Altitude Sickness on Manaslu Circuit Trek & Essential Tips

Overview of Altitude Sickness on Manaslu Circuit Trek with Prevention 

Trekking the Manaslu Circuit is a dream adventure, offering remote Himalayan landscapes, rich Tibetan-influenced culture, and breathtaking views of Mount Manaslu (8,163m), the eighth-highest peak in the world. However, due to its high altitude and challenging terrain, altitude sickness (Acute Mountain Sickness – AMS) is a major concern for trekkers. Understanding the risks, symptoms, prevention methods, and acclimatization strategies is essential for a safe and enjoyable trek.

This blog provides vital insights into altitude sickness on theManaslu Circuit Trekking, including the highest altitude points, the best acclimatization practices, and expert health tips to minimize risks. The trek reaches a maximum elevation of 5,106m at Larke Pass, making proper acclimatization and gradual ascent critical to avoid AMS. Symptoms such as headaches, dizziness, nausea, and shortness of breath can affect trekkers at altitudes above 2,500m, but with the right preparation and precautions, the journey can be both safe and rewarding.

One of the key factors in preventing altitude sickness is following a well-planned itinerary that includes proper acclimatization days, staying hydrated, maintaining a balanced diet, and ascending at a moderate pace. This blog also covers recommended trekking routes for better acclimatization, the best foods and hydration tips, the importance of rest days, and when to seek medical attention in case of severe altitude-related symptoms.

Additionally, we discuss how to prepare physically for the high-altitude trek, the role of altitude sickness medications such as Diamox, and emergency rescue options available on the trail. Whether you’re a beginner or an experienced trekker, understanding how altitude affects your body can be the key to successfully completing the Manaslu Circuit Trek without complications.

With detailed health and safety advice, this blog aims to be the ultimate guide for trekkers planning to conquer Manaslu Circuit’s high-altitude challenges. Whether you’re searching for the best acclimatization tips, ways to prevent altitude sickness or essential health precautions for the Manaslu trek, this guide will help you trek confidently while ensuring your safety at every step. Stay informed, trek smart, and make your Manaslu adventure an unforgettable experience!

Manaslu Circuit altitude sickness, AMS (Acute Mountain Sickness)

The Manaslu Circuit is one of Nepal’s most stunning and remote treks, but with its beauty comes a hidden challenge—altitude sickness. As trekkers journey through deep valleys, past ancient monasteries, and into the high-altitude wilderness, they often feel the thin air creeping in. For some, it begins as a mild headache in Samagaun (3,530m); for others, nausea and dizziness strike unexpectedly as they ascend toward Dharamsala (4,460m), the last stop before crossing the mighty Larke Pass (5,106m). This is Acute Mountain Sickness (AMS), a reality that every trekker must prepare for before stepping onto the Manaslu trail.

Imagine you’ve been trekking for days, your body adjusting to the rising altitude. The crisp mountain air energizes you, and the towering peaks seem within reach. Then, out of nowhere, your head pounds, your breath feels shorter, and exhaustion washes over you even after a short walk. This is AMS creeping in, and if ignored, it can turn a thrilling adventure into a life-threatening experience.

Many trekkers underestimate altitude sickness, thinking it affects only extreme climbers. But on the Manaslu Circuit, where elevations soar above 5,000m, AMS is common among both beginners and experienced hikers. The body struggles to adjust to lower oxygen levels, and symptoms like headaches, dizziness, nausea, and fatigue start appearing above 2,500m. If not managed properly, AMS can escalate into High Altitude Pulmonary Edema (HAPE) or High Altitude Cerebral Edema (HACE), both of which can be fatal without immediate descent.

But altitude sickness isn’t inevitable—it’s manageable. The key is acclimatization, allowing the body time to adjust. Taking rest days in strategic locations like Samagaun and Samdo (3,875m), staying well-hydrated, eating energy-rich meals, and maintaining a steady, slow ascent can significantly reduce the risk. Many trekkers also rely on Diamox, a preventive medication that helps the body adapt faster.

In this blog, we dive deep into real experiences of altitude sickness on the Manaslu Circuit, why some trekkers suffer while others don’t, and how you can train and prepare your body for high altitudes. Whether you’re an aspiring trekker or someone who has faced AMS before, this guide will equip you with everything you need to conquer the Manaslu Circuit safely and confidently.

Acclimatization on the Manaslu trek for Safe trekking

Acclimatization is the key to a successful and safe Manaslu Circuit Trek, ensuring that your body gradually adapts to the decreasing oxygen levels as you ascend into the high Himalayas. Without proper acclimatization, the risk of Acute Mountain Sickness (AMS) increases significantly, which can turn an exciting adventure into a dangerous situation.

The Manaslu trek takes you from the lush lowlands at Soti Khola (700m) to the high-altitude wilderness of Larke Pass (5,106m). As you gain altitude, your body needs time to adjust to the thin air, and this is where acclimatization days become crucial. Rushing through the trek without acclimatization increases the risk of AMS, which can cause symptoms like headaches, dizziness, nausea, and extreme fatigue.

Best Acclimatization Spots on the Manaslu Circuit

1. Samagaun (3,530m) – Essential Acclimatization Stop: Samagaun is the most important acclimatization stop on the Manaslu Circuit Trek. At this altitude, oxygen levels drop significantly, so spending an extra day here helps your body adjust. During the rest day, trekkers can take a short hike to Pungyen Gompa (4,000m) or the Manaslu Base Camp (4,850m) before descending back to Samagaun for the night. This climb-high, sleep-low strategy is highly effective in preventing AMS.
2. Samdo (3,875m) – Another Acclimatization Opportunity: A short day’s trek from Samagaun leads to Samdo, the last settlement before the tough climb to Larke Pass. Spending a night here allows further adaptation to the altitude. A short acclimatization hike to Tibetan border viewpoints (4,200m-4,500m) can help prepare your body for the higher elevations ahead.
3. Dharamsala (4,460m) – The Final Adjustment Before Larke Pass: The trek from Samdo to Dharamsala (also known as Larke Phedi) is steep and demanding, but this final stop before the pass is essential. Some trekkers may feel early signs of altitude sickness here, making hydration and proper rest extremely important.

Tips for Effective Acclimatization on the Manaslu Trek

• Follow the “Climb High, Sleep Low” rule – Take short hikes to higher altitudes before returning to lower elevations for the night.
• Take acclimatization days seriously – Resting may seem unnecessary, but your body needs time to adapt.
• Hydrate Constantly – Drink 3-4 liters of water per day to prevent dehydration, which worsens AMS symptoms.
• Eat a High-Calorie Diet – Focus on carbohydrate-rich foods to maintain energy levels.
• Avoid Alcohol and Sleeping Pills – These can suppress breathing, making altitude sickness worse.
• Consider Diamox – This altitude sickness medication can help prevent AMS but should be taken under proper guidance.

By respecting the altitude and allowing time for acclimatization, trekkers can safely complete the Manaslu Circuit Trek vis Short Manaslu Base Camp Hike while fully enjoying the breathtaking beauty of this remote Himalayan region.

Manaslu Larke Pass altitude challenge

The Larke Pass (5,106m) is the most demanding section of the Manaslu Circuit Trekking, testing trekkers with its high altitude, steep ascent, and unpredictable weather conditions. As the highest point of the trek, Larke Pass presents a true altitude challenge, where thin air, extreme cold, and exhaustion can make the crossing both physically and mentally demanding.

The High-Altitude Struggle: Oxygen Levels and AMS Risk

At 5,106m, oxygen levels are nearly 50% lower than at sea level. Many trekkers start feeling the effects of altitude sickness as they approach Dharamsala (4,460m), the final stop before the pass. Symptoms like headaches, dizziness, and shortness of breath can intensify at higher altitudes, making proper acclimatization and a slow ascent crucial.

Trekkers often start their Larke Pass ascent before dawn to avoid strong afternoon winds. The steep climb over loose rocks and ice demands stamina and careful foot placement, especially in snowy or icy conditions. The high altitude makes even short steps feel exhausting, and the cold can numb fingers and toes despite wearing thermal layers.

Weather Challenges at Larke Pass

The weather at Larke Pass is highly unpredictable. Even in peak trekking seasons (autumn and spring), temperatures at the top can drop to -15°C or lower before sunrise. Sudden snowfall or strong winds can drastically reduce visibility, making navigation challenging.

Many trekkers face extreme exhaustion while crossing the pass due to the lack of oxygen and the long, demanding descent to Bimthang (3,720m). This 1,386m downhill trek can be even harder than the ascent, as tired legs struggle to maintain balance on rocky and icy paths.

Tips to Overcome the Larke Pass Challenge

• Acclimatize properly – Spend extra days at Samagaun (3,530m) and Samdo (3,875m) to adjust to the altitude.
• Start early – Leave Dharamsala by 3:00 AM to avoid strong winds and ensure enough time to cross safely.
• Dress in layers – Wear thermal gear, a windproof jacket, gloves, and warm socks to fight the cold.
• Use trekking poles – They provide stability on steep and icy sections.
• Hydrate constantly – Dehydration worsens altitude sickness, so drink at least 3 liters of water per day.
• Listen to your body – If symptoms of AMS worsen, descend immediately.

The Larke Pass altitude challenge is tough, but with the right preparation, mindset, and safety measures, it becomes a thrilling and rewarding achievement—one that every trekker on the Circuit of Manaslu will remember for a lifetime!

Round Manaslu trek difficulty

The Round Manaslu Trek is considered one of the most challenging treks in Nepal due to its high altitude, long trekking days, steep ascents and descents, and remote terrain. Unlike more commercialized trekking routes like the Annapurna or Everest regions, the Manaslu Circuit remains untouched, demanding physical endurance, proper acclimatization, and mental resilience from trekkers.

1. Long Trekking Days & Tough Terrain

The Manaslu Round is around 177 km (110 miles) long, taking about 14-18 days to complete. Trekkers must walk 6-8 hours per day on rough trails, crossing suspension bridges, navigating rocky paths, and climbing steep inclines. Some sections involve landslide-prone areas and glacier crossings, making the trek both exciting and physically demanding.

2. High Altitude & AMS Risk

The trek starts at Soti Khola (700m) and gradually ascends to Larke Pass (5,106m)—the highest point of the trek. The drastic gain in altitude increases the risk of Acute Mountain Sickness (AMS), which can cause headaches, nausea, dizziness, and extreme fatigue. Proper acclimatization days in Samagaun (3,530m) and Samdo (3,875m) are essential for a safe ascent.

3. Weather & Temperature Challenges

The weather in the Manaslu region is unpredictable. In autumn (September–November) and spring (March), the daytime temperatures range between 10°C to 20°C, but at higher altitudes, night temperatures drop to -10°C or lower. Crossing Larke Pass before sunrise is extremely cold, with strong winds and the possibility of snow, adding to the difficulty.

4. Remote and Limited Facilities

The Manaslu Round Trekking is a restricted region, meaning it is far less developed than the Everest or Annapurna treks. While teahouses are available along the route, they are basic, with limited food options, no heating, and shared bathrooms. Electricity and Wi-Fi are scarce, and phone networks often don’t work. Trekkers must be prepared for a rugged experience with few modern comforts.

5. Physical Fitness & Preparation

This trek is not for beginners—it requires good physical fitness. Trekkers should train at least a month in advance, focusing on cardio (hiking, running, cycling), strength training, and endurance exercises. Carrying a backpack with essential gear while hiking helps simulate trekking conditions.

How Difficult is the Manaslu Circuit Trek?

• Moderate to Strenuous Difficulty – Requires endurance, acclimatization, and good fitness.
• Toughest Section: Larke Pass (5,106m) – Cold, high-altitude, steep climb, and long descent.
• Not Suitable for Beginners Without Training – Experience in multi-day trekking is recommended.

Final Verdict: Is the Manaslu Circuit Trek Worth It?

Absolutely! Despite its challenges, Manaslu Circuit is a thrilling, off-the-beaten-path trek offering breathtaking mountain views, diverse landscapes, and rich Tibetan culture. With proper preparation, acclimatization, and a strong mindset, this trek is a once-in-a-lifetime experience for adventure seekers looking for a raw and remote Himalayan journey!

Altitude sickness symptoms and prevention

Altitude Sickness (Acute Mountain Sickness – AMS) is a common challenge for trekkers on the Manaslu Base Camp Trek, especially as they ascend above 3,000 meters (9,842 ft). The reduced oxygen levels at higher elevations can cause the body to struggle with acclimatization, leading to mild to severe symptoms. Recognizing these symptoms early and taking preventive measures can ensure a safer trek.

Common Symptoms of Altitude Sickness

Mild AMS symptoms usually appear above 3,000m and worsen with rapid ascent. These include:

• Headache – The most common early symptom.
• Dizziness & Lightheadedness – Difficulty balancing and focusing.
• Nausea & Loss of Appetite – Feeling sick or disinterested in food.
• Shortness of Breath – Even small physical activity feels exhausting.
• Disturbed Sleep – Difficulty sleeping or frequent waking at night.

If AMS is ignored, it can develop into severe forms:

1. High Altitude Cerebral Edema (HACE) – Confusion, loss of coordination, inability to walk.
2. High Altitude Pulmonary Edema (HAPE) – Severe shortness of breath, coughing up pink frothy sputum.

Both conditions are life-threatening and require immediate descent.

How to Prevent Altitude Sickness on the Manaslu Circuit

• Acclimatize Properly – Spend extra nights at Samagaun (3,530m) & Samdo (3,875m) before reaching Larke Pass.
• Ascend Slowly – Follow the 300-500m per day rule above 3,000m.
• Stay Hydrated – Drink 3-4 liters of water daily.
• Avoid Alcohol & Smoking – They dehydrate the body and slow acclimatization.
• Eat Carbohydrate-Rich Meals – Provides energy for high-altitude trekking.
• Take Diamox (if needed) – Helps with acclimatization but consult a doctor first.
• Listen to Your Body – If symptoms worsen, descend immediately.

By taking these precautions, trekkers can minimize altitude sickness risks and enjoy the breathtaking journey of the Manaslu Circuit Trek safely!

Hydration tips for high-altitude trekking

Proper hydration is crucial when trekking at high altitudes like the Manaslu Circuit Trek, where the risk of dehydration and altitude sickness is high. The body loses more fluids due to dry mountain air, increased respiration, and exertion, making it essential to drink water consistently. Here are some expert hydration tips to keep you safe and energized:

• Drink at least 3-4 Liters of Water Daily: At high altitudes, dehydration can occur faster than you realize. Aim for at least 3-4 liters of water per day to compensate for fluid loss and keep your body functioning properly.
• Don’t Wait Until You’re Thirsty: By the time you feel thirsty, you’re already dehydrated. Instead, sip water frequently throughout the trek, even if you don’t feel like drinking.
• Use an Insulated Water Bottle or Hydration Bladder: A hydration bladder (like a CamelBak) allows easy access to water without stopping, while insulated bottles prevent water from freezing in cold conditions, especially near Larke Pass (5,106m).
• Avoid Excessive Caffeine & Alcohol: Both coffee and alcohol dehydrate the body, making it harder to adjust to altitude. Stick to herbal teas, soups, and water for better hydration.
• Add Electrolytes: To maintain electrolyte balance, carry ORS (Oral Rehydration Salts), electrolyte tablets, or sports drinks. These help replenish salts and minerals lost through sweating.
• Drink Warm Fluids in Cold Conditions: At high altitudes, drinking cold water can be uncomfortable. Opt for warm ginger tea, soups, or hot water to stay hydrated and warm.
• Monitor Your Urine Color: A pale yellow color means you’re well-hydrated, while dark yellow or orange urine signals dehydration. Drink more water if your urine is dark.
• Eat Hydrating Foods: Consume watery fruits, vegetables, and soups at tea houses to boost hydration naturally. Avoid salty, fried foods that can contribute to dehydration.

By following these hydration strategies, you can prevent altitude sickness, maintain energy levels, and ensure a successful Manaslu Circuit Trek!

Foods to eat to prevent altitude sickness

Eating the right foods is essential to staying healthy and preventing altitude sickness on high-altitude treks like the Manaslu Circuit Trek. Proper nutrition helps the body adjust to reduced oxygen levels, maintain energy, and improve acclimatization. Here are some foods that can help you prevent altitude sickness and stay strong during your trek:

1. Carbohydrate-Rich Foods: Carbs are your best friend at high altitudes. They provide energy that your body needs to cope with the extra physical exertion and oxygen deficit.

• Rice, pasta, and bread – Easily digestible sources of complex carbs.
• Oats and cereals – Great for breakfast and high in energy.
• Potatoes – High in carbohydrates and potassium, they help maintain energy and prevent muscle cramps.

2. Lean Protein: While carbs are essential for energy, protein helps repair muscle tissue and boosts your immune system.

• Chicken, eggs, and fish – Great sources of lean protein that are easy to digest at altitude.
• Tofu, legumes, and nuts – Ideal for vegetarians or those looking for plant-based proteins.

3. Healthy Fats: Healthy fats are important for sustained energy at higher altitudes, especially when trekking for long hours.

• Nuts and seeds – Almonds, walnuts, chia seeds, and sunflower seeds are nutrient-dense and provide a quick energy boost.
• Avocados – Packed with healthy fats and fiber, they keep you full and energized.

4. Hydrating Foods: The air at high altitudes is dry, and staying hydrated is critical to preventing altitude sickness. Eating foods with high water content can help.

• Soups and broths – Rich in hydration and easy to digest.
• Cucumbers, watermelon, and oranges – High-water fruits and vegetables that help keep you hydrated and refreshed.

5. Foods High in Potassium: Potassium helps balance fluids in your body and prevents muscle cramps, which are common at high altitudes due to dehydration.

• Bananas – A great source of potassium and easy to carry on the trail.
• Sweet potatoes – Rich in potassium and fiber, these help with digestion and energy.
• Spinach and leafy greens – High in potassium, they also contain iron, which helps your blood carry oxygen.

6. Iron-rich foods: At higher altitudes, your body requires more iron to produce hemoglobin for carrying oxygen.

• Red meat (like beef) – Provides a good amount of heme iron, which is easily absorbed by your body.
• Lentils, beans, and quinoa – These are plant-based sources of iron and perfect for vegetarians.
• Leafy greens (spinach, kale) – High in non-heme iron. Pair them with vitamin C-rich foods for better absorption.

7. Vitamin C-Rich Foods: Vitamin C helps in iron absorption, boosts your immune system, and helps your body adapt to altitude.

• Citrus fruits (oranges, lemons, grapefruits) – Excellent sources of vitamin C.
• Bell peppers and tomatoes are packed with vitamin C and antioxidants.
• Berries (strawberries, blueberries, raspberries) – Full of vitamin C and can be added to meals or eaten as a snack.

8. Ginger and Herbal Teas

• Ginger – Helps with nausea, a common symptom of altitude sickness. Drinking ginger tea or adding fresh ginger to your meals can calm your stomach and improve digestion.
• Herbal teas (mint, chamomile, or lemon balm) – They help with digestion and can keep you relaxed after a long day of trekking.

Safe ascent rate for Manaslu trekking

When trekking in high-altitude regions like the Manaslu Circuit, maintaining a slow and steady ascent rate is crucial for avoiding altitude sickness and ensuring your body has enough time to acclimatize. The general rule for altitude trekking is to ascend slowly to give your body the best chance of adjusting to lower oxygen levels.

Recommended Ascent Rate

• To minimize the risks of altitude sickness, the safe ascent rate for trekking in areas like Manaslu is:
• No more than 300-500 meters (984-1,640 feet) per day above 3,000 meters (9,842 feet).
• After every 1,000 meters (3,280 feet) of elevation gain, it’s recommended to take a rest day at the same altitude to help with acclimatization.

Why a Slow Ascent Is Important

• Acclimatization: As you climb higher, the oxygen levels drop, and your body needs time to adapt to this change. A slow ascent allows your body to gradually adjust, reducing the risk of altitude sickness.
• Physical Recovery: Gradual elevation gain minimizes physical stress, allowing your body to recover and avoid fatigue, especially when heading towards challenging points like Larke Pass (5,106 meters / 16,752 feet).

Adjusting the Pace for Your Health

Everyone’s body reacts differently to altitude, so listening to your body is key. If you feel fatigued or notice symptoms of altitude sickness (headaches, dizziness, nausea), it’s important to stop and rest, even if you’ve not reached the recommended ascent rate for the day.

By following the safe ascent rate, you significantly increase your chances of completing the Manaslu Circuit Trek safely and enjoying stunning views without compromising your health.

What to do if you get altitude sickness in Nepal

Altitude sickness is a common concern for trekkers in the Himalayas, especially when trekking in regions like Manaslu, Everest, or Annapurna. If you begin to experience symptoms of Altitude Sickness (AMS), it’s important to take immediate action to avoid serious health issues like HAPE (High Altitude Pulmonary Edema) or HACE (High Altitude Cerebral Edema). Here’s what to do if you suspect altitude sickness during your trek in Nepal:

1. Recognize the Symptoms of Altitude Sickness

• Altitude sickness can manifest in a range of mild to severe symptoms. Early signs include:
• Headache
• Dizziness or lightheadedness
• Nausea or vomiting
• Fatigue or weakness
• Loss of appetite
• Difficulty sleeping

If symptoms persist or worsen, they may escalate to more serious conditions such as:

• HACE: Confusion, difficulty walking, loss of coordination
• HAPE: Shortness of breath, coughing up frothy pink sputum

2. Stop and Rest Immediately

If you start feeling any symptoms of altitude sickness, the first step is to stop ascending and rest. Avoid going higher until symptoms improve. Continuing to ascend can worsen your condition.

3. Hydrate and Eat

Dehydration can worsen altitude sickness. Drink plenty of water (aim for 3-4 liters a day) and eat carbohydrate-rich foods to maintain energy levels. Avoid alcohol and caffeine as they can dehydrate you further.

4. Descend to a Lower Altitude

If symptoms persist or worsen, the most effective treatment is descending to a lower altitude. Even a descent of 500-1,000 meters can make a significant difference. Going down helps your body recover and adapt to higher oxygen levels.

5. Take Medication

• Diamox (Acetazolamide): This medication is commonly used to help with acclimatization. It can speed up the process of acclimatization and reduce symptoms of AMS. It is usually taken a day or two before ascending and while trekking at higher altitudes. However, it’s crucial to consult with a doctor before use.
• Pain Relievers: Over-the-counter medications like ibuprofen or paracetamol can help alleviate symptoms like headaches.
• Oxygen: In more severe cases, supplemental oxygen may be necessary, especially if symptoms are severe or if you’re near 5,000 meters.

6. Seek Medical Assistance

If your condition continues to worsen, seek medical help immediately. In Nepal, you can find medical centers in major trekking hubs like Kathmandu or Pokhara, or at certain trekking checkpoints, such as in Namche Bazaar (Everest Region). If necessary, helicopter evacuation is available for severe cases of altitude sickness in remote areas.

7. Avoid Going Higher Until Fully Recovered

It’s crucial to rest at the same altitude until you feel fully recovered. Once the symptoms subside, proceed with slow and careful ascent.

8. Have a Plan for Emergencies

Before you start your trek, ensure that you have a backup plan in case of emergencies. This includes knowing the route to the nearest medical facility, having travel insurance that covers emergency evacuation, and carrying a satellite phone or trekking guide with communication equipment in case of an emergency.

Summary

Altitude sickness is a serious condition, but with the right knowledge and preparation, it can be managed effectively. The key to preventing and treating altitude sickness on a trek in Nepal is to listen to your body, descend promptly, and seek medical attention if needed. Always remember to trek at a safe pace, acclimatize properly, stay hydrated, and rest if you feel any symptoms of AMS.

Best acclimatization stops in Manaslu

Acclimatization is a crucial aspect of trekking in high-altitude regions like the Manaslu Circuit. The goal is to give your body time to adjust to the decreasing oxygen levels at higher elevations, minimizing the risk of altitude sickness. Here are the best acclimatization stops on the Manaslu Circuit Trek that will allow you to gradually ascend and safely acclimatize:

1. Samagaun (3,530 meters / 11,578 feet)

Samagaun is one of the best places for acclimatization on the Manaslu Circuit Trek. Situated near the foot of Manaslu Mountain, this small village offers stunning views of the surrounding peaks and is an ideal spot for rest and acclimatization.

• Acclimatization Opportunity: Spend a full day here to adjust to the altitude. You can explore the village, visit Manaslu Base Camp, or hike up to Pungen Glacier for some light activity.
• Benefits: This stop provides ample time to rest while also offering opportunities to explore the local culture and stunning scenery.

2. Deng (1,860 meters / 6,102 feet)

Deng is a small village located early in the trek and is another excellent spot for gradual acclimatization. While the village itself is at a lower elevation, you can use it to adjust before heading to higher altitudes.

• Acclimatization Opportunity: After a long day of trekking, taking a rest in Deng gives your body a chance to adjust before heading higher. You can also take short hikes to nearby areas to gently elevate your altitude.
• Benefits: Deng allows you to maintain a slow ascent while easing your body into the trek's increasing elevation.

3. Namrung (2,630 meters / 8,629 feet)

Namrung is a picturesque village and a popular acclimatization stop on the way to higher altitudes in the Manaslu Circuit. Nestled in the Buddhist region, it offers a great environment for acclimatization.

• Acclimatization Opportunity: After a day of trekking, take a rest day in Namrung. You can explore the surrounding hills and interact with local people to give your body the necessary time to adjust.
• Benefits: The slightly higher altitude and rich cultural experience make it an ideal acclimatization spot on the trek.

4. Lho (3,180 meters / 10,433 feet)

Lho is a charming village that lies close to Manaslu Base Camp. The village’s altitude provides a good base for acclimatization before heading to Samagaun or higher elevations.

• Acclimatization Opportunity: After a day’s trek from Namrung, you can spend a day in Lho to adjust. A short hike to nearby viewpoints like Lho Monastery or just resting around the village helps with acclimatization.
• Benefits: Lho offers splendid views of the Manaslu Range, and its peaceful environment makes it a perfect place for acclimatization.

5. Samdo (3,875 meters / 12,713 feet)

Samdo is a key acclimatization stop before crossing the high-altitude Larkya Pass. At a slightly higher altitude, it provides a much-needed break before tackling the more challenging parts of the trek.

• Acclimatization Opportunity: Spend an extra day here to ensure that your body is fully adjusted before ascending to Larkya Phedi (the base of Larkya Pass). You can take light hikes to Bimthang or Larkya Glacier to help with acclimatization.
• Benefits: This stop prepares you for the final push to the high-altitude Larkya Pass, which is the highest point on the Manaslu Circuit.

General Tips for Acclimatization

• Gradual Ascent: Avoid ascending more than 300-500 meters (984-1,640 feet) per day after reaching 3,000 meters (9,842 feet).
• Rest Days: Plan for rest days every 3-4 days to allow your body to adjust.
• Stay Hydrated: Drink plenty of water to help your body adapt to the altitude.
• Light Activity: On acclimatization days, engage in light activity like walking or short hikes to help with the process without exerting yourself too much.

By following these tips and incorporating strategic acclimatization stops, you’ll significantly reduce your risk of altitude sickness and improve your overall experience on the Manaslu Circuit Trek.

How to avoid altitude sickness in Nepal

Trekking in the Himalayas is a dream for many, but high-altitude trekking in Nepal comes with its challenges, one of which is altitude sickness. Also known as Acute Mountain Sickness (AMS), this condition occurs when you ascend to higher altitudes too quickly, and your body doesn’t get enough time to acclimatize to the reduced oxygen levels. However, with the right precautions and preparation, you can significantly reduce the risk of AMS and enjoy a safe trekking experience. Here’s how to avoid altitude sickness while trekking in Nepal:

1. Ascend Slowly and Gradually

The most important step in preventing altitude sickness is to ascend slowly. Your body needs time to adjust to the lower oxygen levels at higher altitudes. Follow these general guidelines:

• Ascend no more than 300-500 meters (984-1,640 feet) per day above 3,000 meters (9,842 feet).
• Take rest days every 3-4 days to give your body time to adjust (especially around 3,500 meters/11,500 feet).
• Avoid long days of continuous ascent, and when possible, use the “climb high, sleep low” technique, where you hike to a higher point during the day but return to a lower elevation to sleep.

2. Stay Hydrated

Dehydration is a major contributor to AMS, and it’s easy to forget to drink enough water when trekking in the mountains. At higher altitudes, the body loses more fluids due to dry air and increased respiration, so it’s essential to stay hydrated.

• Drink 3-4 liters of water per day.
• Avoid alcohol and excessive caffeine, as they can dehydrate you.
• Carry a water bottle or hydration pack with you and make sure it’s always accessible.

3. Eat Well and Maintain Energy

Good nutrition is crucial when trekking at high altitudes. The body uses more energy than usual to cope with the lower oxygen levels, so it’s important to consume enough calories and maintain your strength.

• Focus on carbohydrate-rich foods, such as rice, pasta, potatoes, and bread, as they provide sustained energy.
• Avoid heavy meals, and try to eat small portions throughout the day to keep your energy levels steady.
• Don’t skip meals, even if you don’t feel hungry; your body needs the fuel to function properly.

4. Get Proper Rest and Sleep

Sleep quality at high altitudes can be affected due to reduced oxygen levels. However, it’s essential to get enough rest to allow your body to acclimatize. Lack of sleep can exacerbate AMS symptoms.

• Make sure you get adequate sleep each night, preferably around 7-8 hours.
• If you’re having trouble sleeping, try using earplugs and a sleep mask to block out any disturbances in the environment.
• Rest during the day if you feel fatigued, and avoid overexertion.

5. Consider Medication for Prevention

There are medications available that can help prevent altitude sickness. Diamox (Acetazolamide) is commonly prescribed to help speed up the acclimatization process.

• Consult a doctor before your trek to see if Diamox is appropriate for you.
• Take Diamox a day or two before your trek and during the ascent (if recommended by your doctor).
• Pain relievers like ibuprofen or paracetamol can help with headaches, a common symptom of AMS.

6. Know the Symptoms of Altitude Sickness

It’s important to be aware of the symptoms of altitude sickness so that you can take action immediately if you begin to feel unwell.

Early Symptoms of AMS:

• Headaches
• Nausea and vomiting
• Dizziness
• Fatigue or weakness
• Loss of appetite
• Difficulty sleeping

If these symptoms appear, do not ascend further until the symptoms subside. Take a rest day, drink plenty of fluids, and if symptoms persist, descend to a lower altitude.

7. Listen to Your Body

The most important advice for avoiding altitude sickness is to listen to your body. If you feel any unusual symptoms, don’t ignore them. It’s better to take an extra rest day or even descend to a lower altitude than risk serious illness.

• If you feel unwell, stop and assess your symptoms.
• Don’t push yourself to continue climbing if your body is showing signs of AMS.

8. Use Oxygen if Necessary

In severe cases of AMS, such as HAPE (High Altitude Pulmonary Edema) or HACE (High Altitude Cerebral Edema), supplemental oxygen may be needed. Most trekking agencies in Nepal provide oxygen tanks for emergencies, especially on challenging treks like Everest or Manaslu.

• If you experience severe symptoms, such as shortness of breath, confusion, or loss of coordination, descend immediately and seek medical attention.
• Oxygen tanks are available in major trekking hubs and can be used to aid in recovery.

9. Choose a Trekking Agency with Experienced Guides

When trekking in Nepal, particularly in high-altitude regions, it’s always best to go with an experienced trekking agency that understands the risks of altitude sickness. A professional guide will know how to manage the ascent, pace, and when to stop for acclimatization. They can help you make informed decisions and act quickly if any symptoms arise.

10. Prepare Physically Before the Trek

Physical fitness can help you cope with the challenges of high-altitude trekking. While altitude sickness is primarily about acclimatization, being fit can make the trek easier.

• Train for endurance: Long walks, hiking, and cardio exercises can help prepare your body for the demands of the trek.
• Focus on strength training for your legs, as well as stamina and core strength, to handle uneven terrain and long days of walking.

Manaslu Trek Health Precautions

The Manaslu Trek is one of Nepal's most beautiful and challenging trekking routes, offering breathtaking views of the Manaslu Range and an opportunity to explore remote villages. However, trekking in high altitudes comes with certain health risks, particularly altitude sickness and physical strain. To ensure a safe and enjoyable trekking experience, it's essential to take health precautions before and during the trek. Here are the key health precautions to consider for the Manaslu Trek:

1. Acclimatization to Prevent Altitude Sickness

The primary health concern while trekking in Nepal’s high-altitude regions is altitude sickness (AMS). The Manaslu Trek takes trekkers to altitudes over 5,100 meters (16,732 feet) at Larkya Pass, which increases the risk of AMS.

How to Avoid Altitude Sickness:

• Ascend Gradually: Limit your daily altitude gain to 300-500 meters (984-1,640 feet) above 3,000 meters (9,842 feet).
• Rest Days: Include at least one or two rest days in the itinerary, particularly in places like Samagaun and Samdo, to allow your body time to acclimatize.
• Climb High, Sleep Low: If possible, hike to a higher elevation during the day but descend to a lower altitude to sleep, allowing your body time to adjust.
• Symptoms of AMS include headache, nausea, dizziness, fatigue, and loss of appetite. If symptoms worsen, it's crucial to descend immediately and seek medical help.

2. Stay Hydrated

Dehydration is a common problem while trekking at high altitudes. The dry air, coupled with increased physical exertion, can cause rapid fluid loss. Staying hydrated is crucial for maintaining your health and reducing the risk of altitude sickness.

Hydration Tips:

• Drink 3-4 liters of water each day.
• Carry a water bottle or hydration system that’s easy to access during your trek.
• You can also drink electrolyte drinks to replenish lost salts and minerals.
• Avoid excessive caffeine or alcohol as they can cause dehydration.

3. Nutrition and Energy

Maintaining a healthy and balanced diet is essential during the trek to keep your energy levels up and prevent fatigue. The body needs extra fuel at high altitudes to function properly.

Dietary Considerations:

• Carbohydrates: High-energy foods like rice, pasta, potatoes, and bread are staples on the trek.
• Protein: Lentils, beans, nuts, and eggs provide necessary protein for muscle repair and endurance.
• Fats: Healthy fats from cheese, ghee, and nuts help provide sustained energy for long days of trekking.
• Snacks: Carry high-energy snacks like trail mix, granola bars, and chocolate for a quick energy boost.

4. Rest and Sleep

The body’s ability to acclimatize and recover largely depends on how well you rest during the trek. Trekking at high altitudes can lead to fatigue, and getting proper rest is vital for a safe trek.

Sleep Tips:

• Try to get 7-8 hours of sleep each night, especially at higher altitudes, where sleep may be disrupted due to lower oxygen levels.
• If you find it difficult to sleep, consider using earplugs or a sleep mask to block out noise and light.
• During rest days, avoid strenuous activities and focus on relaxation to aid recovery.

5. Physical Fitness and Preparation

Before embarking on the Manaslu Trek, physical fitness is crucial for the success of the journey. Although the trek is accessible to intermediate trekkers, a strong cardiovascular base will help you endure the long trekking days and physically demanding terrain.

Training for Manaslu Trek:

• Cardio Training: Focus on building endurance with activities like hiking, running, or cycling. A minimum of 3-4 weeks of cardio training before the trek will improve stamina.
• Strength Training: Leg strength is particularly important, so incorporate exercises like squats, lunges, and step-ups to prepare for the uphill and downhill climbs.
• Core Stability: Exercises like planks and balance work will help improve your posture and reduce fatigue on uneven terrain.
• Long Hikes: Try to do at least one or two long hikes on varied terrain to prepare your body for trekking at higher altitudes.

6. Carry Personal Medications and First Aid Kit

A first aid kit is an essential part of your trekking gear. Include medications and supplies that you may need in case of injury or illness.

First Aid Kit Essentials:

• Pain relief medication (ibuprofen, paracetamol).
• Bandages and sterile dressings for cuts or blisters.
• Antiseptic wipes and ointments.
• Anti-diarrheal medication and oral rehydration salts.
• Altitude sickness medication (Diamox), if recommended by a doctor.
• Personal prescription medications (if required).
• Sunscreen and lip balm with high SPF to protect against sunburns at high altitudes.

7. Awareness of Extreme Weather Conditions

Weather conditions in the Himalayas can change abruptly, and being prepared for extreme weather is crucial for your health and safety. The temperatures can drop drastically, especially at night, so layering is essential to stay warm.

Weather Tips:

• Pack lightweight, moisture-wicking layers to stay dry and warm.
• Carry a good-quality down jacket and a waterproof shell to protect against rain and wind.
• Use sunglasses and sun protection to guard against snow blindness and harmful UV rays at high altitudes.

8. Know When to Seek Help

If you start to experience symptoms of AMS, HAPE (High Altitude Pulmonary Edema), or HACE (High Altitude Cerebral Edema), it's crucial to descend immediately to a lower altitude. The sooner you take action, the more likely it is that you will recover without further complications.

Signs to Watch For:

• Severe headaches, nausea, or dizziness.
• Shortness of breath or coughing (possible HAPE).
• Confusion, loss of coordination, or swelling (possible HACE).

By taking these health precautions, you’ll be better prepared to face the challenges of the Manaslu Trek safely. Prioritize gradual ascent, proper nutrition, and adequate rest to ensure a smooth trek in the stunning Manaslu region. Always listen to your body and don’t hesitate to turn back or seek medical help if necessary.

Best time to trek Manaslu for altitude adjustment

The Manaslu Circuit Trek takes trekkers through a variety of altitudes, reaching heights of over 5,100 meters (16,732 feet) at the Larkya Pass. Proper altitude adjustment (acclimatization) is crucial to avoid altitude sickness and to ensure a successful trek. The best time to trek in the Manaslu region, especially for altitude adjustment, is during the spring (March to May) and autumn (September to November) seasons. Here's why:

1. Spring (March to May)

• Temperatures: The spring season offers moderate temperatures, making it more comfortable to trek at higher altitudes. Daytime temperatures at lower elevations are mild, and even at higher altitudes, the weather is generally manageable.
• Stable Weather: Spring is considered the best time for altitude adjustment because of clear skies, stable weather, and lower chances of heavy rainfall. This provides consistent weather conditions, essential for gradual acclimatization.
• Beautiful Scenery: Spring is when the Himalayan wildflowers bloom, making the trek even more picturesque. The temperatures are also conducive to spending adequate rest days at key acclimatization stops like Samagaun, Samdo, and Larkya Phedi.
• Crowd Levels: Spring is a popular season for trekking, so there might be more trekkers along the route. However, it's not as crowded as the Everest region.

Why Spring is Ideal for Altitude Adjustment:

• The mild temperatures reduce the risk of harsh weather conditions interfering with acclimatization.
• Rest days for acclimatization can be more comfortable due to pleasant weather.
• Clear visibility for altitude hikes and acclimatization, such as climbing to higher altitudes during the day and descending to lower altitudes to sleep.

2. Autumn (September to November)

• Temperatures: Autumn is another great time for trekking in Nepal, with pleasant daytime temperatures and cooler nights at higher elevations. Similar to spring, autumn provides moderate weather that supports effective acclimatization.
• Clear Weather: This is typically the post-monsoon season, which means clear skies, making it easier to adjust to altitude. The weather is stable, and there is less rainfall, reducing the likelihood of altitude sickness caused by environmental stressors.
• Fewer Weather Disruptions: Autumn also tends to have fewer monsoon-related challenges, such as excessive humidity and rain, which could otherwise hinder your altitude adjustment and make the trek uncomfortable.
• Fewer Trekkers: While autumn is a peak trekking season, the number of trekkers on the Manaslu Circuit is still manageable compared to more popular treks like the Everest Base Camp or Annapurna Circuit. This makes it an ideal time for those who prefer a more tranquil trekking experience.

Why Autumn is Ideal for Altitude Adjustment:

• The dry, clear weather allows for a safe and steady ascent, making it easier to follow your acclimatization plan.
• Moderate temperatures at higher altitudes ensure that you can rest and sleep comfortably during acclimatization days.
• The season is ideal for rest days at key points like Samagaun and Samdo, where your body can fully adjust before pushing towards higher elevations.

3. Avoiding Monsoon (June to August) and Winter (December to February)

• Monsoon (June to August): During the monsoon season, the region experiences heavy rainfall, making trails slippery, more difficult to trek, and not ideal for acclimatization. The wet conditions also lead to foggy weather and limited visibility, which can delay acclimatization and make higher-altitude ascents dangerous.
• Winter (December to February): The winter months bring extremely cold temperatures, with snow blocking the trails and making it challenging to trek at high altitudes. Acclimatization is more difficult due to the harsh weather, and many teahouses and facilities are closed during this time. The cold and snow also make it harder to spend extended time at higher altitudes for acclimatization.

Oxygen level in Manaslu Circuit

The Manaslu Circuit Trek takes trekkers through a variety of altitudes, from the lush foothills at lower elevations to the high-altitude passes that push the limits of physical endurance. As you ascend, the oxygen levels decrease, which can affect how your body adjusts to the environment.

Here's an overview of how oxygen levels change on the trek and what it means for trekkers:

1. Oxygen Levels at Lower Altitudes (600m - 2,500m)

• Oxygen level: At altitudes between 600 meters (starting point) and 2,500 meters, the oxygen levels are close to sea level and do not pose a significant challenge for most trekkers.
• Symptoms: At these altitudes, there is no noticeable drop in oxygen levels. You can trek comfortably without needing extra precautions.

2. Mid-Elevation (2,500m - 3,500m)

• Oxygen level: At altitudes between 2,500 meters and 3,500 meters, oxygen levels begin to reduce slightly. The oxygen concentration in the air is about 74% of what it is at sea level, but the decrease is still minimal.
• Symptoms: For most trekkers, there are no major symptoms at these elevations. However, some people may experience slight shortness of breath, especially during strenuous activities. It’s important to pace yourself and stay hydrated.

3. High Elevation (3,500m - 4,500m)

• Oxygen level: As you approach altitudes between 3,500 meters and 4,500 meters, the oxygen levels drop significantly. The concentration of oxygen is around 60-65% of sea level.
• Symptoms: Trekking at these altitudes may lead to some trekkers feeling fatigue or shortness of breath, especially during physical exertion. Acclimatization is crucial here to avoid the early symptoms of Acute Mountain Sickness (AMS).

4. High Altitude (4,500m - 5,000m)

• Oxygen level: Above 4,500 meters, oxygen levels become noticeably lower. The air has only about 55% of the oxygen you would find at sea level.
• Symptoms: As you continue to climb, it becomes essential to allow your body to acclimatize gradually. You might feel dizziness, headaches, and fatigue. AMS can become a concern if you ascend too quickly without proper acclimatization.

5. Extreme Altitude (5,000m - 5,160m)

• Oxygen level: At the Larkya Pass, the highest point on the Manaslu Circuit at 5,160 meters, oxygen levels are around 50% of what you would find at sea level.
• Symptoms: At these altitudes, trekkers will feel the most significant effects of oxygen deprivation. Altitude sickness can occur, and it’s critical to spend time at lower altitudes for acclimatization. Shortness of breath, nausea, and headaches are common, especially if trekkers haven't acclimatized properly.

Acclimatization and Oxygen Levels

To counter the effects of reduced oxygen, acclimatization is key. Acclimatization refers to the process of giving your body time to adjust to the reduced oxygen levels as you ascend. Rest days at various points along the trek, like in Samagaun and Samdo, allow trekkers to adjust more comfortably before pushing higher.

• Climb high, sleep low: A common technique is to ascend to higher altitudes during the day, then descend to sleep at a lower elevation at night. This allows your body to gradually adjust to the thinning air.

Supplementary Oxygen

While most trekkers do not need supplemental oxygen on the Manaslu Circuit, some experienced trekkers or those with pre-existing health conditions may bring portable oxygen bottles for emergencies. This is particularly true when trekking at extreme altitudes above 5,000 meters.

Altitude sickness medication for Manaslu trek

Trekking at high altitudes, such as those found on the Manaslu Circuit Trek, can increase the risk of Altitude Sickness (AMS), especially as you ascend past 3,500 meters. The symptoms of AMS include headaches, dizziness, nausea, and shortness of breath. While acclimatization is the primary method for preventing AMS, medication can play a crucial role in managing symptoms and ensuring a safe trek.

Here’s an overview of common medications used to prevent and treat altitude sickness during the Manaslu Circuit Trek:

1. Diamox (Acetazolamide)

• Purpose: Diamox is the most commonly prescribed medication for altitude sickness. It works by increasing the breathing rate, which helps improve oxygen levels in the blood. Diamox can prevent the onset of AMS and reduce its symptoms.
• Dosage: The usual dosage is 125mg to 250mg taken twice a day starting 1-2 days before ascending to high altitudes. It is commonly taken in the mornings and evenings.
• Effectiveness: Diamox helps the body adjust more efficiently to lower oxygen levels at high altitudes, significantly reducing the risk of AMS. It's most effective when combined with gradual acclimatization and proper hydration.
• Side Effects: Some common side effects include tingling in fingers and toes, frequent urination, and increased sensitivity to the sun. These effects are usually mild and go away once you stop taking the medication.

2. Dexamethasone

• Purpose: Dexamethasone is a steroid used for treating severe cases of AMS, such as High Altitude Pulmonary Edema (HAPE) or High Altitude Cerebral Edema (HACE), both of which can be life-threatening. It can reduce inflammation in the brain and lungs, allowing the body to handle altitude-related stress better.
• Dosage: Dexamethasone is typically administered in a dose of 4mg every 6 hours. However, it should only be used if symptoms of severe AMS are observed, and a doctor’s prescription is required.
• Effectiveness: It’s a short-term solution to treat severe altitude sickness. It should not be used as a preventive measure and is generally reserved for emergencies.
• Side Effects: Long-term use or overuse can lead to immune system suppression and other side effects.

3. Ibuprofen / Paracetamol (Acetaminophen)

• Purpose: These over-the-counter pain relievers can be used to manage mild headaches, which are a common symptom of AMS. While they don’t treat the underlying cause of AMS, they can alleviate discomfort and make the trek more manageable.
• Dosage: Follow the instructions on the packaging, typically 200-400mg every 4-6 hours as needed for pain relief.
• Effectiveness: These medications are effective for addressing mild symptoms, but they should not be relied upon as the primary treatment for AMS.

4. Nifedipine (For High Altitude Pulmonary Edema - HAPE)

• Purpose: Nifedipine is a medication used to treat HAPE, a serious condition where fluid accumulates in the lungs, causing breathing difficulties. While HAPE is rare, it can occur at higher altitudes, and Nifedipine can help relieve symptoms by dilating blood vessels in the lungs.
• Dosage: The recommended dose is typically 30mg taken twice a day, but this should only be used under medical supervision.
• Effectiveness: Nifedipine is most effective in treating pulmonary edema and can be an important tool if symptoms appear while trekking at altitudes above 4,500 meters.

5. Oxygen Therapy

• Purpose: While not strictly a medication, oxygen is an important remedy for treating severe cases of AMS and other altitude-related illnesses. Portable oxygen cylinders are sometimes used to help trekkers breathe more easily at high altitudes.
• Use: Oxygen therapy is particularly effective in treating severe AMS, HAPE, and HACE. In some cases, supplemental oxygen is provided at higher camps or medical stations.
• Effectiveness: Oxygen helps in rapid recovery from AMS symptoms by improving the oxygen saturation levels in the blood, allowing trekkers to recover quickly and continue their trek safely.

6. Herbal Remedies (Ginkgo Biloba and Garlic)

• Purpose: Some trekkers use herbal remedies like Ginkgo Biloba and garlic as a preventive measure for AMS. These remedies are believed to increase blood circulation and help with acclimatization.
• Effectiveness: While these remedies have anecdotal support, there is limited scientific evidence proving their effectiveness in preventing or treating AMS.
• Side Effects: Ginkgo Biloba can increase the risk of bleeding, so it should be used with caution if you are on blood-thinning medications.

General Tips for Using Medications for Altitude Sickness

• Start Medications Early: For best results, start taking Diamox or other preventative medications a day or two before reaching higher altitudes to help your body adjust.
• Monitor Your Symptoms: Keep track of any changes in your health. If symptoms worsen despite taking medication, descend immediately to a lower altitude.
• Stay Hydrated: Medications for altitude sickness can increase urination, so it’s important to drink plenty of fluids to stay hydrated.
• Consult a Doctor: Before trekking, especially if you have pre-existing health conditions, consult your doctor for recommendations on altitude sickness medications.

Best Manaslu Circuit Trek itinerary to prevent altitude sickness

The Manaslu Circuit Trek is a remarkable adventure that takes trekkers through stunning landscapes, high-altitude passes, and diverse cultural experiences. However, its high altitudes require careful acclimatization to avoid altitude sickness. The following 12-day itinerary is designed by Overland Trek Nepal to ensure a safe ascent, incorporating strategic acclimatization stops to give trekkers ample time to adjust to the thinning air.

Day 1: Arrival in Kathmandu (1,400m / 4,593ft)

• Activities: Arrive in Kathmandu, Nepal's capital. You will be transferred to your hotel. Spend the day resting after your flight.
• Key Consideration: No altitude-related issues at this stage, but stay hydrated and avoid overexertion.

Day 2: Kathmandu to Soti Khola (700m / 2,297ft)

• Driving Time: 6-7 hours
• Activities: Leave Kathmandu and head to Soti Khola, a small village in the foothills, marking the beginning of your trek.
• Key Consideration: The first day of trekking is not physically strenuous, making it ideal for getting used to the trekking routine. The altitude is still low, so there are no acclimatization concerns here.

Day 3: Soti Khola to Machha Khola (900m / 2,952ft)

• Trek Duration: 5-6 hours
• Activities: Follow the trail along the Budhi Gandaki River, passing through small villages. The ascent is gentle, and you will reach Machha Khola by the end of the day.
• Key Consideration: The altitude remains low, but ensure to drink plenty of water and pace yourself. Pay attention to any early symptoms of AMS, such as headaches or dizziness.

Day 4: Machha Khola to Jagat (1,340m / 4,396ft)

• Trek Duration: 6-7 hours
• Activities: Continue trekking along the river. The trail begins to climb more steadily, with several ascents and descents. Jagat is a beautiful village, and it offers a good place for rest.
• Key Consideration: Gradual ascent is key. There’s no immediate threat of AMS, but it’s important to listen to your body and rest as needed.

Day 5: Jagat to Deng (1,860m / 6,100ft)

• Trek Duration: 6-7 hours
• Activities: Trek through a lush forest, with views of the Manaslu range becoming clearer. The walk is moderately difficult, with some uphill sections.
• Key Consideration: As you are reaching over 1,800 meters, it is important to drink fluids and stay hydrated. Keep your pace steady to allow your body to adjust.

Day 6: Deng to Namrung (2,630m / 8,629ft)

• Trek Duration: 6-7 hours
• Activities: Continue your journey along the Budhi Gandaki River. The scenery begins to change, offering breathtaking views of the surrounding mountains and glaciers.
• Key Consideration: This is the first stage where altitude may begin to have an effect on some trekkers. Ensure a slow pace and drink water frequently to combat the effects of altitude.

Day 7: Namrung to Samagaun (3,530m / 11,581ft)

• Trek Duration: 6-7 hours
• Activities: The trek to Samagaun takes you deeper into the mountain zone. The trail climbs steadily, and you will be crossing small bridges and passing through Tibetan-style villages.
• Key Consideration: This is a critical acclimatization day. Samagaun sits at over 3,500 meters, so taking it easy is essential. Spend the rest of the day resting to adjust to the altitude.

Day 8: Rest day in Samagaun (Acclimatization Day)

• Activities: A full rest day in Samagaun will allow your body to adjust to the higher altitude. You can take a short walk or a day hike to Manaslu Base Camp (4,400m) or Pungyen Gompa (3,900m).
• Key Consideration: This day is vital for acclimatization. You’ll stay at Samagaun to help your body adjust to the oxygen levels. Avoid any strenuous activities.

Day 9: Samagaun to Samdo (3,875m / 12,713ft)

• Trek Duration: 4-5 hours
• Activities: From Samagaun, you will ascend to Samdo, a small settlement that offers stunning views of Manaslu and other peaks.
• Key Consideration: Another gradual ascent allows your body to get used to the increasing altitude. Rest and hydrate frequently.

Day 10: Samdo to Dharmashala (4,460m / 14,636ft)

• Trek Duration: 4-5 hours
• Activities: Trek to Dharmashala, a key point before the crossing of Larkya Pass. The landscape gets more barren, and the altitude increases significantly.
• Key Consideration: With the altitude now nearing 4,500 meters, this is where AMS symptoms can arise. Continue to pace yourself, drink lots of water, and monitor for any signs of AMS.

Day 11: Dharmashala to Larkya Pass (5,160m / 16,929ft) to Bimthang (3,590m / 11,778ft)

• Trek Duration: 9-11 hours
• Activities: Today, you will cross the Larkya Pass, the highest point of the trek at 5,160 meters. After reaching the pass, you will descend to Bimthang for a well-earned rest.
• Key Consideration: This is a long and challenging day due to the extreme altitude and strenuous nature of the pass. Acclimatization and hydration are essential, and trekkers should take it slow. The descent to Bimthang helps relieve some of the altitude pressure.

Day 12: Bimthang to Tilije (2,300m / 7,544ft)

• Trek Duration: 5-6 hours
• Activities: The trek today is a descent from Bimthang, passing through forests and picturesque villages, until reaching Tilije.
• Key Consideration: After a challenging ascent and crossing Larkya Pass, descending to a much lower altitude aids in recovering from any altitude-related symptoms.

Day 13: Tilije to Dharapani (1,960m / 6,431ft)

• Trek Duration: 4-5 hours
• Activities: Trek downhill through beautiful pine forests and small villages to Dharapani, where you can take a vehicle back to Besisahar for your return to Kathmandu.
• Key Consideration: With the descent back to 1,900 meters, altitude sickness is less of a concern now, but it’s important to keep hydrated and rest.

Day 14: Drive from Dharapani to Kathmandu

• Driving Time: 6-7 hours
• Activities: Take a scenic drive back to Kathmandu to celebrate the successful completion of your trek.

Key Acclimatization Tips

• Pace Yourself: Gradual ascent is key to preventing altitude sickness. Each day's increase in altitude should be moderate.
• Hydrate Well: Drink 3-4 liters of water each day to stay hydrated.
• Rest Days: Incorporate rest days such as the one in Samagaun to allow your body to adjust to the altitude.
• Stay Alert: Be mindful of any signs of AMS such as headaches, dizziness, and nausea, and take action immediately if symptoms appear.

Emergency rescue options on Manaslu Circuit by Overland Trek Nepal

Trekking in the high-altitude regions of Nepal, like the Manaslu Circuit, comes with the inherent risk of altitude sickness and other health issues. Although these are rare, it’s crucial to have emergency procedures in place to ensure safety. Overland Trek Nepal prioritizes the safety and well-being of all trekkers, and they provide several emergency rescue options should any issues arise on the trail.

Here's an overview of emergency rescue options for trekkers on the Manaslu Circuit:

1. Helicopter Evacuation

One of the fastest and most effective methods of evacuation from high-altitude areas is through helicopter rescue. If a trekker's health is compromised due to Altitude Sickness (AMS), injury, or any other medical emergency, a helicopter evacuation can be arranged from the following points:

• Samdo (3,875m) or Dharmashala (4,460m): These are common locations where trekkers can be airlifted in case of an emergency.
• Larkya Pass (5,160m): While this is a high-altitude pass and very difficult to evacuate from, emergency helicopters can be dispatched from nearby settlements such as Bimthang or Dharapani, depending on weather conditions.

Procedure:

• Contact Overland Trek Nepal’s local team or a designated emergency number, which will coordinate with helicopter services.
• Helicopter evacuations are typically available from Pokhara or Kathmandu.

Advantages:

• Fast response, especially in cases of severe altitude sickness or injuries.
• Useful in remote areas with limited accessibility.

2. Local Medical Assistance

There are small local medical clinics in various villages along the Manaslu Circuit, such as Soti Khola, Jagat, Namrung, and Samagaun. These clinics provide basic medical care, including treatment for minor injuries, and illnesses, and initial assessments for AMS.

Key Points:

• Local medical facilities may not have advanced equipment or the ability to treat severe cases.
• For more serious emergencies, evacuation to higher-level hospitals or medical centers will be necessary.

3. Rescue by Porters and Guides

In the event of a less serious emergency, Overland Trek Nepal's experienced guides and porters are trained in first aid and can offer immediate assistance. Guides will:

• Help stabilize the trekkers.
• Assist in getting them to the nearest medical clinic.
• Ensure that trekkers are well-hydrated, rested, and assessed for AMS symptoms.
• If necessary, guides can also escort the trekkers to a lower altitude, which is often effective for overcoming mild AMS.

4. Vehicle Evacuation from Lower Altitudes

In case of medical emergencies occurring at lower altitudes, vehicles can be arranged for evacuation. This can be effective for cases of injury, exhaustion, or other medical problems that don’t necessarily require helicopter evacuation.

The nearest towns like Dharapani or Besisahar can serve as the starting points for vehicle evacuation, bringing trekkers back to Kathmandu or Pokhara for advanced treatment if needed.

5. Coordination with Nepalese Emergency Services

Overland Trek Nepal has strong connections with Nepalese emergency services, including the Nepalese Army and local police. In extreme cases, where the trekkers are in a dangerous situation or near the mountain slopes, coordination with the Nepalese rescue teams will be made to ensure immediate assistance.

6. Travel Insurance with Emergency Evacuation Coverage

• Overland Trek Nepal strongly recommends that all trekkers have travel insurance with emergency evacuation coverage. This ensures that:
• In case of an emergency, the insurance company will cover the cost of helicopter evacuation or other forms of transport.
• The insurance should cover medical costs, hospital stays, and any required evacuation from the trail.

Note: Ensure that your insurance policy covers trekking at high altitudes and emergency evacuation by helicopter or land transport.

Key Contact Details for Emergencies

• Overland Trek Nepal Emergency Hotline: Available 24/7, trekkers will be given emergency contact numbers for guides, agencies, and medical facilities.
• Local Hospital/Clinic: Details of nearby clinics and hospitals are provided to trekkers during their pre-trek briefing.
• Helicopter Service Providers: Emergency evacuation services are arranged with helicopter companies in Kathmandu, such as Himalaya Rescue or Fishtail Air.

What to Do in an Emergency:

• Alert your Guide: If you're feeling unwell or suspect altitude sickness, notify your guide immediately. They are trained to handle emergency situations.
• Rest and Hydrate: In many cases, taking rest and drinking plenty of water can help alleviate AMS symptoms. Avoid further altitude gain.
• Follow the Plan: Your guide will assess the situation and follow the acclimatization protocol, possibly descending to a lower altitude or evacuating you via helicopter if needed.

Conclusion: Ensuring Safety on the Manaslu Circuit Trek

The Manaslu Circuit Trek offers a thrilling adventure with stunning views, rich culture, and an unforgettable journey through one of Nepal’s most remote regions. However, trekking at high altitudes comes with its challenges, particularly the risk of altitude sickness. Understanding and preparing for these risks is crucial to ensuring a safe and enjoyable experience on the trail.

Throughout the trek, Overland Trek Nepal provides extensive support for trekkers, emphasizing the importance of proper acclimatization, hydration, and early recognition of AMS symptoms. From expert guides to a carefully planned itinerary, the focus is on helping trekkers adjust to the changing altitudes while minimizing health risks.

Emergency preparedness is also a priority, with a range of rescue options in place, including helicopter evacuation, local medical clinics, and professional guides trained in first aid. Having travel insurance with evacuation coverage is highly recommended to ensure peace of mind in case of emergencies.

The best time to trek the Manaslu Circuit for altitude adjustment is during the spring and autumn seasons when the weather is stable, and acclimatization is more effective. Along with proper nutrition, adequate rest, and sensible ascent rates, trekkers can significantly reduce the risks of AMS and enjoy a safe, memorable trek.

With Overland Trek Nepal's comprehensive support system, trekkers can feel confident that safety is always prioritized. By following the guidelines for acclimatization, taking care to stay hydrated, and being aware of the symptoms of altitude sickness, you’ll have everything you need for a smooth and rewarding adventure on the Manaslu Circuit Trek.