Will I experience altitude sickness in Tibet? Common questions about hypoxia, blood oxygen levels, Rhodiola rosea, and oxygen cylinders.

Upon arriving in Lhasa, many people's first action after putting down their luggage is to check if they are out of breath, and then take out a pulse oximeter to measure their fingers. The numbers on the screen may be lower than at ground level, and they may feel that they are walking slower and sleeping more lightly. These are common changes after entering an altitude of about 3,700 meters, but everyone adapts at a different rate.

Traveling to Tibet will inevitably involve varying degrees of oxygen deficiency, but most healthy travelers can gradually adapt. There is no universal age limit, but cardiopulmonary conditions, ascent speed, and a history of altitude sickness require further assessment. If shortness of breath, unsteady gait, or altered consciousness occurs during rest, the ascent should be stopped and medical attention or descent sought immediately.

This Q&A is for understanding risks and planning your trip before departure, and cannot replace a doctor's judgment based on your personal medical history.

Will I experience oxygen deprivation?

Yes. Even at higher altitudes, the oxygen content in the air remains approximately 21%, but the air pressure decreases, reducing the amount of oxygen the body receives with each breath. Upon arriving at high altitudes, a drop in blood oxygen levels, a faster heartbeat, and deeper breathing are all signs that the body is adapting to the low-oxygen environment.

CDC Yellow Book High Altitude Travel GuideIt is noted that Lhasa is at an altitude of approximately 3,700 meters, and acute acclimatization mainly occurs in the first 3 to 5 days. People with good physical fitness may also experience altitude sickness. Past reactions at similar altitudes and rates of ascent are usually more relevant than daily exercise capabilities.

 When you reach high altitudes, a drop in blood oxygen levels is a normal physiological response. Whether it's dangerous or not depends on both the numbers and the symptoms. 

At what age can one not go to Tibet?

There is no universally accepted age limit for high-altitude travel. CDC data shows that children and adults have similar chances of experiencing altitude sickness, with travelers over 50 even having a slightly lower risk of acute altitude sickness. Factors that truly affect safety include cardiopulmonary function, chronic disease control, daily activity levels, rate of ascent, and whether there has been a history of severe altitude sickness.

Infants under 6 weeks old require special care. Young children cannot clearly express headaches and nausea; if they exhibit unusual crying, decreased appetite, paleness, or lethargy after arriving at high altitudes, parents should consult a doctor as soon as possible. Elderly travelers should confirm their blood pressure, heart, and lung conditions are stable before departure and bring sufficient amounts of their usual medications.

Can someone with heart disease go to Tibet?

Some people with stable conditions can go, but they should first be evaluated by a doctor familiar with their medical history.American Heart Association's High Altitude Travel RecommendationsA reminder: Patients with hypertension, coronary artery disease, arrhythmia, or heart failure need to prepare their medication, activity level, and emergency treatment plan before traveling to high-altitude areas.

Individuals with stable conditions, who have completed revascularization and are recovering well, generally have a lower risk. Stable angina, poorly controlled arrhythmias, coronary artery disease without revascularization, or compensated heart failure require more careful individual evaluation. The CDC lists high-altitude travel as contraindicated for individuals with unstable angina, decompensated heart failure, severe pulmonary hypertension, or those who have had a myocardial infarction or stroke within the past 90 days.

What blood oxygen level is considered normal?

Blood oxygen levels must be assessed in conjunction with altitude. A blood oxygen level commonly found at low altitudes is 951 TP3T to 1001 TP3T, but this cannot be directly applied at high altitudes. CDC data shows that in individuals not acclimatized to high altitudes, arterial blood oxygen levels may drop to 881 TP3T to 911 TP3T after rapidly reaching approximately 3050 meters. In Lhasa, at an even higher altitude, a single reading below 901 TP3T does not necessarily indicate altitude sickness.

Before measuring blood oxygen, sit and rest for a few minutes, keep your fingers warm, and take the measurement two or three times in a row to observe the trend.US FDA instructions for pulse oximetersNote that cold hands, poor circulation, nail polish, skin pigmentation, and consumer-grade device errors can all affect the readings.

 If you are still short of breath, unsteady on your feet, or confused even when resting, any of these symptoms require immediate attention more than a single blood oxygen level reading. 

Worried about altitude sickness? How can joining a tour group help?

Route planning, accommodation altitude, transportation connections, and emergency assistance all affect the stress of traveling to high altitudes. Da Wan Jia Travel utilizes a joint service model between Taiwanese travel agencies and local Tibetan teams, providing standardized travel contracts from Taiwan, reception in Chengdu, pre-departure high-altitude health checks, on-board doctor, and oxygen supply equipment. Actual service details and applicable tour types are subject to the specific information provided for each tour.

Even with a group tour, there's no guarantee against altitude sickness. Its purpose is to reduce the burden on travelers who, if feeling unwell, have to handle transportation, accommodation, medical care, and itinerary adjustments independently. First-time visitors to Tibet, older travelers, or those with chronic illnesses can contact Big Player Travel via the official LINE account shown in the image (LINE ID: @tpg0).

Should we take Rhodiola rosea?

Rhodiola rosea can be considered a traditional herbal remedy, but there is currently insufficient evidence to support its use as a reliable preventative medicine for altitude sickness. In a 2013 randomized, double-blind, crossover trial involving 102 participants, the incidence of acute altitude sickness in the Rhodiola rosea extract group and the placebo group was 60.81 TP3T, with no significant difference.Review of Rhodiola rosea clinical trials

There are also differences in species, dosage, and ingredients among Rhodiola rosea products on the market. Studies in Europe and America commonly use Rhodiola rosea, while the Chinese Pharmacopoeia mainly uses Rhodiola rosea macrophylla; therefore, research results cannot be used interchangeably. Individuals already taking anticoagulants, cardiovascular medications, or other chronic disease medications should have the product's ingredients confirmed by their doctor before traveling.

Are oxygen cylinders useful?

It's useful, but its purpose is to temporarily improve hypoxia and relieve symptoms. Regular continuous oxygen therapy can be used to treat altitude sickness; common handheld oxygen cylinders have limited capacity, with the CDC pointing out that some products have a maximum capacity of about 5 liters, which can only provide short-term relief and cannot support long-term treatment.

Feeling better after using supplemental oxygen does not mean you can continue to higher altitudes. If symptoms continue to worsen, you should stop all activities, seek medical attention, and be assessed for descent. The key to managing severe high-altitude pulmonary edema or high-altitude cerebral edema includes providing oxygen, reducing physical exertion, and descending to a lower altitude as quickly as possible.

 Do not proceed to higher altitudes if you still experience altitude sickness symptoms. 

Should I take a shower on the first day?

Yes, you can shower, just remember to "short, warm, and slow." Current high-altitude medicine guidelines do not prohibit showering on the first day after arrival. If you are mentally sound and do not experience headaches, nausea, significant dizziness, or abnormal shortness of breath, you can quickly rinse with warm water for about 5 minutes. Keep the bathroom well-ventilated, and dry yourself off immediately after showering to keep warm.

Avoid soaking in baths, steam baths, and excessively hot water. Also, avoid suddenly standing up after squatting. If you already experience headaches, nausea, chest tightness, unsteady gait, or shortness of breath even at rest, it's safer to take a sponge bath or postpone showering on the first day. Acute altitude sickness usually appears 2 to 12 hours after arrival; observe your condition closely on the first night.

How to reduce altitude sickness?

The most effective way is to give the body time to adapt.Wilderness Medical Society 2024 Clinical Guidelines for Altitude SicknessSlow ascent is the foundation of prevention. Once you enter an area above 3000 meters, try not to increase the altitude of your accommodation by more than 500 meters per day, and arrange an additional acclimatization night for every 1000 meters of ascent.

It's difficult to make the ascent in segments when flying to Lhasa, so you can allow more flexibility for the first 48 hours after arrival:

1. Only engage in light activities, walk slowly, and avoid running, carrying heavy objects, and rushing to tourist attractions.
2. Avoid drinking alcohol for the first 48 hours, and do not use alcohol or medications that suppress breathing to help you sleep.
3. Just drink water as usual; there's no need to force yourself to drink large amounts.
4. If you experience headache, nausea, dizziness, or significant fatigue, do not continue to increase the altitude of your accommodation.
5. If symptoms continue to worsen at the original altitude, or if shortness of breath, unsteady gait, or altered consciousness occur during rest, seek medical attention immediately and descend.
6. If the trip is classified as medium to high risk, you have a history of significant altitude sickness, or if a rapid ascent is required, consult your doctor before departure to see if you need acetazolamide. Do not blindly follow other people's dosages.

Altitude sickness is difficult to overcome with willpower alone. Taking the first day or two to relax, honestly assessing the symptoms, and stopping medications when necessary are often more reliable than carrying a bag full of supplements.

Related FAQs

Reference source

1. CDC Yellow Book: High-Altitude Travel and Altitude Illness
2. Wilderness Medical Society: 2024 Clinical Practice Guidelines for Altitude Sickness
3. American Heart Association: Cardiovascular Disease and High-Altitude Travel