Altitude is the main risk on every route we run — more than weather, more than rivers, more than terrain. Almost all of it is manageable by going slowly and by not skipping the first two days.
The numbers you are dealing with
- Leh: about 3,500 m. You land here from sea level in a few hours.
- Padum: about 3,600 m.
- Our camps: 3,800 to 4,300 m.
- Our passes: 4,800 to 5,150 m.
Flying into Leh means arriving at an altitude most people would take days to walk up to. That is why the two nights there are not a sightseeing suggestion.
What we ask you to do
- Two nights in Leh minimum before travelling on. Three is better. Do very little on the first day: no hiking, no alcohol, a lot of water.
- Tell us your history with altitude, honestly, before you book.
- Walk kulé kulé. If you are the fittest person in the group, walk at the back for the first two days. The people who get ill are usually the strong ones who pushed.
- Drink more than you want to and eat even when you are not hungry.
- Say something early. A headache mentioned at breakfast is a small adjustment. The same headache mentioned at 4,800 m is a descent.
Symptoms to know
Mild altitude sickness — headache, poor sleep, no appetite, mild nausea, breathlessness on effort — is common and usually settles with rest and a slow day. It is not a reason to be embarrassed and it happens to experienced walkers.
The serious forms are rare but they are why we take the mild ones seriously: worsening headache that does not respond to rest, confusion, loss of balance, breathlessness at rest, or a persistent cough. The treatment for all of these is the same and it is not medication — it is going down, immediately.
What we do
We build height gain into the route rather than fighting it: the second day of the Phuktal route deliberately climbs only nine kilometres but gains 500 metres, and sleeps there. We watch people at breakfast. We carry a first-aid kit and can arrange descent with a horse if someone cannot walk. Confirm what we actually carry: oxygen cylinder, pulse oximeter, satellite phone or messenger? Only list what is genuinely on the route.
We are guides, not doctors. Nothing on this page is medical advice. Talk to a travel clinic before you come, especially about acetazolamide and about any existing condition — heart, lung, pregnancy, or medication that affects breathing or fluid balance.