In 2007 we visited Tibet. We wanted to go there by train from Beijing, but planning our visit around China’s Golden Week – when millions of Chinese go on holiday – appeared to be a bad choice. Trains to Lhasa were sold out, so we had to fly. A perfect recipe for altitude sickness.

Without hotel reservations we arrived in Lhasa, at 3.490 meters one of the highest cities in the world. With our backpacks strapped to our backs we set out to find a place to sleep. With most accommodation fully booked it became a tiresome ordeal that took much too long. With a headache slowly building up we decided to settle on the first available place, so at least we’d have a place to lie down our throbbing heads.

Symptoms of altitude sickness


Scenery in Tibet

We’d arrived at altitude almost from sea level in one go and paid the price: a mild case of altitude sickness (also called acute mountain sickness). Altitude sickness mostly occurs at elevations above 2.500 meters and is caused by lower oxygen levels in the thin air.

We displayed all the symptoms usually associated with altitude sickness: we felt hungover, exhausted, short of breath, a little nauseous and slightly dizzy, but worst was the headache. After taking some paracetamol, drinking lots of fluids and a good night’s sleep we felt much better the next day, but we still had to take it very slow.

Altitude sickness risk in Tibet

Driving through Tibet

After that first day we seemed to be dealing with high altitude pretty well, save for a half day trip from Lhasa to the Ganden Monastery which lies at 4.300 meters 40 km northeast of Lhasa. At the end of the visit I had a splitting headache which abated as soon as we took the bus down to Lhasa again. We even slept at 4.800 meters after that without experiencing real problems (except for a severe shortness of breath….)

Miserable first day at altitude in Peru

With this previous experience in mind we didn’t expect much difficulties visiting Peru, Bolivia and Chili in 2015, traveling most of our six week trip at higher elevations. While Eugénie dealt pretty well with the first day at altitude when visiting the Colca Cañon (at about 3.600 meters) in Peru, I had a miserable day. What probably did me in was crossing an almost 5.000 meter high mountain pass.

Despite using proven local traditional precautions like chewing coca leaves (which we both found absolutely disgusting) and drinking coca tea, as well as eating coca candy, drinking lots of water and taking Diamox (an altitude sickness medicine), I felt worse than ever.

altitude sickness

En route to Colca Cañon, the headache hasn’t set in yet…

Looking back I think the cure was worse than the disease. Next to the symptoms of altitude sickness I experienced all the side effects associated with taking Diamox: tingling arms and legs, (even more) nausea and an unusual need to urinate (causing a little bit of dehydration as a bonus). After stopping with Diamox I started to feel much better and didn’t experience these symptoms again.

So dealing with altitude is not really straightforward and susceptibility to altitude sickness appears to be random. There’s no way of predicting if you’re going to get altitude sickness or not. Being very fit, for example, gives no protection. I have been a competitive triathlete and cyclist until 2015 and Eugénie doesn’t work out at all, but despite a significantly lower level of physical fitness she seemed to handle high altitude much better than I did. And like my experience shows, it can even differ between trips.

Preventing altitude sickness

altitude sickness

Salar de Uyuni is at high altitude, over 3.600 meters

Before we left for the Andes we visited an office of the Dutch public health services in our hometown Groningen where we got a brochure about altitude sickness. These are the precautionary measures mentioned to prevent – or at least alleviate – the effects of altitude sickness.

♦ Try to avoid traveling to elevations higher than 2.500 meters directly from sea level, but spend one or two nights at lower altitudes (1.500-2.000 meters) first.

♦ If you do arrive directly at altitude, then take two days to acclimatize and avoid heavy exertion.

Ascend slowly, no more than 500 meters per day, at elevations higher than 3.000 meters.

Drink sufficient fluids, preferably water, at least a few liters per day and don’t drink alcohol or take sleep medication.

♦ In addition the owner of our hostel in Cusco advised to eat light, preferably vegetarian.

Consult your doctor before traveling to high altitude destinations if you have a lung or heart disease.

♦ Only take preventive medication like Diamox (acetazolamide) if you’re susceptible to altitude sickness. Diamox should be taken from one day before arriving at altitude until two days after arriving at maximum elevation.

♦ When showing symptoms of altitude sickness you should not ascend any further and take Diamox (if prescribed). You can also take paracetamol against the headache and medication against nausea.

♦ If the symptoms don’t subside then it’s best to descend until symptoms disappear.

About the author

Roel Kerkhof

Restless wanderer, retired cyclist and triathlete, geographer and writer. Man with a mission impossible: to visit all countries in the world.

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