Altitude sickness poses a significant risk for trekkers heading to Everest Base Camp, but it can often be prevented through proper preparation and acclimatization. Mountaineers emphasize pacing and knowing limits over sheer strength. This guide outlines practical steps to ensure a safer journey in the Himalayas.
Altitude sickness, or acute mountain sickness (AMS), affects hikers above 3,000 meters due to reduced oxygen levels. On the Everest Base Camp (EBC) trek, which reaches 5,364 meters where oxygen is about 50% of sea-level amounts, symptoms like headaches, nausea, and fatigue can emerge quickly, especially after Namche Bazaar at 3,440 meters.
The trek's challenges include long days, cold weather, dehydration, and poor sleep in teahouses, increasing vulnerability even for fit individuals. Severe forms, such as high-altitude pulmonary edema (HAPE) with fluid in the lungs or cerebral edema (HACE) causing confusion, demand immediate descent and medical help.
Preparation begins 8-12 weeks ahead with uphill hiking, endurance walks, and strength training to build resilience, though fitness alone does not prevent AMS. A medical check-up is advised for those with respiratory issues, heart conditions, or prior altitude problems, and travel insurance should cover evacuations.
Key to success are acclimatization days: stay two nights in Namche Bazaar with a hike to Everest View Hotel or Khumjung, then descend to sleep; repeat in Dingboche at 4,410 meters by ascending to Nagarjun Hill before returning. Diamox, at 125 mg twice daily starting before ascent, aids breathing under medical guidance, supplemented by hydration with 3-4 liters of fluids daily and high-carbohydrate meals.
Monitor early signs like dizziness or poor sleep; if mild, rest and reassess, but descend 300-500 meters if worsening. Avoid alcohol, smoking, and sedatives. Hiring a guide helps control pace and spot issues early. As Himalayan guides note, itinerary trumps fitness—slow ascent ensures more reach Base Camp safely.
The Himalayan Rescue Association clinic in Pheriche offers support, but prevention remains essential for enjoying the trek.