Altitude Sickness in China: Tibet, Yunnan & How to Prepare

ByRui Yu Travel Essentials
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Lhasa sits at 3,656 metres. Most visitors feel something on day one. A few end up in hospital. What separates them is not fitness or age. It is preparation. Here is exactly what to do.

altitude sickness china

Your flight touches down at Lhasa Gonggar Airport. The elevation is 3,656 metres above sea level. Before you even pick up your bag from the carousel, some passengers around you are getting headaches. By evening, a few will feel genuinely sick. Most of the people who struggle here did not prepare. This guide makes sure you are not one of them.

Key Takeaways

  • Lhasa is at 3,656m. Most visitors feel something. Prepare before you go.
  • Diamox works. Get a prescription from your doctor at least two weeks before departure.
  • Fitness does not protect you. Altitude sickness is not about how healthy you are.
  • Ascend slowly. Spend a night at 2,000 to 2,500m before going to Lhasa if possible.
  • Descend if symptoms are severe. AMS kills when people push through warning signs.
  • Pack for altitude: see China packing list for what to bring.

What Actually Happens to Your Body

At sea level, each breath delivers enough oxygen to saturate your blood near 100%. At 3,656m (Lhasa), each breath delivers about 60% of that amount. Your body is not designed for this. It can adapt, but it needs time. The adaptation process takes days to weeks. When you arrive by plane, you skip the gradual ascent that gives your body time to adjust. The result is Acute Mountain Sickness (AMS).

AMS is not dangerous on its own. What makes it dangerous is two things: pushing through severe symptoms instead of descending, and letting it progress to High Altitude Pulmonary Edema (HAPE) or High Altitude Cerebral Edema (HACE). Both of those are life-threatening. But they almost never happen to travelers who pay attention to their symptoms.

Altitude Levels: China’s Main Destinations

DestinationAltitudeRisk LevelNotes
Lijiang, Yunnan2,400mLowMild headaches possible on day one for sensitive visitors
Shangri-La (Zhongdian), Yunnan3,200mModerateMore visitors affected. No strenuous activity on day one.
Lhasa, Tibet3,656mHighAlmost everyone feels something. Acclimatise for 1 to 2 days before activities.
Nam Co Lake, Tibet4,718mVery HighDay trip from Lhasa. Do not go without acclimatising first.
Everest Base Camp (Tibet)5,200mExtremeRequires serious acclimatisation. Not a casual day trip.
Tiger Leaping Gorge trailUp to 2,600mLow to ModerateFull trail reaches altitude. Manageable with pacing.

How to Prepare Before You Fly

Get Diamox from your doctor

Acetazolamide (brand name Diamox) is the most effective drug for preventing AMS. It works. It is not a guarantee, but it significantly reduces the chance of serious symptoms. The standard approach: 125mg twice a day, starting one or two days before you ascend to altitude, continuing for two days after arrival. It is a prescription drug in most countries. Book a GP appointment at least two weeks before your trip. Tell your doctor you are going to Tibet or high-altitude Yunnan. Side effects are common but not dangerous: tingling hands and feet, more frequent urination. If those bother you, stop taking it. Current dosing guidelines: Altitude Research Centre.

Spend a night at a medium altitude first

If your itinerary allows it, spend a night in Chengdu (500m) or Kunming (1,900m) before flying to Lhasa. This does not fully acclimatise you, but it eases the transition. A better option is flying to Xining (2,200m) and taking the Qinghai-Tibet Railway to Lhasa. The train takes about 21 hours and arrives in Lhasa gradually, giving your body time to start adjusting. Many travelers who took the train report significantly fewer symptoms than those who flew directly.

What to avoid on arrival

  • Do not exercise hard on your first day. Walk slowly. Rest in the afternoon.
  • Do not drink alcohol. It worsens AMS symptoms and dehydrates you.
  • Do not take sleeping pills. They suppress breathing. The opposite of what you need.
  • Do drink water. Staying hydrated helps. Not a cure, but it helps.
  • Do not ascend higher until you feel fully normal at your current altitude.

Recognising AMS: What to Watch For

SymptomSeverityWhat to Do
Headache, mild fatigueMild AMSRest. Ibuprofen or paracetamol. Drink water. Do not go higher.
Headache unresponsive to painkillers, nauseaModerate AMSRest. Do not ascend. Consider descent if no improvement in 24 hours.
Severe headache, vomiting, unsteady walkingSevere AMSDescend immediately. Do not wait.
Confusion, can’t walk straight, gurgling breathingHAPE or HACEEmergency. Descend immediately. Call for help.
Pink or frothy coughHAPEMedical emergency. Descend and get oxygen now.

The rule is simple: if symptoms are getting worse instead of better, descend. You do not need to descend far. Even dropping 300 to 500 metres often produces rapid improvement. In Lhasa, this means going back to lower altitude areas in the city. On mountain trails, it means turning back.

In Tibet Specifically

Tibet requires a Tibet Travel Permit in addition to a Chinese visa. You cannot travel independently in Tibet as a foreign visitor. A licensed tour guide is mandatory. Your guide will be experienced with AMS and can help you make descent decisions. Do not be the tourist who insists on going to Nam Co Lake on day two because the tour itinerary says so. A good guide will not let you. Listen to them.

Lhasa hospitals can treat AMS. The main hospital used for foreign visitors is the Tibet Autonomous Region People’s Hospital. Supplemental oxygen is available at most hotels in Lhasa for a small fee. For the full picture on medical help in China, see Getting Medical Help in China as a Foreigner.

In Yunnan

Yunnan altitude issues are more common than people expect, and less often discussed. Shangri-La at 3,200m is high enough to cause symptoms in a significant minority of visitors. The standard tourist circuit from Lijiang to Shangri-La to Tiger Leaping Gorge gains elevation quickly. Spend a full day in Lijiang before driving up to Shangri-La. Do not plan a full-day trek on your first day in Shangri-La.

Frequently Asked Questions

Headache is almost always the first sign, usually starting within a few hours of arrival at altitude. Other early symptoms: fatigue that feels out of proportion to what you have done, shortness of breath at rest, loss of appetite, and difficulty sleeping. These are all signs of Acute Mountain Sickness (AMS), which is common and usually manageable. The warning signs that require immediate descent: severe headache that does not respond to ibuprofen, vomiting, inability to walk in a straight line, confusion, and coughing up pink or frothy mucus. If you see those last symptoms in yourself or a travel companion, descend immediately. Do not wait until morning.

Yes. Diamox is the most effective prescription medication for preventing AMS and is widely recommended by altitude medicine specialists. It works by making your kidneys excrete bicarbonate, which causes you to breathe faster and take in more oxygen. The standard dose is 125mg twice daily, starting one to two days before ascent. Side effects: tingling in hands and feet (very common), increased urination, and carbonated drinks tasting flat. It is a prescription drug. See your doctor at least two weeks before your trip to get it. The Altitude Research Centre has current dosing guidelines.

No. Fitness has almost no relationship with susceptibility to altitude sickness. Experienced mountaineers get AMS. Sedentary first-time visitors sometimes feel nothing. The main factors are how fast you ascend, your individual physiology, and whether you have acclimatised before. Previous experience at altitude is the best predictor. If you felt fine in Nepal or Bolivia, you are more likely to be fine in Lhasa. If you have never been above 2,500m, you genuinely do not know until you get there.

Most people start feeling something above 2,500m. Lhasa is at 3,656m. The highest tourist destinations in China are significantly above that. Everest Base Camp (Tibet side) is at 5,200m. Nam Co Lake is at 4,718m. Even Lijiang in Yunnan is at 2,400m, where sensitive visitors can feel mild effects. The golden rule: ascend slowly, spend a night at a lower altitude before going higher, and do not plan your most demanding activities for the first two days.

Yes, though it is milder than in Tibet. Lijiang sits at 2,400m and some visitors feel headaches on the first day. Shangri-La (Zhongdian) is at 3,200m and more visitors are affected. Tiger Leaping Gorge trails reach above 2,600m. Yunnan altitude sickness is rarely serious. Staying hydrated, not drinking alcohol on the first night, and sleeping at a lower altitude before going higher covers most of the risk.

For packing what you need for high-altitude China, see China Packing List. For travel insurance that covers evacuation from Tibet, see China Travel Insurance Guide. For the full safety picture, see Is China Safe for Tourists?.

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