High-Altitude Travel Preparation

What counts as high altitude?

Effects can begin at around 2,500 metres, and become more common above 3,000. Leh is at about 3,500 metres, Kaza in Spiti at about 3,800, Gurudongmar Lake in North Sikkim above 5,000 and Tawang at roughly 3,000. Fitness does not reliably protect you, and people who coped well once can still be affected on another trip.

Before you go

• Talk to your doctor. This is particularly important with heart, lung, blood pressure, anaemia or sleep conditions, during pregnancy and for children or older travellers.
• Build general fitness with regular walking or cardio for some weeks beforehand.
• Plan realistic days. Avoid itineraries that put you straight onto a high pass on day one.
• Insure properly. Check that your policy covers high altitude and emergency evacuation.
• Share medical details with us in advance so we can plan accordingly.

Pace and routing

Gain sleeping altitude gradually and include rest days. Climb high and sleep lower where you can. In remote regions, remember that medical care and evacuation options are limited, and that weather can close roads. See our guides on Ladakh acclimatisation and Spiti road-trip preparation.

What to pack

• Layers: thermals, fleece, a windproof and waterproof outer, warm hat and gloves.
• Sun protection: sunglasses with UV protection, a wide hat and high-protection sunscreen.
• Lip balm, moisturiser and saline spray for the dry air.
• Sturdy, comfortable footwear.
• A refillable bottle, snacks and regular medicines, plus a basic first-aid kit.
• Photocopies and soft copies of identification and permits.

On the ground

Drink water steadily, eat lightly, avoid alcohol in the first days and walk slowly. Sleep may be disturbed, which is common. If you feel unwell, tell your guide at once rather than hoping it passes.

Signs to take seriously

A mild headache and tiredness may ease with rest. Persistent vomiting, severe headache, confusion, loss of coordination, breathlessness at rest or a wet cough are warning signs that need urgent medical advice and, usually, descent. Do not ascend further with such symptoms.

Medication

Some people take preventive medication on medical advice, but it is not a substitute for gradual ascent. Never take someone else's prescription or start medicine without advice.

Responsible travel at altitude

Carry out rubbish, avoid single-use plastic, conserve water in high villages and respect the local culture. Roads and weather can change, so allow flexibility.

Planning tip

Different regions have different permit and seasonal rules, so please check our guides to Ladakh and Spiti Valley, or ask us about remote Himalayan planning. You can also send us your plans for advice.