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How I got altitude sickness on the Annapurna Circuit in Nepal and the mistakes I might have made

Thorong Phedi, 4800m, Annapurna Circuit, Nepal.


People get height sickness for all sorts of reasons or no reason at all. It has nothing to do with age, overall fitness or physique. The explanations following in this article are based upon a personal experience. I do not mean to generalise. Please read with a grain of salt.

How I got altitude sickness on the Annapurna Circuit in Nepal and the mistakes I might have made.

For the past hour and a half, we had been walking in absolute darkness. Half of us were wearing small headlights, which only lit a small part of the path in front of us, moving back and forth. The path was going up steep, making hairpin turns between the bare rocks. Despite the steep path, appropriate clothing and a heavy backpack, I could still feel the dry coldness piercing deep into my skin.

A bit before 5 o’clock, we had crawled out of the 5 blankets, covering our sleeping bags. Still dressed in the full long underwear I hadn’t taken off for 2 days now. Quickly we got dressed, pulling layer over layer, topping it off with gloves and a hat. We threw everything in our backpacks and headed out in the pitch-black morning, to the communal part of the base camp residence.

Luckily, we only had to spend a few minutes outside, before of the residential Nepalese guys, opened the door for us. A quick breakfast before we would try and climb Thorong la Pass, which lied 950 meters higher than our current position. I can barely remember what Koen ate, I only recall the taste of the so called ‘good against height sickness’ garlic soup. Up until this day, the thought of garlic soup makes me physically nauseous.

The anticipation left me feeling a bit better, after reciting a ‘just get over this stupid mountain’ mantra in my head, since the evening before. But all those months planning, dreaming and all the sheer beauty of the Himalaya could not stop me from resenting the ice-cold rock under my feet. I hadn’t slept for more than 1 hour straight for the past 2 nights, before waking up from being out of breath by the simple act of turning myself in my sleeping bag. I was absolutely done with it. The only thing keeping me standing, was my own frustration and stubbornness. Ever wondered what it is like to meet yourself?

But there, on that mountain, one and a half hours and 350 meters higher, all the nausea, dizziness and complete loss of all my carefully prepared fitness, came crushing on my head. We were sent down by a guide at once. Getting down happened in a blur, Koen could have rolled me down and I wouldn’t have cared.

Once we got my miserable butt back at base camp, the real adventure of the day was still to

unveil its wonderful self to us. But that’s a story for another time. Go to the bottom of the page to find a link to that story!

How I got altitude sickness on the Annapurna Circuit in Nepal and the mistakes I might have made.


Now how did I end up so miserably at 4800m high? A small 600m lower than Thorong La Pass, the high of the Annapurna Circuit Trail, crossed by thousands each year. Let me make a reconstruction of all critical steps that advanced this particular ending on the flanks of the Annapurna mountains.

The trail hiking had been a bliss up until we reached the apple tree fields, somewhere three quarters of the way from Dharapani to Chame. All the sudden, you could buy big bags full of apples everywhere. But since I felt already loaded enough with my backpack, I settled with a small bag of dried apple slices. The perfect before-dinner-snack. By the time dinner came around, the apples had my stomach in a tied grip. If Koen didn’t force a small bowl of thin soup on me, I wouldn’t have eaten. Calories I desperately needed. In the nightly hours that followed, the soup and the apples, graciously left my body again, taking my big lunch along with it. The next morning, I was still too nauseous to eat breakfast. Empty, weak and tired I started another hiking day.

By noon, my stomach had recovered enough to take food again, but I couldn’t possibly recover my calorie deficit. To top this, we managed to accidentally take an optional detour on our way to Upper Pisang, adding a good 6km to an already 16km long day.

The day after we hiked another 16km from Upper Pisang to Bhraga, a village 1km form Manang. But it wasn’t until the day after that I totally emptied my energy reserves. We planned on sleeping in Bhraga for 2 nights. To acclimatise to the height of 3500m. But of course, we embarked on ‘acclimatization walk’. This walk took us 6km further and 1150m higher to the ice lakes, and 6km back again. I must admit, we had the nicest view of the entire trail. I was in constant awe of our surroundings, energizing me.

Back down, I was so exhausted, I couldn’t get food down. Which left me even more calorie deprived. I was losing weight, too much and way too fast. Although we seriously cut back in daily walked kilometres for the next 2 walking days, the damage was already done. The two nights after our ‘acclimatisation walk’ I barely slept. We had elevated above 4000m now and my breath had decided not to join me. The cold had started creeping into my weakened body.

This cascade of events made me crash at 4800m high, right before Thorong La Pass.

Here are some tips to prevent altitude sickness, some of them I did, some of them I didn’t:

- Hydration!

- Eat enough calories, don’t get sick and keep them in

- Walk high, sleep low

- Rest day after every 1000m ascend

- Prevent overexertion within 24 hours of ascending

How I got altitude sickness on the Annapurna Circuit in Nepal and the mistakes I might have made.


On journeys like this, you are bound to meet yourself. Multiple times. Don’t forget to say hi and acknowledge yourself. Twist and turn inside your mental and physical state, really feel it. Also this is a part of you.

Then lift your head and see where you are. Isn’t it amazing? Do you realise where it is you are standing? Let it all flow inside you, the beauty but also the harsh reality of Mother Nature surrounding you. Acknowledge her too.

Now let this moment mingle in the creation of the greatest appreciation for her, yourself and the process. Die and be born again, over and over. Love for all stages in between.




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