Acclimatization is essential to trekking in high-altitude areas. Nepal Trekking routes are planned incredibly gradually to get used to the altitude, with many of our trekking trails having extra days to allow time for acclimatization. Mountain Rock Treks advice about acclimatization, and with the sensible approach we take on all of our treks, anyone who is fit and healthy should also have few problems. On our Nepal trekking, climbing trips, and trekking trips in Tibet, we carry a portable altitude chamber as an extra safety precaution.

To make sure that you return from trekking in the Himalayas in Nepal with many happy and unforgettable memories, you must be aware of the altitude acclimatization required by the human body in mountain conditions. By observing a tried and tested altitude acclimatization regime, I'll tell you below you'll succeed in avoiding altitude sickness, which can not only provide unpleasant moments but also force you to change your trekking plans.

Mountain Rock  Treks suggest ten golden rules for successful altitude acclimatization way from high altitude sickness:

1. Increase altitude gradually and stick to a set climbing

The most important and best way to avoid altitude sickness while trekking in Nepal is to gradually and systematically increase altitude. In Nepal, a safe size to which you can climb rapidly and straight away is 2,700 – 3000 m. Nepal's most famous mountain airports are in this altitude range: Lukla and Jomsom. On your arrival, you must spend the night at the same altitude.

Afterward, it would help if you stuck to a set climbing regime of 300 – 400 altitude meters daily. Having climbed 1,000 altitude m, you must have one whole day of altitude acclimatization and stay overnight at the same altitude. In Nepal, you will not find it possible to stick to this climbing rule on all trekking routes in the Himalayas. Therefore altitude acclimatization days are individually planned for each trekking route.

2. Consume lots of liquids while trekking

In the mountains, atmospheric pressure falls as the altitude above sea level increases, affecting your body. Therefore, when trekking in the mountains, it's essential to consume a lot of liquids by drinking lots of tea, juice, soup, and clean water. You should drink at least 3 -4 liters of fluid a day. You can buy a liter of bottled water in teahouses along all the most popular trekking routes in Nepal.

3. Avoid alcohol, smoking, and using sleeping tablets

When trekking in the mountains, particularly during your ascent, you must avoid using alcoholic drinks and sleeping pills. Like smoking, calming unnaturally reduces the flow of oxygen to the brain, particularly in mountain conditions in which the concentration of oxygen is already reduced. In turn, alcohol has the heightened effect of depriving the body of water or dehydrating it, which is a similarly undesirable process when trekking in the Himalayas in Nepal.

4. Use preventive medicines while trekking

Mountain medicine has discovered a range of medicinal products that improve the altitude acclimatization process and reduce the side effects of altitude acclimatization in the mountains, such as sleepless nights. Trekkers widely use these products on popular trekking routes in Nepal, like the Everest Base Camp trek, Gokyo trek, Annapurna Circuit trek, etc.

  • Acetazolamide or Diamox

Of all the medicinal products used to aid altitude acclimatization and treat altitude sickness, the most popular is Diamox, whose active substance is Acetazolamide. On the Everest Base Camp trek, Diamox is widely on sale without a prescription in Kathmandu, Lukla, and Namche Bazaar.

Possible alternative names (trademarks) for Acetazolamide include Acetamox, Acetazolam, Ak-Zol, Apo-Acetazolamide, Atenezol, Cidamex, Dazamide, Defiltran, Dehydration, Diacarb, Diakarb, Diamox, Didoc, Diluran, Diuramid, Diureticum-Holzinger, Diuriwas, Diutazol, Donmox, Duiramid, Edemox, Eumicton, Fonurit, Glaupax, Glupax, Natrionex, Nephramid, Nephramide, Phonurit, Storzolamide, and Vitamix.

Before trekking, it is advisable to use Diamox 24 hours before your ascent. Once you've begun trekking, you should use Diamox twice daily in doses of 125 – 250 mg, depending on your body weight in the late morning and the evening. In addition, kids should be administered a Diamox dose of 2.5 mg per kg of body weight twice daily. TIt'saking Diamox before going to bed is essential because it deepens the depth of inhalation during sleep, thus improving the body's supply of oxygen. In addition, Diamox is an effective means of preventing pulmonary edema.

Diamox can indeed cause some side effects, of which the most common are light tingling of the hands and fingertips, blurred vision, etc. Diamox can also induce allergic reactions; therefore, it is recommended that you consult your doctor before use. According to some sources, you should stop taking Diamox on the second or third day after reaching the maximum height on your trekking route, while others say that it is not recommended to use Diamox for longer than 3 -5 days in a row.

  • Garlic soup

One of the best natural recipes for aiding altitude acclimatization that is often recommended by trekking guides in Nepal is garlic, and the famous garlic soup served in Nepal's trekking lodges and teahouses. At first, it is likely to taste quite strange, but as you get used to it – you'll begin to get a taste for it. Garlic soup is also widely available along the Everest Base Camp trek route.

5. Avoid overexertion from carrying overly heavy rucksacks while trekking

Bearing in mind the physical strain and changes in mountain conditions while trekking, you would be well advised to avoid overexertion and leave the carrying of your heavy bags to bearers. This doesn't cost much, and you can hire a Sherpa to carry your bags. If you still plan to have your own rucksack, its weight should not exceed 10 -12 kg optimally.

6. Don't go trekking alone

It would help if you always took a guide when trekking in the mountains. Altitude sickness symptoms can induce panic or wild behavior, so you must have somebody alongside you who can help you whenever you find yourself in trouble. Typically, altitude sickness symptoms worsen at night due to problems acclimatizing to the new altitude reached during the day. If signs of altitude sickness force you to depart and descend at night, you must have your guide with you at all times!

7. Don't climb higher even if you are only suffering from mild symptoms of altitude sickness

If, after reaching a new altitude on your trekking route, you begin to experience mild symptoms of altitude sickness, you must not climb higher under any circumstances! You must remain at your current altitude and monitor your symptoms. Usually, altitude sickness symptoms begin to appear 6 -12 hours after reaching a new height. Symptoms start appearing in the form of a mild headache which may disappear in a few hours or, on the contrary, get worse, accompanied by panic, loss of appetite, and nausea. Trying to fall asleep, you experience wild dreams and mild hallucinations.

Even though you've lost your appetite during this period, it's essential to drink lots of fluids and eat if you haven't already done so. Garlic soup is recommended as well as Diamox or some headache tablets which liquefy blood and improve blood flow: Paracetamol, Aspirin, Tylenol, or Ibumetin.

8. Descend immediately if your altitude sickness symptoms get worse

If the usual painkillers used to treat headaches (Aspirin, Tylenol, Ibumetin, etc.) don't help, and your headache doesn't pass, the altitude sickness worsens. If upn reaching a new altitude along the trekking route, the symptoms of altitude sickness don't give and get worse; the most effective treatment is to descend without delay to a lower altitude. You must drop without hesitation, even at night. It would help if you were accompanied by your guide and take everything you need for the journey. Under no circumstances should you descend alone.

In such circumstances, you should reduce your altitude to at least the height you made at your previous overnight stay, where you didn't notice any signs of altitude sickness, and, if possible, descend even lower. You will feel the benefits after reducing your altitude by 500 – 1,000 meters. In addition, you should use medicines, additional oxygen, and your compression bag or Gamow Bag if you have them available.

9. Never leave anybody alone with signs of altitude sickness

Never leave a person showing signs of altitude sickness alone. They could begin to experience rapidly deteriorating altitude sickness symptoms, and it may be necessary to evacuate him to a lower place urgently.

10. Dress warmly when trekking, and don't overexert yourself

You should keep warm when trekking and prevent your body from cooling, particularly during the first stage of altitude acclimatization. Check to make sure that your clothing is always dry. In the mountains, the air is dry, and it's usually windy. As sweat evaporates, it increasingly cools the body, narrowing arteries and reducing the supply of blood and oxygen reaching your organs, thus creating conducive conditions for altitude sickness to get worse. Unique technical clothing has been invented for trekking in the mountains, which ensures that the body breathes and gets rid of sweat as effectively as possible.