Aclimatization in Leh Ladakh

One of the foremost things while planning your trip to Leh Ladakh is take into consideration acclimatization to high altitude conditions. In fact, careful planning on how to acclimatize in Leh Ladakh and avoid acute mountain sickness (AMS) is the most important step in planning a successful trip to this region.

So what is acclimatization to altitude?

As per definition, [A]cclimatization to altitude is “[T]he process of adapting to the decrease in oxygen concentration at a specific altitude. A number of changes must take place for the body to operate with decreased oxygen.

These changes include increasing the depth of respiration; increasing the pressure in the pulmonary arteries, forcing blood into portions of the lung that are normally not used at sea level; manufacturing additional oxygen-carrying red blood cells; and manufacturing extra2,4-DPG, a substance that facilitates the release of oxygen from hemoglobin to the body tissues.

Acclimatization generally takes 1 to3 days and occurs after any significant altitude change above 1,220 meters (approximately 4,000 feet). Acclimatization is the body’s natural means of correcting altitude sickness and the rate of acclimatization depends on the altitude, rate of ascent, and individual susceptibility.” [Ref]

In simple words, when people like us living at lower altitude travel to places with higher altitude as in upper Himalayas especially above 10,000 feet (4000 meter), our body needs to get used to or say adapt to the climatic conditions of higher altitude as the level of oxygen in the air at those altitudes are lesser than what our body/lungs are conditioned to.

Not accounting for acclimatization at high altitude can lead to various kind of sickness/illness and more severely to acute mountain sickness.

Here is a classic scenario for developing a high altitude sickness. You fly from New Delhi to Leh at 11,562 feet (3,524 meters). That afternoon you rent a car and drive up to Chang La at 17,688 feet (5,360 meters). Then onward to Pangong Tso at 14,270 feet (4,350 meters).

Pangong Tso: Acclimatization in Leh Ladakh

When the mind is silent like a lake the lotus blossoms

You begin to have a severe headache and feel nauseous and weak. If your condition worsens, you may begin to have difficulty breathing, fatigue, loss of appetite and difficulty to sleep. Scenarios like this are not uncommon, so it is of paramount importance to prepare for physiological effects of high altitude while planning your trip to Ladakh.

Considering Acclimatization Issues and How to Plan a Trip

The key to acclimatization is to ascend gradually. Acute mountain sickness (AMS) is caused due to the low air pressure and relatively lesser oxygen levels that are present at higher altitudes.

The faster you climb, the more chances of you being affected by AMS. This is one of the reasons that even when you are planning a road trip to Ladakh by bike or car, you need to be careful about your route and where you plan your night halts.

One of the reasons experts recommend that you take Srinagar – Leh Highway to plan your Ladakh Bike Trip (or for that matter any kind of road trip) is that on this route you gain altitude gradually. As opposed to this, on Manali – Leh Highway, the ascent is quite dramatic and the mountain passes that you cross are also located at very high altitudes.

Consider this, if you take Srinagar – Leh Highway, the most likely place to make a night halt is Kargil which is located at an altitude of 8,780 feet (2,676 meters). But on Manali Leh Highway, the most likely place where most of the people make a night halt is Sarchu which is located at an altitude of 14,070 feet (4,290 meters).

It’s more likely that you might get sick on Manali – Leh Highway during your road trip. It doesn’t even prepare you for your journey ahead as your body doesn’t get enough time to adapt to the high altitude conditions. 

On the other hand, when you take Srinagar – Leh Highway, it is more likely that your body would have acclimatized to the high altitude conditions by virtue of the fact that you have gained altitude gradually over time.

According to the medical experts, the best way to avoid acute mountain sickness is to make sure that you don’t gain more than 1,000 feet (305 meters) per day and for every 3,000 feet (915 meters) of elevation gained, take a rest day.[Ref]

But what if you are flying to Leh directly?

Well, although experts say to start your journey below 10,000 feet to avoid AMS (Leh is located above 10,000 feet), you can still acclimatize to high altitude climatic conditions and avoid acute mountain sickness by taking a few measures.

What & How of Acclimatization to High Altitude

The most important cause of altitude illnesses is going too high too fast. But the good thing is that given time, your body can adapt to the low level of oxygen molecules at a higher altitude. This process is known as acclimatization and generally takes 1-3 days at an altitude above 10,000 feet (4000 meters).

Steps to Acclimatize: Preventing Altitude Sickness in Leh Ladakh

  1. Once you arrive in Leh, especially by air, give at least 24 hours rest to your body. Don’t head out anywhere except the local markets on your first day of arrival.
  2. Second day ideally should also be reserved for acclimatization but if you are not feeling any effects, you can visit the valley areas towards Leh – Srinagar highway or a few monasteries on the other side like Hemis or Thiksey. Or best just take the day to explore the local sights of Leh town and surroundings.
  3. On the 3rd day, if you are planning to visit Nubra or Pangong, you will have to cross two of the highest mountain passes in Ladakh. Make sure that you don’t spend too much time on the top.
  4. If you feel any symptoms of AMS like severe headaches, nausea, vomiting etc. descend quickly.
  5. Never, I mean never over exert yourself at higher altitude as it may lead to breathlessness and at those altitude ts really tough to catch your breath
  6. If you are going to Pangong Tso or Tso Moriri, you should plan for at least one night halt to give your body proper time to acclimatize as you would gain more than 2000 feet when you travel to these places from Leh. 
  7. Avoid sleeping during day as it decreases respiration and can worsen symptoms if any
  8. Remain hydrated. Acclimatization is often accompanied by fluid loss so drink a lot of fluids. The local garlic soup helps as well.
  9. Hard to do if you are used to it, but avoid alcohol and tobacco as much as you can as they tend to decrease the respiratory drives.
  10. Eat high carb diet as it helps you acclimatize better
  11. If you feel any symptoms of AMS and if they keep increasing as you gain altitude, descend immediately. Don’t go higher until the symptoms go away.
  12. Keep in mind that different people acclimatize to high altitude differently. If you are traveling with kids or elderly, it is not guaranteed that they will acclimatize to those conditions similar to you. They may fare better or worse so keep a tab on that if you are planning a trip to Ladakh with family.

Preventive Medicines for Acclimatization and Acute Mountain Sickness

The two most recommended drugs for acclimatization and AMS are Diamox (Acetazolamide) and Dexamethasone (a steroid). 

Diamox allows you to breathe faster and is especially helpful when taken at night before sleep. Also, Diamox takes time to metabolize hence it is recommended that you start taking it 24 hours before you travel to high altitude and keep taking it for 4-5 days.

As for Dexamethasone, it is only recommended for those suffering from AMS. This drug helps decrease brain swelling and other major symptoms of AMS. But be very cautious while using this and don’t ever use it until a physician advises you so. Keep in mind that as opposed to Diamox, Dexamethasone is a prescription drug and can have some serious side effects. [Ref]

Also refer to posts if you are planning a trip to Ladakh:

  • Traveling to Ladakh with Kids (Coming Soon)
  • Traveling to Ladakh with Elderly or Parents (Coming Soon)
  • Traveling to Ladakh with Infants (Coming Soon)
  • Traveling on Manali – Leh – Highway (Coming Soon)
  • Traveling on Srinagar – Leh Highway (Coming Soon)

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