Altitude Sickness Tips: Unglamorous But Essential

Road trip beside small hill villages in South America

Those travel advertising dweebs have got a lot to answer for – out of all the beautifully Photoshopped pictures of snow-capped mountains, charity hill treks and celebratory Machu Picchu poses, the unglamorous reality of altitude sickness doesn’t get a look-in.

Perhaps the sight of a grumpy tourist clutching their head and begging for a darkened room isn’t much of an incentive for potential customers, but it’s something mountain visitors need to be warned about, much like yodelling or the onslaught of posh children mowing down first-time skiers for kicks.

Unfortunately the sickness (not the yodelling or ski ambushing) can hit anyone, regardless of their age, fitness or habits, so it really does pay to be prepared. Don’t say I didn’t warn you!

High altitude lake in South America with flamingos
At 4,450m above sea level (higher than Mount Fuji, FYI), I could hardly walk straight. Not sure how the flamingos managed it…


Altitude sickness, also known as Acute Mountain Sickness, strikes when your body faces an atmospheric pressure drop at high altitudes, normally from being 2,500m above sea level, but potentially from as little as 1920m.

With less oxygen available in the thinner air, you can’t breathe as deeply as normal. Speaking scientifically (which I rarely, if ever, do), you’re taking in fewer oxygen molecules and your body has to produce more red blood cells to try and cope.

The thing is, many of the world’s must-see sights come with added height – Mount Kilimanjaro is nearly 6,000m above sea level, whilst the city of Lhasa in Tibet clocks in at an elevation of 3,600m. As for the lofty 8,848m tall Mount Everest, climbers at the summit face only 33% oxygen when they breathe in.

Locations high above sea level such as Kilimanjiro and Mount Fuji
How oxygenated are these places? Credit:

Symptoms of AMS

Look out for any of the following typical symptoms, which can be self-monitored:

  • Feeling dehydrated
  • Dizziness and nausea
  • Headache
  • Shortness of breath
  • Fatigue (though you may also have difficulty sleeping – oh joy)
  • Upset stomach or loss of appetite

More serious symptoms, which need urgent medical treatment at a lower altitude, include:

  • Double vision and poor coordination (obviously not to be confused with the effects of having too many beers…)
  • Blue-toned skin
  • Breathlessness even when resting
  • Coughing up frothy liquid, or just a persistent tickly cough
  • Confusion, irrational behaviour or drowsiness
  • An unusual bubbling chest sound

For a full overview, I’d recommend NHS Choices.

Getting these symptoms doesn’t make you a lightweight traveller – famous sufferers include Lady Gaga, who was hospitalised after a gig in Denver (not known as ‘the mile high city’ for nothing), and Martina Navratilova, who experienced HAPE (High Altitude Pulmonary Oedema) during a Kilimanjaro charity climb. Even explorer Hiram Bingham, who unearthed the forgotten Machu Picchu, suffered during his adventures.

Road sign on country highway near Nazca
The sign reads ‘Have a good journey and drive safely’. Not easy if you’re feeling off colour!

My Group Experience

I travelled with Intrepid to Peru, as part of a two week group tour. There, altitude sickness is known as ‘soroche‘ and the Intrepid guides were happy to help us get through the worst of it. Though we were a small group, more than half of us had strong symptoms for several days during the trip. Everyone experienced it differently, but we all became accustomed to the familiar thumping headache and occasional waves of nausea.

My own personal bugbear was the breathlessness; whilst I’m not very sporty, I can normally walk fast and only feel spectacularly unfit if I have to run anywhere or launch myself up 10 flights of stairs. On holiday I often become strangely active and can often be found charging round museums at a rate of knots. However, I was totally unprepared for that chest tightening, throat burning, empty lung feeling to hit when I was walking slowly on a city tour in Cusco, or even just standing still.

It was embarrassing, frustrating and a bit scary to feel so powerless. I remember spending a lot of time pretending to take photos when actually I was trying (and failing) to catch my breath. Looking back, I can see it was perfectly normal to struggle, especially as I rarely spend time in the mountains and don’t live at a high altitude.

Stray dog laying on the ground outside Machu Picchu amid tourists
Make like a sleeping dog and get plenty of rest.

Medication and Treatment – Dos and Don’ts

DO acclimatise slowly, perhaps increasing by 500m per day, which will give your body time to adjust. Taking Peru as an example, flying straight into Cusco could be a shock to the system at 3,300m above sea level, so it may be better to start your trip in Lima, as I did, and progress slowly. When mild symptoms start, try not to increase your altitude until they’re under control.

DO drink coca tea, known as mate de coca, if you’re in Latin America – it’s tasty and beneficial. If you can’t get hold of fresh coca leaves, teabags are available at most hotel breakfast buffets and in supermarkets. Just remember you can’t bring it home with you as a souvenir, due to the miniscule potential for the leaves to be used in cocaine protection.

DO get a prescription for Diamox (a brand name for acetazolamide) before you travel, but bear in mind that the recommended dose can vary wildly. I was told to take three pills a day, whilst travellers from Australia and New Zealand were told to take only half a pill.

Woman in traditional Peruvian costume stands in front of a lake and grass
If nothing else, stay hydrated. Even in the middle of nowhere.

DON’T hit the beers or the double espresso if you’re feeling rough – dehydration and excess caffeine will make things worse. Instead, drink plenty of water and electrolytes (sports drinks) in between cups of coca tea, and try to eat nourishing carb-heavy foods like soup and pasta, which are readily available.

DON’T stop taking the medication, even if you feel it’s not working. It will help to oxygenate your blood, so be patient. If you want to supplement this with alternative remedies, I’d suggest a 4Head stick (a natural headache reliever), ginger tablets or biscuits for nausea, ginkgo biloba to thin the blood, and an Olbas Oil or Vicks nasal inhaler to help clear your head, as menthol can ease symptoms and help you feel marginally less gross.

DON’T push yourself too hard. Yes, you’re there to have a good time, but you can’t really appreciate a place if you’re ill. Take a few hours or a whole day to rest and properly rehydrate; this can make a huge difference. If things don’t improve, or they get worse, seek medical attention.

If you’ve ever suffered from AMS, I’d love to hear your side of the story. What worked for you and what didn’t?