12 Tips to Prevent AMS in Ladakh – Spiti – Zanskar Trips [Acute Mountain Sickness]

Have you heard of things like AMS, Altitude Mountain Sickness, and Acute Mountain Sickness related to high altitude traveling to places like Ladakh, Spiti Valley, Zanskar Valley, or other parts of the Himalayas?

Well, we all want to enjoy the lovely nature and breathtaking views of the high Himalayas. While traveling to the Himalayas, many of us take the high altitude very lightly and always consider the brighter side of the travel which is experiencing the majestic vistas 🙂

However, there is a darker side attached to the high altitude travel as well.

What is AMS?

How many times have you noticed that when traveling to high-altitude places, either you or people around you complained of shortness of breath, nausea, headaches, vomiting, etc.?

I am sure you must have encountered such common situations while traveling in the Himalayas, especially at the high altitudes like regions of Manali – Leh Highway, Leh – Ladakh, Rohtang Pass, Spiti Valley, Zanskar Valley, etc. in India, to name a few.

Acclimatization is the prime reason I propose to choose Srinagar – Leh Road over Manali – Leh Road. To be very frank, some people suffer mildly and some may not suffer altogether; consider yourself very lucky in the latter case. However, some people suffer drastically and the effects can be seriously ugly for them.

Illness or sickness on Himalayan trips is widespread, especially if you are directly flying to places like Leh or driving to a higher altitude, which makes it almost certain that AMS may hit you. Such illness can spoil a much-awaited relaxing holiday in the Himalayas and turn it into something ugly. In some cases, there are very severe/fatal consequences too.

The higher you go directly and quickly, the higher will be the risks of you getting hit with AMS. Hence, it’s always better to know what altitude sickness means and what you can do to prevent it.

Further, in the article, I will try to lay out some important theories and facts about acute mountain sickness and the importance of acclimatization. It may help you be prepared for altitude changes and enjoy that ever-awaited holiday in the Himalayas 🙂

Pro Travel Tip: You can make a trip to Ladakh by following my most recommended Ladakh itinerary which takes care of a gradual increase in altitude. Hence, this itinerary helps in acclimatization and in turn results in a memorable Ladakh trip.

Acclimatization and Acute Mountain Sickness (AMS)

Generally, people can go up to 8,000 feet without many problems with mountain sickness. As you start to increase altitude, the barometric pressure starts to decrease, which reduces the Oxygen intake per breath. Now, to compensate for the less Oxygen intake, your body needs to increase the breathing rate.

Altitude can be categorized into the following scales —

• High (8,000 – 12,000 feet [2,438 – 3,658 meters])
• Very High (12,000 – 18,000 feet [3,658 – 5,487 meters])
• Extremely High (18,000+ feet [5,500+ meters])

Although the increased breathing rate does increase the Oxygen level in the blood, it does not take the Oxygen level to the same level as required by the body while you are at home doing some activity. By spending a proper amount of time at such altitude, your body will adapt to such changes in Oxygen levels, and this process is called acclimatization.

Always keep in mind that different people will acclimatize at different rates. Hence, always try to avoid any sought of comparison and wait for the person suffering in the group better acclimatize.

Acute mountain sickness (AMS) is caused above the altitudes of 10,000 Feet or 3,048 Mtrs to a majority of people. The higher the elevation and rate of ascent, the more will be the effects of AMS.

Hence, do not try to directly go or stay overnight at very high altitudes directly. When you sleep, the symptoms will get worse as your body’s respiration decreases while sleeping.

Pro Travel Tip: You can make a trip to Spiti Valley by following my most recommended Spiti itinerary which takes care of a gradual increase in altitude. Hence, this itinerary helps in the acclimatization and in turn results in a memorable Spiti Valley trip.

The best cure is either to acclimatize properly or to descend. However, the effects of mild AMS can be cured by taking some preventive AMS medicines like headache pain relief or Diamox with proper consultation and prescription from your doctor or physician before the start of the trip.

Diamox is a sulfa drug and does have side effects including allergies. Hence, Diamox shall only be taken after proper prescription by your doctor or physician. Diamox can also be helpful in case a person suffers from periodic loss of breath, which especially occurs in the night while sleeping.

In case, you feel the person is suffering badly then ask him to walk in a straight line by placing him toe to toe. If the person is not able to walk in a straight line i.e. he is suffering from ataxia. IMMEDIATELY DESCEND!!

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Tips for Better Acclimatization

Below are a few tips that will certainly help you in better acclimatization:

Increase the altitude gradually

The acclimatization rules state that after 10,000 feet we must stay overnight for every 1000 feet or 305 Mtrs of elevation in order to properly acclimatize our body. This schedule in between shall allow a complete day of acclimatization rest after 3000 feet or 915 Mtrs with an overnight stay at the same altitude.

If you can adjust your plan to this rule, then perhaps you will not suffer from mountain sickness. However, the ground reality is only a few people stick to this schedule, especially in India where leaves are hard to find from their work life.

It is the prime reason I always recommend traveling to Ladakh from Srinagar side. Similarly, I always suggest people travel to Spiti Valley from Shimla – Kinnaur side.

Keep your body properly hydrated

Do take plenty of intake of water with ORS or fluids like milk tea, juice, and soup (garlic will do wonders). If possible, take ORS soluted water or ORS – L tetra packs with you to replenish the lost nutrients immediately. Also, ginger-flavored water (keep ginger in water bottles) will help much more than drinking plain water which should be avoided. This will help keep the oxygen level normal in the body. You should avoid too much black tea or coffee as well…

AVOID overhydration

As quoted by Vistet linked here(post #12):

Forcing children to drink when they are not thirsty: at best they will vomit ( which will force you to descend), at worst they´ll start to develop cerebral edema – either only from water intoxication or as a mixed result from this and altitude sickness. See, for example, Peter Hackett ( Everest-climbing doctor and co-author of the CDC altitude advisory ) on this: ” Too much water is harmful. It can dilute your body’s sodium levels (hyponatremia), causing weakness, confusion, seizures, and coma.”

Avoid sleeping at high altitudes

As sleeping decreases the respiratory drive of your body, it is recommended that one should hike or travel to high altitudes in the day but should always come back by the evening to sleep at a lower altitude.

Avoid overexertion

Do not overexert your body with any unnecessary physical activity which may lead you to pump more breath.

Avoid tobacco, smoking, alcohol and other depressant drugs

Avoid tobacco, smoking, 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.

Keep your body warm

Keep your body warm with woolens and do not let it cool. Make sure your clothes are always dry. Carry enough warm clothes for the Ladakh trip.

Eat lots of Carbohydrates

Eat a high carbohydrate diet (more than 70% of your calories from carbohydrates) while at high altitude.

Avoid sleep during the day

Try not to sleep during the day and keep yourself involved in some light activity during the day. Respiration decreases during sleep which further exacerbates the symptoms.

Travel Tip: Do not forget to check my itinerary for a combined trip to Spiti Valley and Ladakh.

Sleep in an upright position, if possible

Try to lie down or sleep by resting your back against the wall. If you cannot sleep in such a mode, then do not flatten your head on the bed rather place a bag below your head and then one or two pillows and then sleep in such a posture. It will help you keep your head much lighter.

Carry preventive medicines for AMS

Do take preventive AMS medicines along with you on the trip but only after consultation with your doctor or physician because the AMS medicines may lead to some side effects too. If you are not sure about any allergy to these medicines then try them one or two weeks before you plan the trip. Check to see if there are any allergic effects and decide.

Carry Oxygen Kit

If possible, you may also carry an oxygen cylinder to counter the AMS symptoms. It will certainly help as a supplement but do take proper consultation from your doctor about the intake amount of oxygen, before the trip.

Oxygen intake will help you in case of an emergency and will spare you more time to descend to lower altitudes as soon as possible. You should look into my article on how to rent oxygen cylinders in Leh – Ladakh?

A note from the pioneer, Vistet linked here at post #12: on oxygen cylinders:
Small tanks of even medical-grade oxygen provide a false sense of security: they will at extreme best last for an hour or two. For the value of cheap, portable oxygen solutions see here, # 5 and #7 check here

Immediately descend, if symptoms increase

Last but not least, if the AMS symptoms start to increase then you should consider immediate descent. This is the only cure in some conditions when the symptoms have reached moderate levels and are not decreasing.

Apart from these tips, I will suggest that you also read about 7 things to consider for making a Ladakh trip.

Symptoms of Acute Mountain Sickness (AMS)

Below is the categorization of symptoms for different levels of Acute Mountain Sickness (AMS) along with an indicative cure for it…

AMS Symptoms	AMS Level	Possible Cure
A headache, dizziness, fatigue, shortness of breath, loss of appetite, nausea, disturbed sleep, and a general feeling of malaise	Mild	Medication or Descend
Decreased coordination (ataxia), Severe headache (not relieved by medicine), other mild level symptoms with increased effect	Moderate	Advanced Medication or Descend  about 305-610 Mtrs
Inability to walk, decreasing mental status, and fluid build-up in the lungs	Severe	Immediate Descend about 610-1,220 Mtrs

Taking baby or kid to high altitude?

Many a time when you want to travel to high altitudes, you may likely worry about your kid or baby or infant. Well, I suggest you travel with a kid or infant at least 12 months old. However, studies suggest it is safe to travel with an infant more than three months old IFF he/she is not born prematurely or does not suffer from any illness.

NEVER travel with a baby less than 3 months old. While the above tips are helpful for kids or babies above 3 months old as well there are other tips which need special attention for traveling with Kids and babies. I have tried to cover the details of traveling with babies or kids in my article Traveling to High Altitude with Kids or Babies

References

If you need more detailed information about Acute Mountain Sickness, then you may read the following links as well.

Conclusion

Please share your valuable comments on acclimatization and acute mountain sickness or if you like the article, and it could be of some help to you too. You should note that it is not just humans that get impacted by high altitude, you also beware of tips for carrying a laptop to high-altitude places like Leh – Ladakh, and Spiti Valley.

Having said all that, it is still recommended that you CONSULT A DOCTOR or PHYSICIAN before you make a trip to a high-altitude region just to ensure everything is in the right place.

Have a travel question?? You can subscribe to my YouTube channel and leave a comment to ask your travel questions about traveling to the Himalayas.

Again, these are my suggestions based on my very limited or negligible knowledge of AMS or mountain sickness. But I will suggest that you consult some physician or doctor before going on the trip because I am not any of them. For more details on the same, you MUST READ the links mentioned in the references which explain it in better details