Mountain Sickness in Tibet

Much of Tibet sits at elevations above 3,500 meters (11,480 feet), and an altitude over 3,000 meters (9,840 feet) is usually defined as high altitude. Altitude Sickness, also called Acute Mountain Sickness (AMS), occurs when people accustomed to living at lower altitudes come to Tibet with pretty low oxygen levels. 

Don’t underestimate it. It’s not just a minor discomfort that affects your travel mood. It can significantly impact your physical condition, and in severe cases, it can cause life-threatening complications. 

Here is a complete guide to help you understand how it occurs, how to recognize symptoms, how to prepare for it, and how to deal with it for anyone planning a trip to Tibet. 
Altitude sickness can present itself in many ways, ranging from mild discomfort to severe medical emergencies.
 Blood oxygen levels below 95, potentially causing lips and fingernails to turn slightly purple;
Nosebleeds and dry lips;
Chest tightness and shortness of breath;
Dry cough;
Insomnia or difficulty sleeping
Dizziness and fatigue;
Loss of appetite;
Nausea and vomiting;
Drowsiness;
Mild fever;
A rapid heartbeat.
 Serious vomiting;
Whole body aches;
Coughing accompanied by the production of white or pink frothy sputum;
Slowed reactions or reduced awareness;
Unusual excitement or agitation;
Distorted senses such as hearing, vision, or smell; 
Difficulty breathing or even suffocation. 

If you are experiencing any of the above serious symptoms, you may have developed high-altitude pulmonary edema or high-altitude cerebral edema and should seek medical attention immediately.
 Altitude sickness usually does not occur immediately upon your arrival in Tibet. For most visitors, symptoms often appear 4 to 6 hours after arrival. For example, if you arrive in Lhasa at noon, you may begin to feel discomfort in the evening, even the following morning.

The higher the elevation of your destination, the sooner and more severe your altitude sickness will be. Therefore, you are advised to visit Lhasa, with the elevation of 3650 meters (11,980 feet), first, and then head to Everest Base Camp, elevation 5200 meters (17,060 feet), once you have acclimatized. 

If you have a weak constitution, a history of altitude sickness, poor cardiovascular or respiratory function, are overweight, physically fatigued, or suffering from a cold, you are more likely to experience early-onset altitude sickness.
 Good preparation can significantly reduce the risk of altitude sickness.
 1. Before visiting Tibet, get as fit and healthy as possible, both physically and psychologically. Be careful not to catch a cold. The following groups are strongly advised not to travel: pregnant women, people with asthma, individuals currently experiencing a cold or fever, patients with heart disease, physically weak individuals, and elderly travelers with limited mobility. If you are still eager to visit Tibet, it’s best to consult a doctor for an evaluation and advice.
2. About one month before your Tibet trip, reduce intense aerobic exercise to avoid overstressing your body.
3. One week before departure, take Rhodiola (a traditional herbal supplement) daily to help you acclimate to the high-altitude environment.
4. Get enough sleep and avoid staying up late before your trip.
 If you have plenty of time, it’s highly recommended to take the train to Tibet. It takes quite a long time – the fastest trip from Xining to Lhasa takes at least 19.5 hours. A gradual ascent will allow your body to acclimatize to higher altitudes and the decreased oxygen supply. Flying is fast but not recommended for sensitive travelers, as the sudden altitude change can trigger strong reactions.

See More: Tibet Railway
 Rhodiola supplements.
Pulse oximeter to monitor your blood oxygen levels, which will help you determine whether you need to take glucose, use supplemental oxygen, or seek medical treatment.
Portable oxygen bottles - at least 1,000 ml capacity. Note: You can buy them after arriving in Tibet, as they are banned on the airplane.  
Oral glucose solution to prevent low blood sugar.
A thermometer to monitor body temperature.
A thermos for warm water - very important in high-altitude environments.
Moisturizer to combat dry air.
 1. If you’re flying to Tibet, try to take a late-night flight, then check into your hotel and rest immediately. Make sure to get a good night’s sleep. If you have problems falling asleep, you can take melatonin. 

2. Once you arrive in the high-altitude region, be sure to avoid strenuous exercise. If you can sit, don’t stand; if you can lie down, don’t sit. Just imagine that everything around you is playing in slow motion: move slowly and speak in a soft, breathy voice; avoid sudden head movements, such as quickly looking up or down. 

3. In terms of food in Tibet, steer clear of stimulating dishes and stick to light and mild meals to prevent stomach upset. Since there are virtually no toilets along the way - you’ll have to squat to use the restroom - prolonged squatting can easily trigger altitude sickness or even fainting. Making sure to consume enough carbohydrates can help prevent altitude sickness. 

4. Don't smoke, drink alcohol or take other depressants such as tranquilizers and sleeping pills. These will depress the respiratory drive and limit oxygen intake.

5. One of the most important things is DO NOT wash your hair or take a shower. This is especially true for visitors who have just arrived in Tibet: showering or washing your hair can lead to oxygen deprivation, trigger altitude sickness, or even cause a cold, which can worsen altitude sickness. This is a strict no-no. Once you’ve acclimated to the high-altitude environment, if you do decide to shower, make sure the room is warm and well-ventilated, and finish as quickly as possible to minimize the risk of catching a cold. 

6. Remember to monitor your blood oxygen levels regularly with a pulse oximeter. If it drops below 85%, drink some glucose; if it drops below 80%, rest immediately or take medication. 

7. It’s best to travel with a companion so that someone can spot you immediately if anything goes wrong. This applies not only to daytime activities, but also to nighttime rest - do not sleep alone in a single room. 

8. What you wear can also affect altitude sickness. Try to wear comfortable, loose-fitting clothing. Tight clothing can restrict breathing, increase physical exertion, and make it harder to acclimate to high-altitude environments. 

9. During your Tibet Trip, maintain a regular sleep schedule and avoid staying up late. 

10. Since fluid loss usually accompanies the acclimatization process, drink plenty of water (3 - 4 litres daily at least), eat lightly and take in carbohydrate food to keep the body properly hydrated. Snacks with high caloric content, like chocolate, should come in handy.

11. If you have a headache and have trouble falling asleep, you can use portable oxygen bottles to ensure enough sleep, which is the number one priority for your next-day schedule. 

12. It’s best not to change accommodations frequently, especially if it involves altitude changes. If you need to change accommodations, try not to move to a location with a significant rise in elevation; instead, follow the principle of gradually increasing altitude. Rapid altitude rise can increase the risk of serious conditions like pulmonary edema.
 If you develop a cold, fever, or worsening symptoms, seek medical attention immediately. Do not ignore warning signs, especially in high-altitude environments.
 

1. Any sickness at high altitude is AMS until proven otherwise;
2. Never go higher with symptoms of AMS;
3. It is significant that you report any symptoms of AMS immediately to other group members in the trip.