2 female trekkers hiking in snow towards Thorung La on Annapurna Circuit, Snowy landscape in Annapurna circuit,trekking in Nepal

Visit your doctor before trekking the Annapurna Circuit

Mar 28, 2024
Reading time: 6 minutes

You need to be fit and healthy to trek the Annapurna Circuit safely. We encourage anyone keen for this adventure to first visit a doctor to discuss their health as well as the potential dangers of high-altitude trekking. Forewarned is forearmed!

The Annapurna Circuit is harder than many people think. That doesn't mean it isn't eminently doable, because it is. But you do need to have really good hiking fitness or train in earnest for it. And you do need to take the high altitude seriously. Altitude sickness can be very dangerous, even fatal.

Prayer flags off stupa on Annapurna Circuit, Nepal's Himalayas

You ascend into alpine desert on the Annapurna Circuit

While it's possible to assess on your own your ability to tackle the trek in terms of fitness (if you understand how hard the Annapurna Circuit trek is), it's a really good idea to have your doctor weigh in on your health and overall viability to tackle a challenging trek that takes place at extreme altitude.

Discuss these 3 things with your doctor

The main thing to tell your doctor at your checkup is that you wish to do a multiday high-altitude trek that will take you well over 5,000 m (16,400 ft) above sea level.

Doctors know all about altitude sickness, of course, from how to avoid developing it to how to treat it. So your doctor will likely lead the conversation at your consult, but please do check that the two of you cover the following topics:

1. The dangers posed by high altitude

As we discuss in Must-know Annapurna Circuit safety tips, you can start to feel iffy from the negative side effects of high altitude from around 3,000 (9,800 ft) m above sea level (asl).

The highest point on the classic Annapurna Circuit is Thorung La; this mountain pass is 5,416 m (17,769 ft) above sea level, so you're heading into rarified air on this trek and it's not if you'll feel icky, but at what stage and by how much.

Traditional architecture in the ancient Tibetan Nar village, Annapurna Conservation Area, Nepal

You visit Nar village on the extended Nar–Phu and Annapurna Circuit

Your doctor will explain to you that mild altitude sickness isn't a serious health concern, and you can keep trekking provided you personally feel able to push through the shortness of breath and other unpleasant symptoms (which can include headaches, nausea and poor sleep).

Should your altitude sickness become serious, however, then you must descend rapidly or you could develop high-altitude cerebral oedema (which can be fatal), or trigger another medical issue (such as a heart attack).

2. How to prevent or mitigate altitude sickness

The single best way to avoid developing serious altitude sickness is to only ascend in altitude in a very gradual manner. Your doctor will undoubtedly explain this to you.

The important thing that you can bring to the discussion is the elevation profile of the trek, which includes your starting altitude and overall elevation gain. For these details, please read What's the elevation gain on the Annapurna Circuit?


Summarised map of the Annapurna Circuit

Armed with this info, you and your GP will be able to have a fruitful discussion on how long you should take over the ascent. Note that most trekkers spend at least a couple of nights in the town of Manang, from which you can do some helpful and beautiful acclimatisation day hikes. You can learn more about the route and settlements offering overnight accommodation in What does the Annapurna Circuit route look like?

In addition to offering advice on your itinerary, your doctor will most likely want to prescribe you an altitude medication (such as Diamox) to help prevent and reduce the symptoms of altitude sickness. They might also raise the question of having spare oxygen with you should your breathing become too laboured. This is an important topic, and the point here is that you need to choose a reliable trek guide who is trained in wilderness first response, carries spare oxygen, and will monitor your health closely at all times.

Finally, your doctor might also want to prescribe you the following:

  • Painkillers for headaches (a common symptom of mild altitude sickness).
  • Strong anti-nausea tablets (another common symptom of altitude sickness).
  • Cortisone (should your breathing become properly troubled).
Female trekker in pink shirt and sports cap looking at barren trail on Annapurna Ciruit with mountain peaks in distnance

It's possible to keep trekking if you're only experiencing mild altitude symptoms

Please note that there are also things to put into your personal first aid kit that your doctor won't discuss, such as antiseptic for cuts and abrasions. While your trek guide might have such things, having your own little first aid kit is always a good idea for any adventure trip. We discuss all of the health and safety items we think you should consider bringing for yourself in Your complete Annapurna Circuit packing list.

You can also download our free Himalayan trekking packing checklist (see below).



3. Any potential concerns based on your personal medical history

This final point is, of course, an invaluable part of the consult. Does your doctor believe, based on your medical records as well as your current physical examination, that you are in good enough health to tackle this challenge?

If you have a serious or rare health concern, perhaps you should also schedule an appointment with the relevant specialist?

Teahouses high up in alpine desert of Annapurna Circuit in Nepal-s Himalaya mountains

One of the higher teahouse lodges on the Annapurna Circuit

Please note that every year plenty of Annapurna Circuit trekkers have to turn around or be airlifted out of the region because they've developed serious altitude sickness, or the high altitude has exacerbated another medical condition. And yes, sadly, the odd person has even died from an altitude-related illness on the Annapurna Circuit.

This isn't an adventure you should skip into on a whim – please take your doctor's advice seriously and only do the trek if they deem you healthy enough.

Visit a doctor before paying a deposit

A final note.

Please book your doctor's visit before paying anything towards your Annapurna Circuit trek. We say this because the moment you part with any money it becomes harder to objectively listen to any disappointing advice regarding the advisability of you undertaking such a trek.

Prayer wheels in high Himalaya Mountains, Nepal village. Focus on the stupa and prayers flags. Annapurna Two range region in Nepal, located at Annapurna Circuit Trekking Hiking Trail small

Snow is common along the upper Annapurna Circuit

Another scenario is that you're given a qualified thumbs up from the doc ("make some changes first and then you're good to trek," for instance), and then you're in a position to take the time necessary to get your health in line before booking your trek dates.

Please take your doctor's advice seriously and do everything possible to ensure you're fit and healthy enough before embarking on an Annapurna Circuit trek. You want to ensure it's a truly memorable trip for all of the right reasons!