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Tips for Altitude Acclimatization

High Altitude

Hippophae is the herb resource of Gaoyuan'an which is used to prevent AMSHigh altitude-we all enjoy that tremendous view from a high summit, especially standing at the rooftop of the world-Tibet. But there are risks in going to high altitude, and it's important to understand these risks. Here is a classic scenario for developing a high altitude illness. You fly from Chengdu to Kunming at 1,895 meters. That afternoon you fly to Lijiang at 2,400 meters, then drive up to Shangri-la at 3,280 meters. The next day you fly to Lhasa at 3,680 meters. You begin to have a severe headache and feel nauseous and weak. If your condition worsens, you may begin to have difficulty hiking. Scenarios like this are not uncommon, so it's essential that you understand the physiological effects of high altitude.

What is High Altitude

Altitude is defined on the following scale:

High
8,000 - 12,000 feet or 2,438 - 3,658 meters
Very High
12,000 - 18,000 feet or 3,658 - 5,487 meters
Extremely High
18,000+ feet or 5,500+ meters

Since few people have been to such altitudes, it is hard to know who may be affected. There are no specific factors such as age, sex, or physical condition that correlate with susceptibility to altitude sickness. Some people get it and some people don't, and some people are more susceptible than others. Most people can go up to 8,000 feet (2,438 meters) with minimal effect. If you haven't been to high altitude before, it's important to be cautious. If you have been at that altitude before with no problem, you can probably return to that altitude without problems as long as you are properly acclimatized.

What is Altitude Sickness

Altitude sickness, also known as Acute Mountain Sickness(AMS), or altitude illness is common at high altitudes, and depends on the elevation, the rate of ascent and individual susceptibility. Most visitors to Tibet will suffer from at least some symptoms that will generally disappear through acclimatization in several hours to several days. Symptoms tend to be worse at night and include headache, dizziness, lethargy, loss of appetite, nausea, breathlessness and irritability. Difficulty sleeping is another common symptom, and many travelers have trouble sleeping for the first few days after arriving in Lhasa.

What Causes Altitude Sickness

The concentration of oxygen at sea level is about 21% and the barometric pressure averages 760 mmHg. As altitude increases, the concentration remains the same but the number of oxygen molecules per breath is reduced. At 12,000 feet (3,658 meters) the barometric pressure is only 483 mmHg, so there are roughly 40% fewer oxygen molecules per breath. In order to properly oxygenate the body, your breathing rate (even while at rest) has to increase. This extra ventilation increases the oxygen content in the blood, but not to sea level concentrations. Since the amount of oxygen required for activity is the same, the body must adjust to having less oxygen. In addition, for reasons not entirely understood, high altitude and lower air pressure causes fluid to leak from the capillaries which can cause fluid build-up in both the lungs and the brain. Continuing to higher altitudes without proper acclimatization can lead to potentially serious, even life-threatening illnesses.

Acclimatization

The major cause of altitude illnesses is going too high too fast. Given time, your body can adapt to the decrease in oxygen molecules at a specific altitude. This process is known as acclimatization and generally takes 1-3 days at that altitude. For example, if you hike to Yampachen at 4,300 meters, and spend several days at that altitude, your body acclimatizes to 4,300 meters. If you hike to EBC at 5,200 meters, your body has to acclimatize once again. A number of changes take place in the body to allow it to operate with decreased oxygen.

  • The depth of respiration increases.
  • Pressure in pulmonary arteries is increased, "forcing" blood into portions of the lung which are normally not used during sea level breathing.
  • The body produces more red blood cells to carry oxygen.
  • The body produces more of a particular enzyme that facilitates.
  • The release of oxygen from hemoglobin to the body tissues.

Prevention of Altitude Sickness

Prevention of altitude sickness falls into two categories, proper acclimatization and preventive medications. Below are a few basic guidelines for proper acclimatization.

  • If possible, don't fly or drive to high altitude. Start below 10,000 feet (3,048 meters) and walk up.
  • If you do fly or drive, do not over-exert yourself or move higher for the first 24 hours.
  • If you go above 10,000 feet (3,048 meters), only increase your altitude by 1,000 feet (305 meters) per day and for every 3,000 feet (915 meters) of elevation gained, take a rest day.
  • "Climb High and sleep low." This is the maxim used by climbers. You can climb more than 1,000 feet (305 meters) in a day as long as you come back down and sleep at a lower altitude.
  • If you begin to show symptoms of moderate altitude illness, don't go higher until symptoms decrease (Don't go up until symptoms go down).
  • If symptoms increase, go down, down, down!
  • Keep in mind that different people will acclimatize at different rates. Make sure all of your party is properly acclimatized before going higher.
  • Stay properly hydrated. Acclimatization is often accompanied by fluid loss, so you need to drink lots of fluids to remain properly hydrated (at least 3-4 quarts per day). Urine output should be copious and clear.
  • Take it easy; don't over-exert yourself when you first get up to altitude. Light activity during the day is better than sleeping because respiration decreases during sleep, exacerbating the symptoms.
  • Avoid tobacco and alcohol and other depressant drugs including, barbiturates, tranquilizers, and sleeping pills. These depressants further decrease the respiratory drive during sleep resulting in a worsening of the symptoms.
  • Eat a high carbohydrate diet (more than 70% of your calories from carbohydrates) while at altitude.
  • The acclimatization process is inhibited by dehydration, over-exertion, and alcohol and other depressant drugs.

Preventive Medications

Diamox (Acetazolamide) allows you to breathe faster so that you metabolize more oxygen, thereby minimizing the symptoms caused by poor oxygenation. This is especially helpful at night when respiratory drive is decreased. Since it takes a while for Diamox to have an effect, it is advisable to start taking it 24 hours before you go to altitude and continue for at least five days at higher altitude. The recommendation of the Himalayan Rescue Association Medical Clinic is 125 mg. twice a day (morning and night). (The standard dose was 250 mg., but their research showed no difference for most people with the lower dose, although some individuals may need 250 mg.) Possible side effects include tingling of the lips and finger tips, blurring of vision, and alteration of taste. These side effects may be reduced with the 125 mg. dose. Side effects subside when the drug is stopped. Contact your physician for a prescription. Since Diamox is a sulfonamide drug, people who are allergic to sulfa drugs should not take Diamox. Diamox has also been known to cause severe allergic reactions to people with no previous history of Diamox or sulfa allergies.

Dexamethasone (a steroid) is a prescription drug that decreases brain and other swelling reversing the effects of AMS. Dosage is typically 4 mg twice a day for a few days starting with the ascent. This prevents most symptoms of altitude illness. It should be used with caution and only on the advice of a physician because of possible serious side effects. It may be combined with Diamox. No other medications have been proven valuable for preventing AMS.

Both Diamox and Dexamethasone are Western Medicine. You are recommended to consult your doctor for the prescription as they can have some serious side effects.

Rhodiola is the herb resource of Hongjingtian used to prevent AMSTibetan Herbal Medicine-Hongjingtian and Gao Yuan An are very good preventive and treatment effects for Altitude Sickness and AMS (Acute Mountain Sickness). Honjingtian and Gao Yuan An (Rhodiola Eoccinea and Hippophae) may help sleep at high altitude and thus increase oxygenation at night. The two Tibetan Medicines can be quite effective in treating altitude sickness. But it also has one side effect: if you take the medicine, your alcohol resistance will be higher, i.e. you can drink more before you get drunk. In accdordance with theories of modern medicine,"oxygen deficit is the mother of all sickness". Highland Hongjingtian can better regulate oxygen deficit in the local parts of the internal organs of human beings, can increase the degree of blood oxygen saturation, generating selfcure immunity, thereby enhance life vitality. In addition. Hongjingtian has also function of relieving alcoholism (more alcohol can be consumed when intaking this kind of beverage before or after).

Before you come to Tibet

Get as fit and healthy as possible, both physically and psychologically. Visitors having record of heart, lung, other organ problems or anemia should consult their doctor before making the decision to visit Tibet.

Who'd better not come

People who suffered from high blood pressure and severe heart disease are not suggested to travel in Tibet.



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