Altitude acclimatization rules:
Gradually increase altitude to a set climbing regimen,The most important prerequisite and the best way to avoid altitude sickness while trekking in Nepal itn is to gradually and systematically increase. In Nepal, a safe altitude to which you can climb quickly and immediately is 2,700 to 3,000 meters. The most popular mountain airports in Nepal are located in this altitude range: Jomsom and Lukla, Simikot, Jufal. On the day of your arrival, you must absolutely spend the night at the same altitude.

Then you should to set climbing regimen: 300 to 400 meters in elevation per day. Accordingly, each overnight stay must be at an altitude of 300 to 400 meters higher than your previous overnight accommodation. After climbing a total of 1,000 meters in altitude, you should dedicate a full day to altitude acclimatization and spend the night at the same altitude. It is advisable to spend the altitude acclimatization day doing a short trek leading to a short stay at a higher altitude (300 – 400m) before returning and spending the night at the previous altitude. In Nepal, you will not find it possible to adhere to this exact climbing regime on all Himalayan trekking routes, so altitude acclimatization days are planned individually for each trekking route.

Altitude Acclimatization Rule:
Consume plenty of fluids while trekking
In the mountains, the atmospheric pressure decreases as the altitude above sea level increases and this affects your body. Therefore, when hiking in the mountains, it is very important to consume plenty of fluids by drinking plenty of tea, juice, soup and clean water. You should drink at least 3-4 liters of liquid per day. You can buy a liter of bottled water from teahouses along all of the most popular trekking routes in Nepal. You should avoid drinking too much black tea while hiking, as well as skipping coffee on tough days, as these beverages can cause heart palpitations and put extra strain on your heart.

Altitude Acclimatization Rule:
Avoid Alcohol, Tobacco, and use of sleeping pills
When trekking in the mountains, especially when ascending, you should categorically avoid the use of alcoholic beverages and sedatives or sleeping pills. Like smoking, sedatives artificially reduce the flow of oxygen to the brain, especially in mountain conditions where the oxygen concentration is already reduced. In turn, alcohol has the increased effect of depriving the body of water or dehydrating it, which is an equally undesirable process when trekking in the Himalayas of Nepal.

Altitude Acclimatization Rule:
Use Preventative medication while trekking
Mountain medicine has discovered a range of drugs that improve the process of altitude acclimatization and reduce the side effects of mountain altitude acclimatization such as sleepless nights. These products are widely used by trekkers on popular trekking routes in Nepal like Everest Base Camp trek, Gokyo trek, Annapurna Circuit trek, Dhaulagiri Trek etc.
Acetazolamide or Diamox?
Of all the drugs used to aid altitude acclimatization and treat altitude sickness, the most popular is Diamox, the active substance of which is acetazolamide, Diamox is widely available without a prescription in Kathmandu, A pack of Diamox contains 10 tablets of 250mg and in Nepal you can buy it for 150-200 rupees.
Possible alternative names (trademarks) for Acetazolamide include: Acetamox, Acetazolam, Ak-Zol, Apo-Acetazolamide, Atenezol, Cidamex, Dazamide, Defiltran, Dehydratin, Diacarb, Diakarb, Diamox, Didoc, Diluran, Diuramid, Diureticum -Holzinger, Diuriwas, Diutazol, Donmox, Duiramid, Edemox, Eumicton, Fonurit, Glaupax, Glupax, Natrionex, Nephramid, Nephramide, Phonurit, Storzolamide and Vetamox.

Before trekking it is advisable to start using Diamox 24 hours before your ascent and once you have started trekking you should use Diamox twice a day in doses of 125-250mg depending on your body weight depending late morning and evening. Children should be given a Diamox dose of 2.5 mg per kg body weight twice a day. It is important to take Diamox before going to bed, as it deepens the depth of inhalation during sleep, thereby improving the supply of oxygen to the body. Diamox is an effective means of preventing pulmonary edema.

It is true that Diamox can cause some side effects, the most common of which are slight tingling in the hands and fingertips, blurred vision, etc. Diamox can also induce allergic reactions, therefore recommended to consult your doctor before use. According to some sources, you should stop taking Diamox on the second or third day after reaching the maximum height on your trekking route, while others say it is not recommended to use Diamox for more than 3/5 consecutive days. Based on my own experience on the way to 4000m to 8000m on trek, I would recommend starting to think about using Diamox upon reaching up to (3,440m).
In traditional medicine, acetazolamide is also used to treat epilepsy and glaucoma.

Ginkgo Biloba extract
Studies on the effectiveness of Ginkgo biloba extract during the process of acclimatization to altitude and its impact in mountain conditions are continuing, but experiments have shown that it is effective in helping to reduce the symptoms of altitude sickness while trekking. Ginkgo biloba functions as an antioxidant, reducing stress and oxygen supply to the brain. it is recommended to start using Ginkgo biloba extract at least five days before increasing to doses of 80 to 120 mg twice daily and continuing to use it in the mountains.
Ginkgo biloba extract is a natural product made from ginseng and can be used prophylactically to improve brain function and not just in the mountains. It can be purchased in pharmacies as a dietary supplement without a prescription.

Garlic soup
One of the best natural recipes to help in altitude acclimatization, often recommended by Nepal trekking guides, is garlic and the popular garlic soup served at trekking lodges and trekking lounges. tea from Nepal. At first it is likely to taste quite strange, but as you get used to it you will start to like it. Garlic soup is also widely available along the trekking route.

Altitude Acclimatization Rule:
Avoid Over exertion from Carrying Too Heavy Backpacks While Trekking
Considering the physical effort and the evolution in the mountain conditions, during the trek, advisable to avoid overwork and to leave the carrying of your heavy bags to the carriers. It is cheap and you can hire a Sherpa to carry your luggage on almost all stages of the local peoples where you evver reach or Kathmandu or Pokhara. If you still plan to carry your own backpack ideally its weight should not exceed 10 -12 kg.

Altitude Acclimatization Rule:
Don’t Hike or Trek Alone,
You should always take a guide with you on mountain hikes in trekking. Symptoms of altitude sickness can induce panic or wild behavior, so you need to have someone by your side who can help you at all times if you find yourself in trouble. Typically symptoms of altitude sickness worsen at night due to problems acclimatizing to the new altitude reached during the day. If symptoms of altitude sickness require you to leave and descend at night, you simply need to have your guide with you at all times!

Altitude Acclimatization Rule:
Don’t Climb Higher Even If You Have Only Mild Altitude Sickness Symptoms
If, after reaching a new altitude on your trekking route you begin to experience mild symptoms of altitude sickness, under no circumstances should you climb any higher! You should stay at your current altitude and monitor your symptoms. Usually, the symptoms of altitude sickness begin to appear 6 to 12 hours after reaching a new altitude. Symptoms begin to appear in the form of a mild headache, which can disappear within a few hours or, on the contrary, worsen accompanied by panic, loss of appetite and nausea. When trying to fall asleep, you have wild dreams and mild hallucinations.

During this time, even if you have lost your appetite, it is very important to drink plenty of fluids and to eat, if you haven’t already. Garlic soup is recommended as well as Diamox or certain headache tablets that thin the blood and improve blood circulation: Paracetamol, Aspirin, Tylenol or Ibumetine.

A concrete example of inadequate acclimatization to altitude that which personally experienced during trek to Everest Base. you most be first day of altitude acclimatization Usuall at Namche Bazaar, but we skipped it and the next day we continued climbing to spend the night at Khumjung (3870 m) which is 400 m higher than Namche.

Altitude Acclimatization Rule:
Descend immediately if you have Altitude Sickness Symptoms or it will be worse.

If the usual painkillers used to treat headaches, Aspirin, Tylenol, Ibumetin, etc. do not help and your headache does not go away, this indicates that the altitude sickness getting worse. In case, after reaching a new altitude along the trekking route, The symptoms of altitude sickness do not disappear and worsen, The most effective treatment is to descend without delay to a lower altitude. You must descend without delay even at night. You must be accompanied by your guide and take with you everything you need for the trip. Under no circumstances should you descend alone. if you are trekking in Everest BC, there in Machermo HRA medical point in the Himalayan region in Khumbu, heard the story of a trekker who died at night after falling into a ravine from a narrow or icy hill path while suffering from Altitude sickness causing loss of balance and feeling disoriented.

In such circumstances, you should reduce your altitude to at least the altitude at which you spent the previous night when you noticed no signs of altitude sickness, if possible go even lower. You will feel the benefits after lowering your altitude from 500 to 1000 meters above sea level. You should use medication supplemental oxygen and your compression bag or Gamow bag if you have available.

Acclimatization Rule:
Never leave anyone alone with signs of altitude sickness
Never leave a person showing signs of altitude sickness alone. He may begin to experience rapidly deteriorating symptoms of altitude sickness and may need to be urgently evacuated to a lower location. Or ? helicopter rescue.

Acclimatization Rule:
Dress warmly when trekking and don’t overexert yourself
During the hike, You must stay warm at all times and prevent your body from getting cold, especially during the first phase of altitude acclimatization. Make sure your clothes are always dry. In the mountains, The air is dry and it is usually windy. As the sweat evaporates, It increasingly cools the body, narrows the arteries and reduces the supply of blood and oxygen reaching your organs, creating conditions for the condition to worse. Elevation. Special technical clothing has been invented for mountain trekking, which ensures that the body breathes and wicks away sweat as efficiently as possible.
You can follow and observing all these rules, During trekking in Nepal,