High Altitude

Read to stay
safe at High Altitude

Altitude can be defined on the following scale:

High Altitude Very High Altitude Extremely High Altitude
8,000 - 12,000 feet (2,438 - 3,658 meters) 12,000 - 18,000 feet (3,658 - 5,487 meters) 18,000plus feet (5,500plus meters)

Most people can go up to 8,000 feet (2,438 meters) with minimal effects. If you have been at that altitude before and had no problems, you can probably return to that altitude without problems if (and only if) you are properly acclimatized.

Ladakh, known as "the land of high passes", lies between the Himalayas and the Kunlun mountain range at a height of more than 3,000 metres (9,800 feet). It is a high-altitude desert which has become a popular destination for adventure travellers in the last decade, drawn by its unique culture and extraordinary natural beauty.

Where will anyone suffer from AMS  in Ladakh can differ for each person; but chances are highest at Pang, Tanglang La, Tso Moriri, Pangong Tso and Changthang. Please be advised that these places are located at highest altitude in this region where most people feel the symptoms but anyone may suffer from AMS at other places too.


oxygen level at High Altitude

Air is comprised of different molecules, with nitrogen (79.04%) and oxygen (20.93%) making up the majority of each breath we take. This composition of air remains consistent, whether we are at sea level or at altitude.  At sea level, because air is compressible, the weight of all that air above us compresses the air around us, making it denser. As you go up a mountain, the air becomes less compressed and is therefore thinner,  the thinner air means there is less oxygen to breathe.This results in breathlessness, tiredness, and dizziness.

The body makes a wide range of changes in order to cope better with the lack of oxygen at high altitude. This process is called acclimatisation.

Challenges at High Altitude

The environment is completely different at high altitude compared to that at sea level - the air is thinner and temperatures are usually much colder. Most people going high have to deal with altitude related illnesses. Dealt with correctly, they are unlikely to be a major problem. Dealt with incorrectly they can be disastrous - spoiling the trip. In fact, when you think how clever your body is at dealing with such big changes, you may even want to know more!

Acute Mountain Sickness (AMS): The most common illness associated with travel and altitude, is termed acute mountain sickness (AMS).  is quite similar to a hangover - it causes headache, nausea, and fatigue. This is very common: some people are only slightly affected, others feel awful. AMS is common at high altitudes, that is above 8,000 feet. Three-quarters of people have mild symptoms of AMS over 10,000 feet.

HAPO/HAPE (High-Altitude Pulmonary Oedema)

HAPE/HAPO - High Altitude Pulmonary edema is a condition caused by dangerous excessive fluid in the lungs. This fluid collects in the numerous air sacs in the lungs, thus making it difficult to breathe. In this way, HAPE/HAPO can be fatal within hours.

HACE (High-Altitude Cerebral Edema)

HACE is a medical condition in which the brain swells with fluid because of the physiological effects of traveling to a high altitude. It occurs when the body fails to acclimatize while ascending to a high altitude. HACE can also occur in people with HAPE and vice versa. Factors that increase the risk of HACE are similar to those for acute mountain sickness and HAPE.

Dealing with Pre-existing conditions at High Altitudes

Physical fitness is the first and the foremost thing you need to consider while undertaking a trip to high altitude areas like Ladakh region. If you suffer from a condition, you must talk to your doctor about whether or not you should go to high altitude and, if you do, how you should take care of yourself. With any condition there is more risk to health when travelling to remote locations. The key is to lower this risk as far as possible. Be prepared to give up part or all of your trip for safety reasons.

People with pre-existing medical conditions should talk with a doctor before travelling to high altitudes:

Heart conditions & high blood pressure

People with heart conditions should seek medical advice from a doctor familiar with high altitude medicine, bring extra doses of regular medications and return to a lower altitude should they start having warning signs such as chest pain or shortness of breath.  Experts recommend that patients with severe heart conditions —like those with severe heart failure or uncontrolled very high blood pressure—or patients recovering from heart attack or a stent procedure should avoid traveling to high altitudes.


People with diabetes need to be aware that complications of diabetes may be triggered by altitude illness and may be hard to treat if they are taking medicine for altitude illness. Not all glucose meters read accurately at high altitudes.

Before booking get expert medical advice. Always carry emergency glucose, glucose monitor and medication. Avoid infection. Get help fast if you become ill.


Don’t stop travelling… but plan ahead. Just because you have asthma doesn’t mean you shouldn’t travel – it just means you have to do a little more planning before you start your journey.

If you’re fit and healthy with well-managed asthma you should have no problems, as long you climb slowly and are alert to changes in your asthma. Some people get worse as cold and exercise trigger attacks.

  1. Do not go unless your asthma is stable.
  2. Know triggers for your asthma and try to avoid these on your trip.
  3. Carry all your inhalers at all times.
  4. Prevent problems by reducing activity, taking medication and descend if needed. 
  5. Avoid anti-inflammatory drugs (like aspirin and ibuprofen)



Pregnant women can make brief trips to high altitudes, but they should talk with their doctor before bookings because some doctors recommend that pregnant women not sleep at altitudes above 12,000 feet. But they should :

Avoid any kind of strenuous activity

Ascend very gradually

Have lots of rest and drink plenty of water

Have easy access to medical help in the area they're travelling to.

Advisory tips to deal with pre-existing conditions before you go:
  • See your doctor / specialist before your trip and find out about the risks for travel at high altitude.
  • Make a medical plan and what, if any, support you will need. Find out what medical help may be available. Think about what you will do if things go wrong.
  • Make everyone aware of your medical condition, the signs, symptoms and treatment. Your illness could affect everyone in your group.
  • If possible, carry Oxygen cylinders as oxygen can be life saving as far as AMS is concerned.
Ask and confirm from your tour operator about the availability of Oxygen cylinder in taxi to secure yourselves against unexpected emergencies.
Ask and confirm from your tour operator, booking managers, home stay owners  about the availability of Oxygen cylinder in taxi to secure yourselves against unexpected emergencies especially at very high altitude destinations like Pangong Tso, Tso Moriri etc.
  • Make a kit with your medicines. Make clear labels and instructions. Have spare supplies.
  • If symptoms worsen avoid further ascent and descend as necessary.

    Be honest with everyone about changes in your medical condition.

Children at high altitude

Children have the same problems at high altitude as adults, but it is more difficult to tell when they are having these problems. It is essential to climb slowly to allow children time to acclimatise. Young children can’t tell you how they feel. The carer should be guided by the child’s fussiness, eating, sleeping and playing. If these are worse than usual the child should be assumed to have altitude illness and stay at the same altitude or descend until they are better. Older children can describe the symptoms of AMS, which are the same as for adults.

Precautions while travelling high altitude with Kids

When travelling with kids take care of the following precautions:

  1. Discuss plans with your doctor at least 3 months before leaving. The doctor may suggest some medicines. Carry these from your home itself and always keep them ready while travelling high altitudes regions.
  2. Ascend very gradually and slowly to allow proper acclimatization
  3. keep them properly hydrated by giving proper liquid intake like water & juices,but do not over-hydrate; it may lead to vomiting. Do not also force feed them to eat also. Digesting food at high altitude can be a time consuming process.
  4. Try to cut short your time at high altitudes. Avoid spending a night at high altitude places like Tso Moriri or Pangong Lake if you are travelling with a kid.
  5. Train the child to breathe more deeply and at a slightly faster rate than normal, to get more oxygen into the lungs.
  6. Check their activities and movement closely. If your condition worsens, please rush to a hospital.
  7. Keep an oxygen tank/cylinder with yourselves, it can help as well if your child is having breathing problem.
Elderly at high altitude

Senior or older adults are generally at an increased risk of getting altitude sickness because it takes their bodies longer to acclimatise at high altitudes.

When travelling with elderly people take care of the following precautions:

  1. If the older persons are suffering from any heart condition or Asthmatic problems, consult their doctor before bookings. Dealing with altitude sickness can be a problem for elderly with chronic conditions.
  2. Do not forget to carry all the prescribed medicines and other medicines including the altitude sickness medicines. Consult their doctor about whether the medicines can be taken along with other medicines or not.
  3. Avoid spending a night at very high altitudes.
  4. Make possible that seniors have adequate time to acclimatize to high altitudes.
  5. Consider how you would get help if they became seriously ill at high altitudes.
  6. Keep an oxygen tank/cylinder with yourselves, it can help as well if elder person is having breathing problem.