Why is altitude dangerous?

Altitude is a real concern in the mountains. Here are some basics to get you started.

Altitude scares me. When I planned my first trek — and actually throughout my first trek and even now after 4 treks — altitude was the scariest factor. It affects everyone differently, and there is no way to truly prepare before you hit the trail other than to educate yourself. But, I didn’t want that to keep me from the mountains.

Higher elevations mean lower air pressure, which in turn means thinner oxygen levels. This means, you’re taking in less oxygen with each breath. Your body, as a result, has to work harder to compensate.

Everyone’s body reacts to altitude differently: your level of physical fitness has little correlation to how you react. Maybe one time you’ll have no symptoms, maybe you’ll show symptoms another time.

Altitude sickness is an umbrella term for three altitude-related illnesses: Acute Mountain Sickness (AMS), High-altitude Pulmonary Edema (HAPE), and High-altitude Cerebral Edema (HACE). Typically, the very first symptoms are felt around 3000–3500m, sometimes as low as 2500m.

AMS is most commonly experienced by trekkers, including a mild headache, nausea, fatigue, dizziness, or waking up short of breath. Treated properly, AMS is not life threatening. Left untreated, AMS can become the more dangerous HAPE or HACE.

HAPE is dangerous. In simple terms, HAPE is where your lungs fill with fluid and you slowly drown. Common symptoms include shortness of breath, elevated heart rate at rest, and a dry cough. As it progresses, you might hear bubbling sounds in your lungs and your nailbeds and lips may turn blue. If you show any of the commonly listed symptoms, stop and get help. Your only option may be to descend and get oxygen.

HACE is more rare than HAPE, but just as threatening. HACE involves brain swelling leading to a coma and usually occurs above 4000m, but has been known to occur lower. Symptoms include disorientation, lack of energy, stumbling, and hallucinations. If you show any of the commonly listed symptoms, stop and get help. Your only option may be to descend and get oxygen.

Acclimatize. Acclimatize. Acclimatize.

Be kind to your body and give it time to adjust to the lower levels of oxygen in the air. It is common to feel some discomfort as you climb higher than 3000m. Keep tabs on these symptoms and be sure to acclimatize: stay long enough at each altitude to let your body adjust before climbing higher. The higher you’re going, the longer you need to acclimate.

Here are some general preventative measure:

Preventative measures aside, let’s say your headache is persistent or you’re feeling worse. Rest doesn’t seem to be helping. At this point, it’s probably best to descend to a lower altitude. I know, it’s hard to turn back, and maybe this is ruining your plans to cross that gorgeous high pass.

To sum this up, altitude is a real threat. But, it shouldn’t keep you from the Himalayas.

Rather, think of altitude as a challenge: educate, plan, and overcome this. It’s part of the experience of being in the mountains.

You’re doing the first step by starting to read about altitude. Plan your trip to allow for acclimatization days, educate yourself, and be prepared to turn back if that’s what your body dictates.

Here is some reading on altitude sickness to get you started!

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