Altitude Sickness Guide
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KEDARNATH TRIP BOOKING 2026 – TRAVEL PREPARED WITH OUR ₹5000 PACKAGE

Our ₹5000 Kedarnath trip package includes a pre-departure health and preparation briefing. We tell every guest exactly what medicines to carry, when to acclimatize, and what symptoms to watch for. You do not go into the mountains uninformed. Book today and travel with confidence.

OXYGEN LEVELS AT KEDARNATH – THE REAL NUMBERS

Understanding why altitude sickness happens starts with understanding oxygen levels at Kedarnath.

At sea level (0 metres): Atmospheric oxygen concentration is approximately 21%. SpO2 (blood oxygen saturation) in a healthy person at sea level is typically 96 to 99%.

At Gaurikund (1,982 metres, trek start): Oxygen concentration drops to approximately 16 to 17%. SpO2 for most people: 92 to 96%.

At Bheembali (2,850 metres): Oxygen is around 14 to 15%. SpO2: 88 to 94% for most people.

At Lincholi (3,100 metres): Oxygen around 14%. SpO2 can drop to 85 to 92% in some individuals.

At Kedarnath (3,583 metres): Oxygen drops by nearly 35 to 40% compared to sea level. SpO2 for many pilgrims falls to 82 to 92%. This is why breathlessness, headaches, and fatigue are so common at this altitude.

What this means in plain language:

• - At Kedarnath, every breath you take delivers 35 to 40% less oxygen to your blood than at home.

• - Your heart beats faster to compensate, pumping blood more rapidly to deliver adequate oxygen to your organs.

• - This increased cardiac workload is why Kedarnath is potentially risky for people with heart conditions, high blood pressure, and respiratory diseases.

• - A healthy, fit person adjusts to this relatively well. An unfit, unhealthy, or unprepared person struggles significantly.

What is a safe SpO2 level for continuing the trek:

• - SpO2 above 90%: Generally safe to continue with normal precautions.

• - SpO2 85 to 90%: Caution. Rest, hydrate, breathe deeply. Do not push on if symptoms are present.

• - SpO2 below 85%: Do not continue. Use supplemental oxygen and consider descending.

• - Medical camps at Bheembali, Lincholi, and Kedarnath conduct free SpO2 checks. Carry a personal pulse oximeter (costs ₹400 to ₹800) for continuous self-monitoring.

SYMPTOMS OF ALTITUDE SICKNESS ON KEDARNATH TREK

AMS symptoms range from mild to severe. Knowing the difference between normal trekking fatigue and actual altitude sickness is critical.

Mild AMS — these symptoms are common and manageable:

• - Headache — the most common and earliest symptom. Typically a dull, persistent pressure headache rather than a sharp pain.

• - Mild fatigue and weakness beyond what the physical exertion justifies.

• - Slight loss of appetite. Not wanting to eat even though you have not eaten for hours.

• - Mild dizziness when standing up quickly.

• - Difficulty sleeping at night at altitude — waking up frequently, feeling short of breath while lying down.

• - These mild symptoms typically begin at Lincholi (9 km) or at Kedarnath itself. They are the body's normal response to altitude. Rest, hydrate, and slow your pace.

Moderate AMS — take these seriously and stop ascending:

• - Persistent, worsening headache that does not improve with paracetamol.

• - Nausea and vomiting.

• - Significant breathlessness even while at rest — not just while walking uphill.

• - Dizziness that affects balance.

• - Extreme fatigue — feeling unable to take another step despite adequate rest.

• - If you experience moderate AMS symptoms, stop immediately. Do not continue toward Kedarnath. Rest at the nearest checkpoint. Take Diamox if you have it (see dosage section below). If symptoms do not improve within 1 to 2 hours of rest, descend.

Severe AMS — this is a medical emergency:

• - Confusion, disorientation, or inability to think clearly.

• - Loss of coordination or inability to walk in a straight line (this is High Altitude Cerebral Edema — HACE).

• - Severe breathlessness even at rest, bubbling or crackling sound in the chest, frothy or pink-tinged sputum (this is High Altitude Pulmonary Edema — HAPE).

• - Lips or fingernails turning blue.

• - Unconsciousness.

• - If you see any of these symptoms in yourself or another trekker, call for emergency help immediately — SDRF helpline: 1800-180-4236. The only treatment for severe AMS is immediate descent and medical evacuation. Severe AMS can become fatal if not treated promptly.

HIGH-RISK GROUPS FOR ALTITUDE SICKNESS AT KEDARNATH

Heart patients:

• - The extra cardiac workload at 3,583 metres altitude puts significant stress on the heart. People with coronary artery disease, previous heart attacks, arrhythmias, or weak heart function face genuine risk on the Kedarnath trek.

• - Recommendation: Get written medical clearance from a cardiologist before planning the trek. If your cardiologist advises against high-altitude travel, take the helicopter instead. Helicopter is not a compromise — for cardiac patients it is the responsible choice.

• - Carry all regular cardiac medications. Do not skip doses.

• - Carry a pulse oximeter and personal ECG device if available.

High blood pressure patients:

• - Altitude causes blood pressure to rise temporarily in most people. For those already on BP medication, this can push levels into a dangerous range.

• - Recommendation: Have your BP checked by your doctor within 1 week of travel. Ensure your medication is optimized for altitude travel. Carry your BP medication and a personal BP monitor.

• - Continue your BP medication throughout the trek without interruption.

Diabetic patients:

• - High altitude affects blood sugar levels, often causing them to fluctuate more than usual. Exercise at altitude and reduced appetite both impact glucose control.

• - Recommendation: Monitor blood sugar more frequently than usual during the trek — at minimum before each meal and before sleep. Carry extra glucose tablets or juice packs for hypoglycaemia emergencies.

• - Carry all insulin and oral diabetes medications plus 50% more than your usual requirement.

• - Inform your travel companion of your condition and how to administer emergency glucose.

Asthma and lung patients:

• - Cold, dry, low-oxygen air at altitude can trigger bronchospasm and worsen asthma symptoms significantly.

• - Recommendation: Consult your pulmonologist before travel. Ensure your inhaler is up to date. Consider helicopter if your asthma is moderate to severe.

• - Carry a spare inhaler. Cold temperature can occasionally make inhalers less effective — keep the inhaler in an inner pocket close to your body.

Pregnant women:

• - High altitude restricts oxygen supply to the foetus. Trekking at altitude during pregnancy, especially in the second and third trimester, is not recommended.

• - Recommendation: Consult your gynaecologist. If you wish to visit Kedarnath during pregnancy, use the helicopter and limit time at high altitude.

Children below 10 years:

• - Children are more susceptible to altitude sickness than adults and have more difficulty communicating symptoms.

• - Recommendation: Children below 5 years should not go to Kedarnath altitude. For children 5 to 10, helicopter is the safest option. Watch closely for irritability, vomiting, refusal to eat, and unusual drowsiness — these can be AMS symptoms in young children.

DIAMOX (ACETAZOLAMIDE) FOR KEDARNATH TREK

Diamox is the most commonly used and medically proven medicine for preventing altitude sickness. Here is everything you need to know before taking it.

What Diamox does:

• - Diamox (Acetazolamide) is a diuretic medicine that works by stimulating faster and deeper breathing, which increases oxygen intake and helps the blood maintain its acid-base balance at altitude.

• - It does not eliminate AMS — it significantly reduces the risk and severity.

• - It is effective for prevention (taken before symptoms appear) and for treating mild to moderate AMS.

Standard Diamox dose for Kedarnath trek (always consult your doctor first):

• - Preventive dose: 125 mg twice daily, starting 24 hours before reaching high altitude (before arriving at Guptkashi is ideal) and continuing for 48 hours after reaching your highest point (Kedarnath).

• - Treatment dose if symptoms develop: 250 mg twice daily. Consult the medical camp staff or descend.

Who should NOT take Diamox:

• - People allergic to sulpha drugs or sulfonamide antibiotics.

• - People with kidney disease or kidney stones.

• - People on specific blood thinners. Diamox can interact with certain medications.

• - Always consult your doctor before taking Diamox. It requires a prescription.

Side effects of Diamox to expect:

• - Increased urination — this is normal and expected. Drink more water to compensate.

• - Tingling in fingers, toes, and lips — very common and harmless. Goes away when you stop taking it.

• - Slightly blurred vision in some people.

• - Drowsiness — avoid operating vehicles while on Diamox.

• - Carbonated drinks will taste flat while on Diamox. This is harmless.

FULL MEDICINES KIT TO CARRY FOR KEDARNATH TREK

Basic medicines every trekker should carry:

• Diamox 125 mg or 250 mg: After doctor consultation. For altitude sickness prevention.

• Paracetamol 500 mg: For headache and fever — the most common uses on the trek.

• Ibuprofen 400 mg: For muscle pain, joint pain, and stronger headache relief.

• Antacid (Gelusil, Digene, or Eno): Digestive issues are common at altitude.

• ORS sachets (at least 8): Mix in 1 litre water and drink twice daily on trek days. Prevents dehydration.

• Antiemetic (Ondansetron or Domperidone): For nausea and vomiting from AMS or motion sickness on the road.

• Loperamide (Imodium): For diarrhoea — change of water and diet at altitude can trigger it.

• Cold and cough syrup: Mountain cold is common. Carry a syrup suitable for you.

• Antihistamine (Cetrizine): For allergy reactions from pollen or dust on the trail.

• Portable oxygen can: Buy in Haridwar for ₹150 to ₹200 — same product costs ₹300 to ₹500 on the trek route.

• Blister plasters (Compeed or moleskin): Foot blisters are extremely common on the 18 km trek.

• Crepe bandage: For ankle sprains. The rocky, uneven terrain on the trek makes ankle rolling a real risk.

• Antiseptic cream (Betadine or Savlon): For small cuts or abrasions on the trail.

• Lip balm with SPF: High-altitude UV radiation cracks and burns lips significantly.

• Personal prescription medicines: Carry 50% more than your usual requirement for any long-term condition.

Carry everything in a small, waterproof ziplock bag inside your backpack. Not at the bottom — somewhere you can access quickly without emptying your bag.

ACCLIMATIZATION STRATEGY FOR KEDARNATH

The single most effective thing you can do to prevent AMS on the Kedarnath trek is proper acclimatization. This means spending at least one night at a mid-altitude point before ascending to 3,583 metres.

One night at Guptkashi (1,319 metres) before the trek:

• - This is the standard recommended acclimatization stop for Kedarnath.

• - Guptkashi is a full 1,300 metres above Haridwar. One night here adjusts your blood and breathing to the lower oxygen environment before you climb to 3,583 metres.

• - Studies on high-altitude medicine show that sleeping at altitude — not just spending daytime hours there — is what triggers the body's acclimatization response.

• - Skipping Guptkashi and going directly from Haridwar to Gaurikund in one day then trekking immediately is the most common cause of severe AMS among Kedarnath pilgrims.

Optional second acclimatization night at Sonprayag (1,829 metres):

• - If you have an extra day, a night at Sonprayag (1,829 metres) before the trek gives you an additional altitude step.

• - This is especially recommended for elderly pilgrims, those with mild health conditions, and anyone who has experienced AMS before.

On the trek day itself:

• - Walk slowly and steadily. The Kedarnath trek is not a race. Fast ascent is the number one trigger for AMS in otherwise healthy people.

• - Take breaks every 800 to 1,000 metres of walking. Sit, drink water, breathe deeply.

• - Use the Pressure Breathing technique: breathe in slowly through the nose for 4 counts, hold for 2 counts, exhale fully through the mouth for 6 counts. This maximises oxygen extraction from each breath.

• - Drink 3 to 4 litres of water across the trek day. Hydration is second only to slow ascent in preventing AMS.

• - Avoid alcohol and sleeping pills before and during the trek — both suppress breathing, reducing oxygen intake.

WHAT TO DO IF YOU OR SOMEONE DEVELOPS AMS ON THE TREK

If you develop mild symptoms (headache, mild fatigue):

• - Stop walking. Find a rest point and sit down.

• - Drink a full glass of water with ORS dissolved in it.

• - Take paracetamol for the headache.

• - Rest for 30 to 45 minutes. If symptoms improve, continue at a much slower pace.

• - If symptoms do not improve after rest, do not ascend further. Descend to the previous checkpoint.

If you develop moderate symptoms (persistent headache, nausea, significant breathlessness):

• - Stop immediately. Do not take another upward step.

• - Inform the nearest SDRF or medical post.

• - Take Diamox 250 mg if you have it.

• - Use a portable oxygen can.

• - Descend to the nearest medical camp (Bheembali or Lincholi).

• - Rest at the medical camp under supervision. The medical camp staff will advise on whether to continue or return.

If you see severe symptoms (confusion, inability to walk straight, extreme breathlessness at rest):

• - This is an emergency. Call SDRF immediately: 1800-180-4236.

• - Keep the person warm, lying down at a slight incline (head raised slightly).

• - Use supplemental oxygen if available.

• - Begin descent immediately — even 300 to 500 metres of descent can begin to reverse severe AMS quickly.

• - Do not leave a severely ill person alone.

HEALTH SCREENINGS ON THE KEDARNATH ROUTE 2026

Health screening points and what happens:

• - Sonprayag check post: Basic health check for visibly unwell pilgrims. Those appearing seriously unwell may be advised not to proceed.

• - Gaurikund medical post: BP and SpO2 check available. Declared medical conditions (cardiac, severe asthma) may be flagged.

• - Bheembali medical camp: Full SpO2, BP, and pulse check for any pilgrim who requests it. Free of charge. Oxygen available.

• - Lincholi medical post: Same as Bheembali.

• - Kedarnath medical camp: Full first aid services. Oxygen available. In emergencies, helicopter evacuation is coordinated from here.

If you are found medically unfit at any checkpoint:

• - The medical staff will advise you to stop or return. This is advice, not a legal order in most cases — but refusing medical advice at altitude is extremely dangerous.

• - If the staff insists you do not continue, listen. The Kedarnath mountains do not negotiate. Your health and life matter more than completing the trek.

• - Pilgrims turned back at checkpoints can opt for helicopter service from Phata or Sirsi helipads to still reach Kedarnath for darshan without the physical trek.

PEOPLE ALSO ASK – ALTITUDE SICKNESS FAQ

Q: What is the oxygen level at Kedarnath?

A: The oxygen level at Kedarnath (3,583 metres) is approximately 35 to 40% lower than at sea level. Blood oxygen saturation (SpO2) typically drops to 82 to 92% at this altitude. This is why breathlessness, headaches, and fatigue are so common.

Q: Is Diamox necessary for Kedarnath trek?

A: Diamox is not mandatory but is strongly recommended for those who have experienced altitude sickness before, those with reduced fitness, or those going directly from low altitude cities. Always consult your doctor before taking it.

Q: Is Kedarnath trek safe for heart patients?

A: The Kedarnath trek is not recommended for people with active heart conditions, recent heart surgery, or unstable angina. The altitude causes extra cardiac stress. Cardiac patients should take the helicopter and consult their cardiologist before any visit to Kedarnath altitude.

Q: What SpO2 is dangerous at Kedarnath?

A: An SpO2 reading below 85% at altitude is concerning. Below 80% is dangerous. If your SpO2 drops this low, you should descend immediately and seek medical help at the nearest camp.

Q: What medicines to carry for Kedarnath trek?

A: Essential medicines include Diamox (after doctor consultation), paracetamol, ibuprofen, ORS sachets, antacid, antiemetic, portable oxygen can, blister plasters, and a crepe bandage. See the full list in Section 5 of this page.

Q: What is the first sign of altitude sickness at Kedarnath?

A: The first and most common sign of altitude sickness at Kedarnath is a persistent headache — typically a dull, pressure headache that does not go away with rest. If you develop a headache that keeps getting worse rather than improving with rest, stop ascending.

Q: When should you turn back on the Kedarnath trek?

A: Turn back if you develop persistent worsening headache, nausea and vomiting, extreme breathlessness at rest, dizziness affecting your balance, or confusion. Descending 300 to 500 metres typically begins to improve symptoms quickly. Never push through severe symptoms.