Real HimalayaNepal

Useful info

The knowledge our guides
share on every trail

Altitude, seasons, insurance, and packing — written by the guides who manage these decisions for real groups, every season.

Chapter one

Altitude sickness, honestly explained

Altitude sickness can affect anyone — fitness is no shield. Even experienced athletes and repeat trekkers develop symptoms. What matters is not how strong you are, but how wisely you ascend. The mountains reward patience, not speed. Despite the risks in the table below, every one of these journeys is achievable: thousands of trekkers complete them each year with patience and proper acclimatisation.

AMS risk level by adventure and maximum altitude
AdventureMax altitudeRisk of AMS
Langtang Valley Trek4,984mModerate
Annapurna Base Camp Trek4,130mModerate
Everest Base Camp Trek5,364mHigh
Manaslu Circuit Trek5,106mHigh
Everest Three Passes Trek5,500m+Very High
Gokyo Lakes Trek5,357mHigh
Annapurna Circuit Trek5,416m (Thorong La)High
Island Peak Climbing6,189mVery High
Mera Peak Climbing6,476mVery High
Mount Manaslu Expedition8,163mExtreme
Mount Everest Expedition8,849mExtreme

Mild symptoms (6–24 hrs at altitude)

Most trekkers feel some of these; they usually pass with rest and hydration:

  • Headache
  • Fatigue and weakness
  • Dizziness
  • Loss of appetite, nausea
  • Poor sleep
  • Breathless on effort

Emergency signs — descend immediately

HAPE (fluid in the lungs) and HACE (brain swelling) are rare but life-threatening:

  • Breathless even at rest
  • Severe, worsening headache
  • Confusion, slurred speech
  • Loss of balance
  • Blue lips or fingertips

Our guides carry pulse oximeters and emergency oxygen on every trek, and coordinate helicopter evacuation when needed.

Prevention, the short version

  • Ascend slowly — never gain more than 500m of sleeping altitude per day above 3,000m
  • Take the acclimatisation days your itinerary includes
  • Drink 3–4 litres of water daily
  • Eat enough calories — dal bhat is power
  • No alcohol or smoking at altitude
  • Tell your guide about symptoms early, always

Chapter two

When to come

Spring (March – May)

Warm days, rhododendron forests in bloom, and stable weather. The second-busiest season — expedition teams head to Everest in April and May for the summit window.

Best for: Everest, Annapurna, peak climbing

Autumn (September – November)

The clearest mountain views of the year after the monsoon cleans the air. The most popular trekking season — book lodges and flights early.

Best for: All regions — our busiest season

Winter (December – February)

Cold nights and snow at high camps, but empty trails and pristine views. Lower-altitude treks like Poon Hill and Langtang remain very comfortable.

Best for: Poon Hill, Langtang, Everest View

Monsoon (June – August)

Rain, leeches, and cloud on southern routes — but the rain-shadow regions stay dry. Green terraced hillsides at their most dramatic.

Best for: Upper Mustang, NarPhu Valley, Dolpo

Chapter three

Travel insurance — what your policy must cover

We require every client to hold comprehensive insurance before departure. Helicopter rescue in the Himalaya costs thousands of dollars and is arranged fastest when your insurer can authorise it directly.

  • Trekking to the maximum altitude of your chosen itinerary (check the policy altitude limit — many cap at 4,000m or 6,000m)
  • Helicopter evacuation and rescue — costs run US$3,000–10,000 in Nepal's Himalaya
  • Medical treatment and hospitalisation, including repatriation
  • Trip cancellation, delay, and lost baggage cover
  • For peak climbing and expeditions: mountaineering or 'climbing' cover — standard trekking policies exclude roped climbing

Chapter four

What to pack

Keep it under 10kg for the porter. Almost everything on this list can be rented or bought in Thamel, Kathmandu, at a fraction of Western prices — we take you shopping the day before departure.

Essentials

  • Broken-in trekking boots (the single most important item)
  • Down jacket (rentable in Kathmandu) and 4-season sleeping bag for high camps
  • Layered clothing: merino base layers, fleece, shell jacket
  • 30–40L daypack + duffel for the porter to carry (max 10kg)
  • Headlamp, sunglasses (Cat. 4), high-SPF sunscreen, lip balm

Health

  • Personal first aid kit + blister care
  • Diamox (accliazolamide) — discuss with your doctor before the trek
  • Water purification: tablets or filter bottle (we provide boiled water too)
  • Altitude-safe snacks: nuts, chocolate, electrolyte sachets

Papers

  • Passport (6+ months validity) + 2 photos for permits
  • Insurance certificate printed + saved offline
  • Cash (NPR) for drinks, showers, charging, and tips — no ATMs on trek