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Alcohol and High Altitude: What Really Happens to Your Body

Jul 21, 2025

Does alcohol hit harder at high altitude? Learn how elevation impacts drinking, and what to know before enjoying a drink in the mountains.

Woman sitting on step

by  Emma Marais

 

8 min read

A quick drink at elevation? Think again 

So you’re hiking Mount Kilimanjaro, and someone in your group whips out a hip flask at base camp. You’re tired, the stars are out, and the idea of a celebratory sip sounds tempting.

But here’s the thing, alcohol and high altitude don’t mix as nicely as you’d think. Whether you’re toasting a summit or winding down after a long trek, elevation changes the game completely.

What altitude does to your body 

Let’s start with the basics. As you climb higher, the air pressure drops, which means there’s less oxygen in every breath. Your body scrambles to compensate:

  • Your heart rate goes up
  • Breathing gets faster
  • Dehydration kicks in faster than you’d expect
  • You may feel light-headed, nauseous, or oddly euphoric

This process is known as acclimatisation, and it’s your body’s way of coping. Now, imagine adding alcohol to the mix. It’s not ideal.

Alcohol at high altitude: a dodgy combo 

Drinking at altitude isn’t just a stronger buzz. It’s a recipe for magnified symptoms and delayed reactions.

What alcohol already does to your system 

  • Slows brain function
  • Affects coordination
  • Dehydrates you
  • Influences sleep and body temperature

At sea level, you can handle a few drinks with a solid meal and some water. But take that same routine up the mountain? You’ll feel it much harder,  even if your blood alcohol concentration (BAC) doesn’t technically rise.

Why does alcohol feel stronger at altitude 

This is where it gets interesting. Your BAC stays the same whether you’re in London or on the slopes of Kilimanjaro. But at altitude, your brain is already oxygen-starved. Alcohol just makes that worse. The result?

  • You feel inebriated faster
  • Your metaphorical coordination drops off a cliff
  • Altitude symptoms like nausea or dizziness get worse
  • Your sleep turns to rubbish

It’s not that the alcohol is stronger; it’s that you’re weaker in that environment.

Caucasian male walking towards surreal Himalayan background in the Langtang region

Does altitude affect alcohol tolerance? 

The short answer: not chemically, but functionally, yes 

Your liver doesn’t suddenly forget how to process alcohol when you’re trekking the Annapurna Circuit. The chemical breakdown stays the same. But your physical and mental tolerance drops dramatically.

Think of it like trying to walk in a straight line during an earthquake. You’re still you,  the ground just isn’t.

So when people say, “one drink hits like three,” it’s not entirely off. You’ll likely:

  • Stumble sooner
  • Slur earlier
  • Get tired more quickly
  • Wake up feeling worse

Even seasoned drinkers find themselves caught off guard. Altitude doesn’t play favourites.

Common myths (and the science to squash them) 

“Alcohol keeps you warm in the cold.” 

You’ll feel warm, sure, but it’s a lie. Alcohol dilates your blood vessels, which pulls heat away from your core. In high places like Everest Base Camp, that effect can become dangerous, fast. Dr. Chris Colwell, an emergency medicine specialist, warns about the risks of drinking alcohol at high altitude and how it might make you feel warm, but alcohol at high altitude makes you miss vital signs that you're heading into hypothermia and altitude sickness. 

“A few drinks will help you sleep better at altitude.” 

Not at all. Alcohol might make you feel sleepy, but it disrupts REM sleep and worsens sleep apnoea, which is already common at altitude. That’s a double hit to your rest and recovery.

“You can drink your way through mild altitude sickness.” 

That’s not how any of this works. Alcohol can mask symptoms of acute mountain sickness (AMS), making it harder to catch early signs like confusion or headache. You’ll think you’re fine, until you’re not.

Real risks of mixing alcohol and altitude 

Let’s be clear: this isn’t fear-mongering. People have landed in the hospital for:

  • Worsening AMS after drinking
  • Fainting from dehydration and alcohol
  • Hypothermia after drinking in cold, high places
  • Falls and injuries from impaired balance

Many understand the dangers of alcohol at altitude, especially on treks like Mount Meru or the Manaslu Circuit, where elevation gain is fast and accommodations are rustic. A misstep, literal or figurative, can cost you your entire trip.

How to stay safe (and still enjoy yourself) 

We’re not saying don’t drink, we’re saying be smart about it.

1. Wait until your body adjusts 

Good news: alcohol and high altitude don’t have to be enemies forever. It’s all about timing, awareness, and moderation.

Best times to drink on a trek 

  • After you’ve fully acclimatised, ideally on your last night before descent
  • At lower elevations, during your approach or descent
  • After rest days, when your body has had a chance to recover

For example, a glass of wine at the lodge after summiting Kilimanjaro is far smarter than a beer at Shira Camp, 3,800 metres up.

The key? Wait until your body has won the fight against elevation before inviting alcohol to the party.

2. Hydration is king 

  • Aim to double your usual water intake.
  • Drink a litre of water for every alcoholic drink
  • Avoid alcohol on days when you’re gaining a lot of elevation.

3. Stick to low-ABV options 

Beer > wine > spirits.

A light beer or spritzer is easier on the system than whisky at 3,000 metres.

4. Don’t drink alone, and know your limits 

  • Let your group know if you’re drinking
  • Watch for signs of altitude sickness in yourself and others
  • If you feel dizzy, short of breath, or emotional, stop drinking immediately

What makes hangovers worse at elevation? 

Hangovers are unpleasant anywhere, but at altitude, they can feel like a full-body betrayal.

Here’s why they hit harder:

  • Oxygen deprivation amplifies brain fog and headaches
  • Dehydration is more severe due to dry air and alcohol’s diuretic effects
  • Fatigue and altitude insomnia combine with poor sleep from drinking
  • Your body is already stressed, and alcohol adds another layer that it can’t handle

The next morning, after drinking at elevation? Expect headaches, nausea, dizziness, and mood swings that feel out of proportion. You’ll also find physical performance drops, which is exactly what you don’t want mid-trek.

Alcohol and altitude sickness: don’t blur the line 

One of the most dangerous things about drinking at altitude is how it can disguise the symptoms of AMS. That’s a serious risk on treks like:

  • Everest Base Camp, where altitude builds steadily
  • Mount Meru, where the climb is fast and steep
  • Annapurna Circuit, with its long days and high passes

Alcohol can make you feel drowsy or off-balance, but so can cerebral oedema, a rare but deadly form of altitude sickness. If you’re even slightly unsure, skip the drink.

Always ask yourself:

  • Am I feeling dizzy because of the hike, or because I drank too much?
  • Is my headache from the altitude, or is it a hangover?
  • Would I still feel this way without the alcohol?

If you don’t know, don’t risk it.

Trekkers starting Everest Base Camp trek

What to pack (and what to avoid) if you want a drink 

What to pack responsibly 

  • A small flask of your favourite spirit (for end-of-trek celebration)
  • Electrolyte tablets to counter dehydration
  • A reusable water bottle with a filter
  • Snacks to eat while drinking
  • Paracetamol (not ibuprofen) for any next-day symptoms

What to avoid at all costs 

  • Hard liquor at high altitude
  • Mixing alcohol with altitude meds like Diamox without checking interactions
  • Caffeine + alcohol combos
  • Drinking on summit day or acclimatisation days

It’s all about intentional indulgence. A shared drink to mark a successful journey? Lovely. A few rounds at altitude before a tough climb? Not clever.

Final tips for high-altitude drinking 

Let’s wrap up with some smart, sensible advice.

1. Respect the mountain, respect your body 

Every altitude gain is a stress test. Let your body win that test before introducing alcohol.

2. Drink socially, not excessively 

  • Stick to one drink, maximum, until you know how your body responds
  • Drink with others, not alone
  • If you’re feeling off, skip it–your trek is more important

3. Save the party for lower ground 

There’s always time to celebrate once you’re down from the mountain. That gin and tonic? It’ll taste ten times better when your head isn’t pounding.

So, can you drink at high altitude? 

Sure, but only if you know what you’re doing.

Altitude doesn’t change how your body metabolises alcohol, but it absolutely changes how alcohol affects your body. Dehydration, oxygen deprivation, fatigue, and altitude sickness all team up to make drinking riskier, uncomfortable, and a lot less fun than you’d expect.

If you’re trekking Kilimanjaro, Annapurna, Machu Picchu, or anywhere high and remote, play it smart. Let your body acclimatise, stay hydrated, and save the celebration for the right moment, ideally, after you’ve made it down safely with stories to tell and no regrets.

That cold beer or a splash of whisky? It’ll taste much better when it’s earned.

Read more about our comprehensive guide on “What is altitude sickness? And can I prevent it?” and “How to prepare for high altitude: Tips for a safe and successful trip,” to make sure you complete every adventure with informed safety in mind.