This is intended for trek leaders, but very useful for everybody and anybody going to altitude. You should also read this about Diamox for acclimatisation at altitude. If you have questions, leave a comment below.

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While as a trek leader you must always be checking on the health of your clients, especially with regard to altitude, it is better to plan your trek in advance to minimise the risk of altitude sickness by making a safe acclimatisation profile.

Above 2,000 metres (6,300 feet), only increase your altitude by 300 metres (1,000 feet) per day, and for every 900 metres (3,000 feet) of elevation gained, take a rest day to acclimatise.

Altitude specialist doctors recommend taking a minimum of 2-3 nights to reach 3000m.

NOTE! around 12% of people ascending directly to the height of Lukla (2850m) experience noticable AMS. 84% of people arriving by plane to Syangboche have symptoms of AMS.

NOTE! About 1% of people of ascend to above 3000m get HACE.

This ascent profile can be shown as a table. Of course you will never find a trek that perfectly matches these heights, but it is a good guideline for planning a trek that will prevent your clients feeling bad, getting sick and having to change your itinerary.

Days above 2500m Recommended maximum sleeping altitude Change/rest
Day 1-3 2000m – 3000m  2-3 days reaching this height
Day 4 3000m 1st night at high – altitude
Day 5 3300m up 300m
Day 6 3600m up 300m
Day 7 3900m up 300m
Day 8 3900m — rest day —
Day 9 4200m up 300m
Day 10 4500m up 300m
Day 11 4800m up 300m
Day 12 4800m — rest day —
Day 13 5200m up 300m
Day 14 5500m up 300m

Example of a Mera peak trek itinerary

The Mera Peak trek is a perfect example of breaking acclimatisation recommendations. Below is a day by day chart comparing the recommended rate of ascent and rest versus a common Mera itinerary.

acclimatisation-profile-mera-peak-recommended-1024x535

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