With an average altitude of 4,500 m (14,800 ft), getting Acute Mountain Sickness (AMS) on the Tibetan Plateau is not a question of “if” but rather a question of “when.”
The general consensus in preventing AMS is to ascend slowly to allow your body to adapt to the decreasing oxygen in the atmosphere. But with limited vacation days and full itineraries, ascending the prescribed 300 m (1000 ft) per day is sometimes just not possible.
A study published in the Journal of Public Health suggests that travelers who know the symptoms and prevention of AMS are less likely to suffer from the illness. To minimize the effects of AMS, we’ve compiled this Tibet-specific prevention guide for you.
If you’re traveling by plane or train to Tibet, as most travelers do, you will experience one or more of these symptoms in the first 48 hours:
- Nausea and Dizziness
- Loss of apetite
- Shortness of breath
- Disturbed sleep
- General feeling of malaise
In severe cases, AMS can progress to:
High Altitude Pulmonary Edema (HAPE): excess fluid in the lungs.
- Coughing up frothy spit
High Altitude Cerebral Edema (HACE): excess fluid on the brain.
- Loss of consciousness
If you experience any HAPE or HACE symptoms, you need to descend to a lower altitude immediately.
Here are 7 steps you can take to decrease your chances of getting altitude sickness:
1. Drink plenty of water
Drinking enough fluids at high altitudes is important for three reasons:
- Your body tends to lose more water in the acclimatization process
- Symptoms of dehydration are similar to AMS
- Medicines used to treat AMS can have diuretic side effects
According to the Institute of Altitude Medicine, you need to drink an additional 1 to 1.5 liters of water per day at high altitude. Use the color of your urine to gauge whether or not you are properly hydrated. Clear urine means you are properly hydrated, while dark urine suggests that you need to drink more.
2. Take it easy for the first 48 hours
During the initial acclimatization process, limit your movements as much as possible even if you feel energetic. It is crucial for your body to get proper rest as it is working hard to adjust to the decreased oxygen in the atmosphere. If you do need to move about, move 25-50% slower than you normally would.
3. Don’t shower for the first 48 hours
A hot shower as soon as you get to Lhasa sounds like the perfect way to take it easy right? Wrong. Actually, as Lhasa tends to be quite cold, the sudden change in temperature from in and out of the shower can adversely affect your immune system. You will be more susceptible to catching the cold and other ailments that will derail your acclimatization process.
4. Start a prescription of Diamox (Acetazolamide)
Highly recommended by guides and travelers, Diamox is 75% effective in preventing AMS. It reduces the fluid pressure in the eyeball by decreasing fluid formation in the eyeball and speeds up the natural process of acclimatization. But it also increases the rate at which the kidneys expel water from the body.
Start taking Diamox 24 hours before ascent and continue taking throughout the first two days. However, proceed with caution, as there are a number of side effects:
- Drowsiness or temporary vision changes
- May sunburn more easily
- Loss of appetite
For more information on Diamox (Acetazolamide) click here
5. Bring Ibuprofen
If the side effects of Diamox have you thinking twice, Ibuprofen is a great alternative. It’s safe, proven to decrease the likelihood of experiencing AMS, easy to find and available over the counter. Also it only needs to be taken 6 hours prior to ascent to be effective, whereas Diamox needs to be taken a full day before.
Though the exact physiological mechanism of how decreased oxygen leads to AMS is still not clearly understood, some researchers believe a lack of oxygen may cause the brain to swell with fluids. Ibuprofen may help reduce the swelling.
6. Avoid alcohol
Steer clear of alcohol for the first 48 hours. Besides its dehydrating effect, alcohol can suppress breathing and you need to get all the air you can get in your first two days.
There’s a common myth that drinking alcohol at high altitudes will make you more drunk. That is not true. It will, however, make you feel worse than drinking alcohol at sea level because its effect will be combined with symptoms of AMS.
Be especially careful to not consume any alcohol when you are taking Diamox to help with AMS. Alcohol has been known to worsen the temporary vision changes and drowsiness you may experience while taking the drug.
7. Eat a high calorie diet
The cold temperatures and lack of oxygen means your body will be working hard to increase your core temperature and get more oxygen to your muscles. When your body is working hard to adjust to the altitude, it needs more energy.
Luckily, Tibetan cuisine has a wide range of high calorie options. Tsampa, or roasted barley flour, is a Tibetan staple and is highly touted for its ability to give the consumer rapid energy boosts. It’s found in many traditional dishes and breads, but it can also be mixed with butter tea and eaten as a sort of porridge.
Butter tea is also great in the high altitude. Made from tealeaves, water, yak butter and a little salt, its high caloric content helps maintain energy levels, while it’s oiliness act as a moisturizer for your lips.
To learn more about what to eat in Tibet, check out our article on Tibetan cuisine here.