How to avoid high-altitude sickness in Tibet

When people plan to travel to Tibet,  what are they most concerned about? Obviously, it is the high-altitude sickness. Tibet, as 'the roof of the world', has the highest plateau in the world, with an average elevation of around 4,500 meters (14,764ft). The elevation of the capital city Lhasa is about 3,650m (12,000ft) and the Mount Everest Base Camp is about 5,200m (17,060ft).

Table of Contents

1. Symptoms of acute altitude sickness
2. Travel tips at the stage of planning your Tibet tour
3. Travel tips prior your Tibet tour departure
4. Travel tips while during the trip
5. What to do when you have altitude sickness when you are in Tibet

Symptoms of acute altitude sickness

As we understand that the higher the place you reach, the lower the air pressure and the thinner oxygen you get. If you, living in a lower altitude, travel to a place with a higher altitude rapidly, it is very common to get altitude sickness due to the sudden change of the air pressure and oxygen content., below are symptoms of acute mountain sickness from mild to severe:

Symptoms of mild altitude sickness include:

• Headache
• Dizziness 
• Nausea
• Fatigue
• Sleeping difficulty/Insomnia
• Shortness of breath
• Loss of appetite

It usually occurs 4-24 hours after you enter a place higher than 2,500meters (8000 feet) quickly. Those symptoms are obvious in the first one or two days and will gradually disappear after a 2-4 days’ good acclimatization at a moderate altitude. Normally in our WindhorseTour itineraries to Tibet, we include 3 days’ acclimatization in Lhasa city at the beginning of the tour, so the clients can slowly adapt to the high altitude.

After over-the-counter medications and as time goes on, if the symptoms don’t get better but might feel more intense, you might have moderate altitude sickness. If anyone suffers from this symptom, it's highly recommended to see a doctor and take medicine based on the doctor's advice. Below are the symptoms might appear:

Symptoms of moderate altitude sickness:

• Severe headache
• Severe nausea/vomiting/diarrhea
• Shortness of breath while resting
• Elevated blood pressure
• Chest tightness
• Trouble walking

If any of our clients suffer moderate altitude sickness during their Tibet tour, our guide will assist the clients to visit the nearby clinic or hospital, we will also suggest the clients to stop doing any further travel for better treatment and cure.

If it develops into severe altitude sickness, you should return to a lower altitude and seek medical attention immediately. The symptoms that you might have are as below, however, such altitude sickness is extremely rare to occur. 

Symptoms of severe altitude sickness:

• Fainting
• confusion
• Pulmonary edema, 
• Brain edema

Based on our over 10 years’ experience to organize and deliver the tours in Tibet for both individual and group travelers, we very much like to share some of our practical travel tips here on how to prevent yourself from the high altitude sickness, what you can prepare before and during the tour. 

Travel tips at the stage of planning your Tibet tour

​​​​​​1. Consult your doctor and have a physical examination

• When you plan your trip to Tibet, it is highly recommended to consult your doctor for advice, at necessary have a physical examination to check your physical fitness.
• People with heart, lung, brain, liver, and kidney disease, mental illness, and severe anemia or hypertension are easy to get high altitude sickness, those people should avoid traveling to Tibet.

2. Plan a reasonable itinerary following the gradually ascending rule

• The most effective way to prevent yourself from the high altitude sickness is following the gradually ascending rule. A gradual ascend can allow time for your body to get used to the new altitude and reduce the chance to get altitude sickness. You should check the travel plan with your Tibet travel agency back and forth to ensure it follows this rule.
• When traveling at altitudes above 2,500-3,000 meters, it is advisable to: 
  • Ascend no more than 500 meters(1,640 feet) daily; 
  • Have a rest day after each 600 - 900 meters (1,969 - 2,953 feet) ascent; 
  • A 2-3 days’ acclimatization before proceeding to the higher altitude; 
  • Avoid flying directly to Tibet if possible.

• When you plan a trip to Tibet, the ideal choice would be to stop 1 or 2 days somewhere at the altitude between 2,000 - 2,700 meters (6,562 – 8,858 feet) before you head to Lhasa. Xining could be a good place to stop over if you have enough time. 
• Xining is located in Qinghai province, with an elevation of ( 2,261 meters/7,418 feet), a great place to acclimatize the high altitude before traveling to Tibet. Xining is the start point of the Qinghai-Tibet railway, where you can take the train to Lhasa (approximately 21 hours) to enjoy the wild and original Kekexili (Hoh Xil) from the train window:
  • • Firstly, spend a couple of days in Xining before heading to Lhasa. In Xining, you may have a day tour to Qinghai Lake to enjoy the well-mixed scenery of grassland, lakes, snow-capped mountains, or have a half-day short excursion to Kumbum monastery to better understand Tibetan culture.
    • Then, take the train to Lhasa (it is highly recommended to book a soft sleeper train ticket to have better sleep and rest.).
    • After arrival, spend another 2-3 days in Lhasa city for further acclimatization. 
    • You may read over our 9 days Qinghai Tibet train tour to get more ideas.

Once your Tibet tour is booked, the rest will be the preparation before the tour starts.  Follow the tips below to make a good preparation to prevent altitude sickness before the trip.

Travel tips prior your Tibet tour departure

1. Do some adaptive exercises 

• Before entering Tibet, it is advisable to do some adaptive exercises physically. You should not exercise suddenly and excessively which is likely to cause physical damage and more inclined to cause altitude sickness. Periodic aerobic exercise can help to adapt to the hypoxic environment on the higher altitude areas, so you can perform a small amount of aerobic exercise a month in advance. Such as jogging, cycling, swimming, and other low-intensity, rhythmic, long-lasting sports. You may exercise at least 40 minutes per time and persist 4 times a week, which can effectively enhance and improve cardiopulmonary function, regulate physical and mental conditions, and respond to the high altitude places environment. 

2. Supplement Vitamins and drink some brown sugar water

• Before the start of your Tibet tour, drinking a glass of brown sugar water daily about 15 days in advance and supplement vitamins daily in advance can help you to adapt to the high altitude quicker upon your stepping into Tibet.

3. Take some high altitude sickness medicine - Diamox is recommended  

• To some extent, medication can help to prevent altitude sickness, but it doesn’t work for everyone. Apart from this, mild altitude sickness symptoms are able to be treated with proper medication. Before your tour starts, you may take some medicine under your doctor’s instructions. Diamox and Hongjingtian (Rhodiola Eoccinea) are popularly used to prevent and reduce altitude sickness symptoms.
• We also recommend you to carry a well-supplied first-aid kit for your Tibet tour, especially if you take a trekking tour, make sure your kit includes comprehensive supplies. Below is our suggested list to bring:
  • Antibiotics
  • Diamox – to aid with the prevention of altitude sickness
  • Homeopathic medicines like gentiana for altitude sickness
  • Diarrhoea and dysentery medicines
  • Pain relievers
  • Cold and flu tablets, throat lozenges and nasal decongestant

4. Be positive and optimistic

• It is required to be healthy not only physically but also psychologically. No matter before the trip or during the trip, you should keep an optimistic and positive attitude, imagine that you are still in the lower altitude not the higher altitude, Don’t be too nervous and just take it easy to enjoy the nice scenery when you are traveling to Tibet, in this case, you can adapt to the altitude environment faster.

5. Be healthy and pack properly

• Avoid catching a cold. If you catch a cold, it is easy to cause respiratory tract infection which will induce acute altitude sickness. To prevent catching a cold, you should pack suitable clothes based on the local weather. 

It’s time to start your Tibet adventure! We also prepared some other travel tips for you to avoid the high altitude sickness while during the trip.

Travel tips while during the trip

1. Truly rest for the first 2-3 days

• We highly suggest that you truly rest on your first day arrival at Lhasa. And avoid any strenuous exercise at the following 2-3 days. Normally at our WindhorseTour itineraries, we have the first 3 days in Lhasa with mild travel activities while adapting to the high altitude. 

2. Drink water and eat properly

• You should drink enough water/fresh fruit juice (no less than 4L per day), staying hydrated is very important in preventing altitude sickness. During your trip to Tibet, you may try some butter tea/sweet tea at local tea houses  which will have a certain effect on alleviating the altitude sickness.
• Eat some light, digestible food such as high-carb food.
• Do not eat food that is particularly spicy and irritating.

3. Avoid alcohol and smoke 

• Drinking alcohol will make your heartbeat and breath faster, then cause severe hypoxia and worsen your altitude sickness.
• The carbon monoxide of cigarettes can be easier to combine with hemoglobin. If you smoke a lot, it will significantly increase altitude sickness.

4. Sleep lower

• A mantra ‘Climb High and sleep low’ is popularly acknowledged by the climbers, Altitude sickness usually gets worse at night when you’re sleeping as sleeping at high altitude deprives your body of adequate oxygen more than a day trip does. So it’s better to return to sleep at the lower altitude if you ascend more than 1,000 feet (305 meters) in a day. 
   

We expect you all will have a great smooth travel time in Tibet after following our travel tips on preventing the high altitude sickness as above. But if there is something going the opposite way, then

What to do when you have altitude sickness when you are in Tibet?

• Share your symptoms with your guide to seek help. The guide normally will give you suggestions based on your actual symptoms, visit pharmacy or clinics. Or have some oxygen bottles.
• If you appear to have some moderate altitude sickness symptoms, then your guide will assist you to visit a local clinic or hospital for a more comprehensive treatment. You will be advised to stop your travel schedule or delay it until it lightens or disappears. 
• Ask for oxygen if you feel you need it.
• Move to the lower altitude and seek medical attention immediately if you experience some more severe altitude sickness. 

In conclusion, it’s hard to predict whether you will suffer from altitude sickness or not when you travel in Tibet, as different people have different reactions. The best way to prevent altitude sickness is ascending slowly and gradually and following the tips above to do some preparation.

Furthermore, visitors having the record of heart, lung, other organ problems, high blood pressure or anemia should consult their doctor before making the decision to Tibet.