Acclimatisation

There are no tricks or shortcuts to acclimatisation. It just takes time, and how much depends more on your physiology than level of fitness. In fact, fitter people often suffer more as they tend to over-exert themselves too early. Remember that it’s not the altitude that makes you sick – it’s ascending to a high altitude too quickly. For this reason, our itineraries err on the side of caution, with extra days worked in to help acclimatise, particularly for the trips that begin in Leh.

Altitude

There isn't any less oxygen in the air at high altitudes than at sea level. However, high altitude areas do have less atmospheric pressure, which is relied on to push oxygen from the air into the blood. The body responds by producing more red blood cells and making the heart work faster. (Once you’re back home, make the most of those extra red blood cells and improved fitness they bring. The life cycle of a red blood cell is 2 weeks, so it won’t last long!)

Ways to help prevent altitude sickness

If arriving into Leh by air, take it easy for the first 3 days, adding gentle exercise, as you feel comfortable.
Drink copious amounts of water, until your urine is light coloured. Keep water by your bedside for whenever you wake up, as the ultra-dry climate of Ladakh causes moisture to evaporate from your breath. Avoid alcohol, as well as fizzy drinks, black tea and coffee – caffeine is a diuretic.
Eat well even if your appetite is low. Eating healthfully helps keep your body strong.
Avoid over-exertion. Particularly in Leh, it’s tempting to jaunt around straight away and enjoy all the sights, but do listen to your body. Even if others are up for morning yoga and you just feel like reading a book, then do, we’ll get plenty of exercise once we get going.
Be aware of the symptoms of Acute Mountain Sickness (AMS). See below.

As cyclists, we have the advantage that our pace is dictated by the speed of a bike – most severe problems occur in jeeps, buses and on hikes, when sharp increases in altitudes can be made very quickly. As a rule of thumb, aim to climb high and sleep low. Try not to advance more than 300m each night, and if you must, take rest days.

Most people won’t begin to feel the effects of altitude until around 3000m – though some will sense the change from 2500m. It’s quite usual to feel discomfort if you fly into Leh. According to www.high-altitude-medicine.com, the following changes to the body are considered normal: faster breathing, a shortness of breath when exercising, increased urination, changed breathing at night, waking up at night, and weird dreams. A headache is one of the first signs of altitude illness, and when combined with another symptom you should seriously consider against ascending any higher.

Symptoms of mild AMS include: headaches, nausea, loss of appetite, difficulty sleeping, dizziness and generally feeling unwell. These are warning signs and you should be wary of ascending any higher. Stay at that altitude and let your body catch up.

Symptoms of severe AMS include: headache which doesn’t disappear, loss of coordination and balance, altered mental state, severe fatigue, nausea with vomiting, shortness of breath, rapid breathing and pulse with very little activity, blueness of lips and fingers, and a dry cough. Any of these symptoms could indicate either HAPE (high-altitude pulmonary edema) or HACE (high-altitude cerebral edema). Both conditions are very serious (even fatal) and you should descend immediately and seek qualified medical attention (ideally in the most advanced/westernized hospital).

Supplements and medication

We’ve had good feedback from cyclists taking Ginkgo Biloba a week before departure. This natural supplement has shown to increase blood flow, which may help acclimatisation, amongst other things...

Acetazolamide (Diamox) is increasingly used to reduce headaches and help the body acclimatise to the lack of pressure in the air. There are small side effects, so make sure you discuss the pros and cons with your doctor. You can find more information on our blog, under Diamox and Acclimatisation.

Further information on altitude

The British Mountaineering Council

www.thebmc.co.uk/world/mm/mm3.htm

High Altitude Medicine Guide

www.high-altitude-medicine.com

Trailblazer’s Trekking in Ladakh guidebook has an excellent section on AMS.