will also help. Driving or flying to high altitude means more people will suffer from mild AMS. It is sensible to find out about the height of your planned route before you travel. Better still make a drawing to show the height that you will sleep at each night. If you don’t know as. There is no better way to spot the days which are likely to cause altitude illness.

Start your journey below 3,100 m or 10,000 feet. If you should fly or drive somewhere that’s higher up, stop at one destination that’s lower for at least a full day before going any higher. Like Xining is a good destination before you head into Tibet, Xining is only 2,275m and the train journey from Xining to Lhasa through the Tibet Skyline train is magnificent.

If you have a trekking tour, hiking tour, or climb over 3,100m or 10,000 feet, only go up an additional 300 m to 400m (980 feet to 1,300 feet) per day.

“Climb high and sleep low”: If you must climb over high passes during the day, make sure you come back down to a lower altitude to sleep.

Drink 3-4 quarts of water every day

Don’t use tobacco, alcohol, or other medications, such as sleeping pills.

Know how to identify the first signs of altitude sickness. Immediately move to a lower elevation if you start to develop these symptoms.

The Common Symptoms of Altitude Sickness (AMS) are:

With a higher chance of altitude sickness due to the extreme elevations outside Lhasa, travelers should know how to recognize the symptoms of altitude sickness, in case they experience it. If you deal with correctly, they are unlikely to be a major problem at all. Dealt with incorrectly they can be disastrous. Failing to treat mild altitude sickness can make it worse and can even result in death in some extreme cases. The onset of mild altitude sickness includes:

Headache

Dizziness

Fatigue

Shortness of breath

Loss of appetite

Nausea (feeling sick)

Disturbed sleep

General feeling of malaise

Poor appetite (not hungry)

Altitude Sickness Treatments.

While there is no way to guarantee that you will not get altitude sickness, there are many ways to protect yourself from the more serious outcomes, which only happen rarely. Knowing the early signs of altitude sickness and being willing to acknowledge that they are present, is half of the battle. Mild altitude sickness is more common than you would think and is generally not debilitating if taken seriously. Once you have recognized that you or someone in your party has the symptoms, it is important not to ascend to a higher elevation, and it is recommended to descend to an altitude where the symptoms disappear or decline. Since Kunlun is the extreme part of the climb, and the rest of the journey is relatively level, before dropping on the route into Lhasa, this can help with the treatment.

One way to help counter the effects of altitude sickness it to breath in a little oxygen through a nasal breathing tube, like those used in hospitals. Oxygen canisters are available almost everywhere in Tibet and can be filled in most cities if you run out. They are expensive to buy, but most shops will buy them back off you when you leave. Alternatively, your tour operator and guide may carry some in the car for emergencies.

Air contains the same 20.9% of oxygen at all altitudes, and it is the change in pressure that makes it feel lower, so you have what is known as “effective” oxygen content. By breathing oxygen, you are effectively increasing the oxygen content of the air, the lack of which is the main cause of AMS. However, there is a risk that too much oxygen dependency can have detrimental effects, so it should only be used when necessary.

Medications for Altitude Sickness.

There are also some medications that are helpful in treating and preventing altitude sickness on the plateau, but you should only use them if permitted by your doctor. Diamox is one of the most popular of all the medications that can help with AMS, and many people will tell you to get some if you are traveling to Tibet. You should make sure you discuss the possible effects with your own doctor before traveling, as it may have detrimental effects if you are already taking other medications or have any heart problems.

There is no foolproof way to avoid getting altitude sickness, as everyone has a different response to high altitudes. However, majority of visitors can avoid getting sick by ascending slowly once over 2,500 meters above sea level.

A good way to help prevent altitude sickness when traveling to Tibet is to spend a few days at a lower altitude that is not above 2,400 meters. Xining, at 2,275 meters above sea level, is ideal for acclimatization, and if you are careful and able to recognize the symptoms if they attack on the way up to Lhasa, you should be able to get through with no problems at all.

Diamox the drug acetazolamide (trade name Diamox) is well recommended by many travelers to reduce the effects of AMS, it is useful if you ascend high altitude that is unavoidable. It also helps periodic breathing. It works by speeding up acclimatization but does not mask the symptoms of AMS. You can still get AMS, HAPE and HACE while taking it.

You must be noted that some people are allergic to Diamox. There are side effects, e.g. tingling, especially of hands, feet and face. Some people find this unpleasant, but it is not harmful and will go away when you stop taking the drug. It also makes you pee even more.

Your mouth and throat will get dry when you breathe through your mouth. Drink lots and use cough lozenges. The sun can burn your lower lip badly. Using a zinc sun screen will help to protect it.

Do Children Get Altitude Sickness by Traveling in Tibet?

Children have the same problems at high altitude as adults, but it is more difficult to tell when they are having these problems. If you are travelling with children, then you need to specially concern the altitude when you arrange the Tibet tour, make sure your tour will ascend slowly and get enough time for your children to acclimatize, it is good way to have a day or two contingency day in the tour, in case if you need to spend additional day at some places in Tibet when the children feel the altitude illness. Parents should be guided by the children’s fussiness, eating, sleeping and activeness. If these are worse than usual the child should be assumed to have altitude illness and stay at the same altitude or descend until they are better.

Who Gets Altitude Sickness?

Anyone who go to high altitude can develop altitude sickness, no matter how fit you are, how young you are, or how healthy you are -- even sometimes Olympic athletes can get it. In fact, being physically active at a high elevation makes you more likely to get it, especially during first few days of your arrival at high altitude places.

Your chance of getting altitude sickness depends on a few other things: how quickly you move to a higher elevation, how high you go up within a single day, the altitude where you sleep, and other factors.

Having certain illnesses like diabetes or lung disease doesn’t automatically make you more likely to develop altitude sickness. But your genes could play a role in your body’s ability to handle higher elevations.