KILIMANJARO ALTITUDE SICKNESS
Acute Mountain Sickness (AMS) / Altitude Sickness on Kilimanjaro
If you are planning to climb Mount Kilimanjaro with Re Leone Tanzania Safaris, you will sooner or later hear about altitude sickness – also known as Acute Mountain Sickness (AMS). Understanding the causes, symptoms, and prevention is key to a safe and successful summit.
What is Altitude Sickness?
Altitude sickness occurs when the body cannot adjust quickly enough to lower oxygen levels at higher elevations.
At sea level, oxygen concentration is about 21% with normal barometric pressure (760 mmHg).
At 3,658 meters (12,000 ft), barometric pressure drops to 483 mmHg – meaning each breath contains 40% fewer oxygen molecules than at sea level.
Above 5,500 meters (18,000 ft), acclimatization becomes impossible and the body begins to deteriorate.
Your body responds by breathing faster, increasing heart rate, and producing more red blood cells – but this process (called acclimatization) takes time.
Acclimatization on Kilimanjaro
The main cause of AMS is climbing too high, too fast. With enough time, the body adapts. This adjustment generally takes 1–3 days at a given altitude before moving higher.
To cope with decreased oxygen, the body:
Increases breathing rate and depth.
Raises blood pressure in the lungs to circulate oxygen more effectively.
Produces more red blood cells to carry oxygen.
Activates enzymes to improve oxygen transfer to tissues.
At Re Leone Tanzania Safaris, our guides carefully pace climbs and monitor your health to give your body the best chance to adjust safely.
Cheyne–Stokes Respiration
Above 3,000 meters (9,842 ft), many climbers experience irregular breathing at night, called Cheyne–Stokes Respiration. This involves shallow breathing, deep sighs, and short pauses where breathing may briefly stop, often waking climbers with a feeling of suffocation. Although disturbing, it is common at altitude. Diamox can help reduce these episodes.
Symptoms of Acute Mountain Sickness
Mild AMS (common and usually manageable):
Headache
Nausea, dizziness, loss of appetite
Fatigue and shortness of breath
Difficulty sleeping
👉 Climbers can usually continue at a slow pace but must communicate symptoms to the guide.
Moderate AMS (requires caution and monitoring):
Severe headache, nausea, and vomiting
Increased fatigue and weakness
Shortness of breath at rest
Decreased coordination
👉 Even a descent of 300 meters can dramatically improve symptoms. If a climber cannot walk in a straight line, immediate descent is required.
Severe AMS (life-threatening):
Extreme shortness of breath
Loss of coordination and inability to walk
Confusion, drowsiness, or loss of consciousness
Fluid in the lungs
👉 The only treatment is immediate descent.
Other Severe Altitude Illnesses
High Altitude Pulmonary Edema (HAPE)
HAPE occurs when fluid builds up in the lungs, preventing oxygen exchange.
Symptoms: breathlessness at rest, cough with frothy fluid, weakness, confusion, drowning sensation.
Action: Immediate descent and evacuation.
High Altitude Cerebral Edema (HACE)
HACE is swelling of the brain caused by fluid leakage.
Symptoms: severe headache, loss of coordination, confusion, hallucinations, vision loss, coma.
Action: Life-threatening. Requires immediate descent and urgent medical attention.
Preventing Altitude Sickness
At Re Leone Tanzania Safaris, we emphasize:
Pole, pole (go slowly): gradual ascent is the best prevention.
Climb high, sleep low: take acclimatization hikes when possible.
Stay hydrated: drink at least 4–6 liters per day.
Eat well: high-calorie, high-carbohydrate diet (about 70%).
Avoid alcohol, tobacco, and sleeping pills: these worsen symptoms.
Communicate: always inform your guide of any AMS symptoms.
Preventative Medications
Diamox (Acetazolamide)
Helps you breathe faster, improving oxygen intake.
Start 24 hours before reaching altitude and continue 5+ days.
Typical dose: 125–250 mg twice daily.
Side effects: tingling fingers/lips, frequent urination, altered taste, blurred vision.
Not suitable for people allergic to sulfa drugs. Always consult your doctor.
Other Medications
Ibuprofen: helps with altitude-related headaches.
Dexamethasone: reduces brain swelling in HACE (prescription only).
Nifedipine: helps treat HAPE by reducing lung artery pressure.
Furosemide: may help clear lung fluid but requires medical supervision.
✅ At Re Leone Tanzania Safaris, our experienced guides are trained to recognize AMS early and take necessary action. With the right pace, proper hydration, and awareness, most climbers successfully adapt and safely reach the summit of Kilimanjaro.
