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Altitude Sickness on Kilimanjaro

Altitude Sickness Kilimanjaro

Acute Mountain Sickness (AMS) – also know as altitude sickness and altitude illness – is a pathological effect on humans caused by going to high altitudes too fast, where lower levels in oxygen inhibit normal physiological processes.

People typically start experiencing Acute Mountain Sickness symptoms at about 10,000 feet (3,000 m).

Some people can experience symptoms as low as 8,000 feet (just over 2,400 m).

Due to Kilimanjaro’s rather rapid ascent profile altitude sickness amongst trekkers is unfortunately quite common.

There are three levels of Acute Mountain Sickness symptoms – mild, moderate and serious. We discuss each here.

  • MILD

These include:

  • Fatigue
  • Headaches
  • Nausea and Dizziness
  • Shortness of breath
  • Disturbed sleep
  • Loss of appetite

If you suffer any of the symptoms above it is important to communicate to your climbing partners and guide how you are feeling. These symptoms generally disappear if you rest for a day at the level at which they originally started. This is why an acclimatization day where you climb high and sleep low is so important!

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High Altitude Pulmonary Edema (HAPE)

High Altitude Pulmonary Edema (HAPE) is a condition associated with Acute Mountain Sickness and occurs because of fluid build up in the lungs.

Fluid in the lungs prevents the effective exchange of oxygen and thus a decrease of oxygen into the bloodstream.

HAPE almost always occurs because of ascending too high, too fast.
It is a life threatening condition and therefore every precaution should be taken to avoid it when trekking Mount Kilimanjaro.

Clear symptoms that one is suffering from HAPE include:

  • Very short of breath, even while resting
  • Very tight chest
  • The feeling of suffocation, particularly while sleeping
  • Coughing that brings up white, frothy fluid
  • Extreme fatigue and weakness
  • Confusion, hallucination and irrational behaviour

If the last symptom occurs (i.e. confusion, hallucination and irrational behaviour) one can assume that the pulmonary edema has started to affect the brain due to a lack of oxygen in the bloodstream.

Any available oxygen should be administered. The drug, Nifedipine, has been shown to ameliorate the condition, but descent is the only cure.

Trekkers should take care to ensure that the person descending with High Altitude Pulmonary Edema doesn’t exert themselves as this can result in worsening of the condition. A stretcher evacuation is the preferred method of descent.

Once the person has reached the lower limits of the mountain, medical support should be sought immediately.


High Altitude Cerebral Edema (HACE)

High Altitude Cerebral Edema (HACE), is a condition associated with severe Acute Mountain Sickness. It occurs due to swelling of the brain tissue from fluid build up in the cranium. It is a life threatening condition.

On Kilimanjaro, people suffering from HACE should descend immediately and seek medial attention when they get to the lower reaches of the mountain.

HACE can be identified if someone is suffering from the following symptoms:

  • Severe headaches which cannot be relieved by medication
  • Hallucination
  • Loss of consciousness
  • Disorientation
  • Loss of coordination (i.e. ataxia)
  • Memory loss
  • Coma

HACE tends to set in at night. Do not hang around until morning if someone in your group is suffering HACE symptoms. The longer you wait at altitude the greater the probability of fatality. Descend immediately – even under darkness. Under no circumstances should one ascend if they have suspected HACE symptoms. If you have oxygen it can be administered along with a steroid called, dexamethasone, but these should only be used in conjunction with rapid descent.

8 day private camping trekking tour + 2 nights' hotel stay. The Lemosho route is traditionally one of the quieter and lesser-known routes on the mountain.

Lake Louise Altitude Sickness Scorecard

There are a number of ways to monitor altitude sickness symptoms. The most common method uses the Lake Louise Altitude Sickness Scorecard (as seen below).


Scores between 3-7 are a sign of mild to moderate AMS. Scores above 7 are a sign of severe altitude sickness.

Reliable Kilimanjaro tour operators will use a combination of the Lake Louise scorecard method and spot oximeter and pulse readings to monitor your performance on the mountain.

If you score over 8 on the Lake Louise scorecard or have an SO2 reading below 75%, it is likely that you will need to forego your summit attempt and descend.

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Golden Rules

Trekking Kilimanjaro need not be a very risky or dangerous adventure as long as you follow some basic rules.

In particular:


  • If you have a chance to pre-acclimatize before trekking Mount Kilimanjaro, do so. A good option in Tanzania is to trek the neighbouring Mount Meru (4,565 m) before attempting Kilimanjaro
  • If you are a novice high altitude trekker then choose a Kilimanjaro route that is at least seven days long (6 up, 1 down). In our opinion, the seven day Machame or 7/8 day Lemosho are the most suitable routes for the average trekker
  • Ensure the route allows for a good climb high, sleep low opportunity (both the Machame and Lemosho do)
  • When on the mountain make a point to go as slowly as possible, do not overexert yourself, even on the lower reaches
  • Drink loads of fluid (2.5-4 liters a day)
  • Do not drink alcohol, take stimulants, smoke or consume caffeine on the mountain
  • We recommend taking acetazolamide (Diamox)

Finally, as recommended by the charity,, always remember these 3 Golden Rules when at altitude:

  • If you feel unwell, you have altitude sickness until proven otherwise
  • Do not ascend further if you have symptoms of altitude sickness
  • If you are getting worse then descend immediately

Preventative Medications – Diamox

Acetazolamide, or Diamox, is a drug that has been proved to be effective at mitigating altitude sickness.

The drug helps to increase the acidity of the blood by acting as a diuretic and promoting urination. Increased acidity in the blood is equated by our bodies as increased CO2, and hence one starts breathing deeper and faster to get rid of the CO2. Deeper, faster breathing increases the amount of oxygen received by the blood and this helps prevent the onset of AMS symptoms.

It is important to note that Diamox is a prophylactic (preventative medicine), and does not cure the symptoms of AMS. Once altitude sickness symptoms have started, the only way to stop them is descent. Under no circumstances should Diamox be used to continue an ascent with AMS.

Diamox is also a prescription drug so it is important that you first consult your doctor to check whether it is a suitable drug given your particular medical history. It is not suitable for pregnant women or anyone with kidney or liver disease issues.

We recommend taking Diamox for 2-3 days 2 weeks before departure to test whether you experience any side effects.

Typical side effects associated with Diamox are:

  • Frequent urination – everyone experiences this when taking Diamox. It can result in the development of kidney stones so it is important that you drink loads of fluids whilst taking the medication
  • Numbness and tingling in the fingers, toes and face – Many people experience this side effect when taking Diamox. The sensation is a little discomforting but not dangerous
  • Taste alterations (some foods might taste weird)
  • Nausea, vomiting and diarrhea – this is rare. These side effects should be identified during your test before departing for Kilimanjaro. Unfortunately these side effects are common with AMS and therefore can easily be misdiagnosed as AMS
  • Drowsiness and confusion is also possible – again these side effects can be confused with AMS

Diamox comes in 250mg tablets. Most people take half a tablet in the morning and half in the evening. You should start taking tablets one day before arriving in Kilimanjaro and continue taking the same dosage for all ascent days. You can cease taking Diamox on descent.

Kilimanjaro Altitude Sickness FAQ

Kilimanjaro Altitude sickness occurs when there is a difficulty adjust to high altitude, where there is lower oxygen especially 6000 meters above the sea level. While Climbing Mount Kilimanjaro more than 90% of the climber face symptoms of Kilimanjaro Altitude Sickness.

The best thing to do for Kilimanjaro Altitude Sickness is to stop and rest for a day or two on the mountain. In case you have a headache, take ibuprofen or paracetamol and if you feel sick, take an anti-sickness medicine, such as promethazine. The best thing to do for Kilimanjaro Altitude Sickness is to take a day or two to acclimatize as it increases your  Kilimanjaro Success Rate as well.

To avoid Acute Mountain Sickness (AMS) we suggest you acclimatize well before the climb. You can also add hiking as part of your training and preparation. We advise you to take it easy on the trail and the camp. Go slow as there is no need to rush. Mount KilimanjaroClimbingis not a competition and trekkers must understand that.

Some of you might have heard the term acute mountain sickness (AMS) bandied about. This is simply another term for the mildest version of altitude sickness.

AMS is not serious in and of itself, but it’s important to monitor the symptoms to ensure it doesn’t develop into a more severe form of altitude sickness.

We can classify the symptoms of altitude sickness into two camps:

  1. Mild symptoms
  2. Severe symptoms

Mild symptoms

Mild symptoms of altitude sickness indicate that you’ve developed acute mountain sickness (AMS), which as mentioned is the mildest form of altitude sickness.

AMS can be likened to experiencing a bad hangover. Its symptoms are generally worse at night when your respiratory drive is decreased.

AMS symptoms include:

  • headaches
  • fitful sleep or insomnia
  • vivid dreams
  • fatigue
  • shortness of breath with physical exertion
  • dizziness
  • loss of appetite
  • nausea and vomiting
  • irritability
  • muscle aches
  • swelling of the hands, feet and face
  • a rapid heartbeat

There’s a common misconception that if you’re physically fit, you’re less likely to be struck by altitude sickness. But this just isn’t true.

Young, old, fit, unfit – altitude sickness seems to choose its victims at random.


More than 75% of climbers will experience mild symptoms of altitude sickness when climbing Kilimanjaro.


That said, while you can’t necessarily avoid altitude sickness altogether on a Kilimanjaro climb, you can reduce its severity. The three main ways of doing this are:

  1. Visit your doctor and ask for acetazolamide, which can be used to treat altitude sickness and so will help you cope with the unpleasant symptoms associated with it.
  2. Do an acclimatisation hike like climbing Mt Meru just prior to climbing Kilimanjaro.
  3. Choose a Kilimanjaro route that offers a relatively gentle rate of ascent.

We discuss all of these suggestions in more detail further on in this post.

How we keep you safe on kilimanjaro Prev Post
How we keep you safe on Kilimanjaro

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