Tips to avoid high altitude sickness problem in Tibet tour

Important Tips and Information on Altitude Changes and High-Altitude Sickness Problems in Tibet

Thousands of people travel to Tibet every year to experience the unique culture and visit some of the highest, 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 consider is the hugely increased altitude on the Qinghai-Tibetan Plateau.

For many travelers, altitude sickness problem is the most concerning part of a Tibet tour and few of them may give up the once-in-a-lifetime experience in Tibet just because of the high altitude breathing problem. Truthfully, it is a natural effect of being at such a high altitude. It is nothing to be afraid of, but it is important to know about altitude sickness treatment and how to prepare for and to know about natural remedies for altitude sickness.

Altitude	Categories and zones	Corresponding Attractions and Tours in Tibet
9000 m / 29530 feet	Death Zone	Mt Everest, Mt Shishapama, Mt Lotse, Mt Makalu, Mt Choyu Tibet Mountaineering Tours only
8000 m / 26240 feet	Death Zone
7000 m / 22965 feet	Extreme Altitude	Mt Lhakpa Ri Trekking
6000 m / 19685 feet	Extreme Altitude	Mt Lhakpa Ri Trekking
5000 m / 16404 feet	Very High Altitude	Mt Everest Base Camp Tours, Mt Kailash Tours, Tibet Trekking Tours
4000 m / 13123 feet	Very High Altitude	Tibetan Cultural Tour to Shigatse, Tibet Spiritual Tours to Tsedang. Namtso lake, Yamdrok lake, Mt Kailash
3900 m / 12795 feet	High Altitude	Tibet Group Tours, Tibet Lhasa Tours
2000 m / 6561 feet	High Altitude	Lhasa, Potala Palace, Jokhang temple
1000 m / 3280 feet	Sea Level
0m / 0 feet	Sea Level

What is Altitude Sickness?

Altitude sickness is a disorder caused by being at a 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 in our usual environment. When we travel higher they need 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 to the change in the new environment and low oxygen levels. If you go up too fast 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 high altitudes can tell you about having headaches, being out of breath, sleeping badly, and losing 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 a worse situation. We at Explore Tibet will never push you beyond your limit and allow more than enough time for your personal acclimatization.

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

Generally, if you are given enough time to acclimatize, most people can easily adjust to an altitude between 5,000m (Mt Everest Base Camp) and 5,500m (Mt Kailash Trekking). Above 5,500m would take a longer time for acclimatization and may need special high altitude training to help adaptation.

So, what is the difference between traveling at high altitudes? The main difference is that as you go higher the air pressure gets lower (the air gets thinner), and this means for every 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 as well as many other biological functions 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 carry more oxygen in the blood. These changes take time to happen. Therefore, acclimatization is very important while you arrange your Tibet tour itinerary, normally we advise you 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. We will always help monitor your condition and make sure you are always comfortable during your journey.

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 work effectively. Over 3000m, ascend slowly and make sure you have at least two full days at the same altitude to adapt and examine yourself and 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 at high altitudes means people may 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. Again, this is nothing to worry too much about as we are beside you the whole way.

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.

Altitude Change from China to Tibet

When traveling from China to Tibet, you are going from an altitude of around sea level (Beijing is at an elevation of just 43 meters) to an elevation in Lhasa of 3,490 meters. Moreover, on the way, you will get as high as 5,072 meters above sea level when traveling through the Tanggula Mountain Pass.

If you are traveling from Xining to Lhasa, you will start at an elevation of 2,275 meters in Xining, and rise sharply once the train passes Golmud, which sits at an altitude of 2,809 meters. From there it is a short journey of just a few hours before you reach the Kunlun Mountain Pass, which is at an elevation of 4,800 meters. The train ascends very quickly to this high elevation, before leveling out and dropping slightly to continue the journey to the next high point, and the highest on the Qingzang Railway, Tanggula Pass. After Tanggula Pass, the railway descends slowly on the route to Lhasa, where it ends at an elevation of 3,490 meters.

The trip from Xining to Lhasa covers major changes in altitude along the route, from medium altitudes such as those in Xining to the extreme altitude of Tanggula Pass. And it is this sharp change in altitude that often causes High Altitude Sickness, or Acute Mountain Sickness (AMS) as it is sometimes known. This can be even worse if you fly to Lhasa, as there has been no chance to acclimatize at all.

The same can be said of the journey from Lhasa to the far west of Tibet, in the region of Mt. Everest or Mt. Kailash. As you travel west there is an increase in elevation, which can cause altitude sickness, even if you are not exerting yourself. Lhasa is at an altitude of 3,490 meters, while Rongbuk Monastery sits at 4,980 meters above sea level, a difference of almost 1,500 meters. Similarly, Everest Base Camp is at an elevation of 5,200 meters, an increase of over 1,700 meters. It is this change in altitude that causes AMS when one travels too high too fast.

The Common Altitude Sickness (AMS) Symptoms are:

With a higher chance of altitude sickness due to the extreme elevations outside Lhasa, travelers should know how to recognize the altitude sickness symptoms, in case they experience it. If you deal with them 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 A general feeling of malaise Poor appetite (not hungry)

Altitude Sickness Treatment		Altitude Sickness Medication
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 actually dropping on the route into Lhasa, this can help with the treatment. One way to help counter the effects of altitude sickness is to breathe 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 from you when you leave. Alternatively, your Tibet Travel Agency 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.		There are also some medications that are helpful in treating altitude sickness prevention 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, the 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 as long as you are careful and able to recognize the symptoms if they attack 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 altitude sickness. 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 in 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.

Basic Altitude Sickness Medication Guideline for Tibet Tours:

Problems	Drugs	Suggested Dose
AMS Headache	Paracetamol	500mg tablet, 2 Tablets 4 times a day
AMS Nausea	Metoclopramide	400mg tablet, 1 tablet 3 times a day
AMS Nausea	Or Prochlorperazine	1 to 2*5mg tablet up to 3 times a day
AMS Prevention	Acetazolamide	Half a 250mg tablet 2 times a day, started 2 hours before ascent
HACE	Oxygen Gas	Breathed continuously – cylinder or pressure bag
	Dexamethasone – Corticosteroid	8 – 16mg a day in divided doses, for up to 5 days
	Acetazolamide	250mg tablet, 1 tablet 3 times a day
HAPE	Oxygen Gas	Breathed continuously – cylinder or pressure bag
	Nifedipine	20mg MR tablet 2 times a day
	Acetazolamide	250mg tablet, 1 tablet 3 times a day
Diarrhea	Ciprofloxacin	750mg 2 times a day
	Or Azithromycin	Capsules are taken daily for 3 days
	Loperamide	2 mg capsules taken up for 3 days
Infections	Amoxycillin	250mg 3 times a day for at least 5 days
Infections	Or Metronidazole	200mg 4 times a day or as recommended by Doctor
Cough	Pholcodine	Linctus 10ml up to 4 times a day
Sore Throat	Lozenges with anesthetic	i.e. Benzocaine
Dry chapped lips and skin	Lip balm & sunscreen	With at least SPF 15 – skin section
Dry chapped lips and skin	Moisturizer cream
Blocked nose	Pseudoephedrine	60mg 3 times a day
Blocked nose	Or Xylometazoline	Nasal spray
Cold sores	Acyclovir / Aciclovir	5% cream – 5 times a day for 5 days
Note: the above medicines and dosages are collected based on travelers and other medical resources, so please consult your physician or doctor if you have any allergy or other ailment records.

Do Children Get Altitude Sickness by Traveling in Tibet?

Children have the same problems at high altitudes as adults, but it is more difficult to tell when they are having these problems. If you are traveling with children, then you need to be especially concerned about the altitude when you arrange the Tibet tour with us. We will make sure your tour will ascend slowly and get enough time for your children to acclimatize, it is a good way to have a day or two contingency days in the tour, in case you need to spend additional days 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 goes 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 the 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.

Fast Facts on altitude sickness and its influences in Tibet

At higher elevations, the number of oxygen molecules per breath decreases, so your body increases your breathing speed to get more oxygen.
Symptoms of altitude sickness include weakness, sleepiness, lack of appetite, and easy to forget, so it is very common that sometimes you could make silly mistakes.
Electronic Batteries have a shorter life in high altitude areas, so your mobile devices and Cameras may need to recharge frequently, don’t think it is your device’s problem.
Disturbed sleep during the first few nights at high altitudes is common and normal. You may be slow in getting to sleep, wake up a lot and feel that you have not slept well, or feel less refreshed. Poor sleep may be related to how well your body is adjusting. As you acclimatize sleep usually improves.
Consume between 4 to 6 liters of water per day. Eat a high-calorie diet while at high altitude. Climb high and sleep low. Avoid smoking as much as possible. Do not consume alcoholic drinks, especially for the first few days of your arrival.
You will need to pee more, your balance may become unsteady, your eyesight could change and your nails will grow differently.
Cosmetics bottles and snack packs are inflated and expanded in size, it is because of the low atmospheric pressure in the high altitude which imbalanced the pressure inside and outside the containers, so be careful when you open the toothpaste and hand creams when you arrive in Lhasa, it will puff out a mess.