There aren't many experiences as rewarding or moving as climbing all day to reach and enjoy the sweeping view and solitary environment that can be found at the top of a mountain. However, while it can be wonderful near the summit, there are some health and physical challenges you may face when seeking adventure at high altitudes.

The Right Gear

You should always make sure to wear the proper gear for hiking, including well-fitting shoes that provide ankle support, stability, and grip. If you're hiking on rocky trails, use one or two walking sticks or poles to help maintain your balance while navigating on uneven terrain. A walking stick will also take some of the physical impact off your knees, hips, ankles, and lower back.

Wear clothing in which you can comfortably move and maneuver. It is always a good idea to carry gear for all types of weather: hot and cold, wet and dry, bright and shady. At high altitudes, the air is thinner, which can lead to extreme and fast changes in temperatures, both up and down. Therefore, be sure to carry some sort of warm-weather gear in your pack. Whether that's a baseball hat or sunglasses, bring something to keep the sun out of your eyes. Also, bring a rain- and wind-proof outer layer made of lightweight material that you can pull out in case the sky opens up.

Being high up in the mountains usually means you'll be pretty far from civilization and access to sustenance, so make sure to carry food and water for the day. Carry all extra gear and food in a backpack with at least two straps. Make sure your backpack fits snugly, and has padded straps and, preferably, a waist belt.

Preventing Altitude-Related Illnesses

Besides the hardship of hiking up a mountain, the high altitude itself can cause serious health concerns. Acute mountain sickness (AMS, also commonly referred to as "altitude sickness") is the most common altitude-related disorder. Its primary symptom is a severe headache, but may also include nausea, fatigue, dizziness, drowsiness, and insomnia

Most altitude-related concerns are caused by a lower concentration of oxygen in the air and thus can be (at least partially) mitigated by proper acclimatization. To avoid altitude disorders, make sure to stay hydrated, avoid drinking alcohol, stay warm, and eat regularly.

The drug acetazolamide (Diamox), when properly used, has been shown to help some people make ascents without developing related illnesses. Acetazolamide works by stimulating breathing, allowing for higher oxygen intake. It also mimics the physiological changes associated with acclimatization. Climbers and trek leaders sometimes carry an oxygen supply when travelling to extreme high altitudes.

People who are prone to anemia may want to consider taking an iron supplement before and during travel to high altitudes. Since oxygen is transported in red blood cells, and anemia causes a lowered red blood cell count, persons with anemia are more likely to suffer from altitude sickness than are persons with normal blood counts.

Sleeping at high altitudes can be difficult; low oxygen intake during the night can interrupt sleep and/or leave you feeling unrefreshed in the morning. Acetazolamide (Diamox) can help with breathing throughout the night. Sleep-aids like temazepam (Restoril), zaleplon (Sonata), and zolpidem (Ambien) can also help, but should only be taken under medical supervision.

"Climb high, sleep low" is a phrase many climbers swear by; it means sleeping at the lowest altitude possible that is compatible with your trip, and is one good way to attempt to avoid AMS. 

Some other altitude-related disorders include:

  • High-altitude pulmonary edema (HAPE)
  • High-altitude cerebral edema (HACE)
  • Peripheral edema (swelling in the hands, feet, and face)
  • Altitude throat
  • Altitude bronchitis

Always take AMS seriously, because it may put you at risk for HAPE or HACE, which are very serious—even deadly—conditions. HAPE is excess fluid in the lungs, and causes shortness of breath, difficulty breathing, and coughing up of frothy sputum. HACE is fluid in the brain, and causes confusion, uncharacteristic behavior, drowsiness, and loss of consciousness. If you or a climbing partner experience any of these symptoms, descend immediately, preferably 3,000 feet or more. If descent is not immediately possible, being placed in a pressurized (e.g., Gamow) bag, given oxygen, or taking certain drugs (such as dexamethasone [Decadron]) can act as a temporary measure until descent is possible.

Learn More

With the proper preparation and careful ongoing attention to safety, high altitude hiking and mountain travel can be a fun, challenging, and truly inspiring experience. 

Temperature Swings on the Trail

Hiking on Rocky Trails


Avalanche Injuries

Swelling at Altitude

Gingko Biloba for Mountain Sickness

Proper Hydration at High Altitudes

Hiking at Altitude While Pregnant