Kilimanjaro Altitude Sickness

Kilimanjaro Altitude Sickness its happen as you climb high, the percentage remains the same but the number of oxygen molecules per breath are reduced. At 12,000 feet (3,600 m) there are roughly 40% fewer oxygen molecules per breath so the body must adjust to having less oxygen.

Altitude sickness, known as AMS, is caused by the failure of the body to adapt quickly enough to the reduced oxygen at increased altitudes.

Altitude sickness can occur in some people as low as 8,000 feet, but serious symptoms do not usually occur until over 12,000 feet.

Mountain medicine recognizes three altitude categories:

  • High altitude: 4,900 to 11,500 ft (1,500 to 3,500 m)
  • Very high altitude: 11,500 to 18,000 ft (3,500 to 5,500 m)
  • Extreme altitude: 18,000 ft and above (5,500 m and above)

There are four factors related to AMS:

  • High Altitude
  • Fast Rate of Ascent
  • High Degree of Extertion
  • Dehydration

The main cause of altitude sickness is going too high (altitude) too quickly (rate of ascent).

Given enough time, your body will adapt to the decrease in oxygen at a specific altitude. This process is known as acclimatization and generally takes one to three days at any given altitude. Several changes take place in the body which enable it to cope with decreased oxygen:

  • The depth of respiration increases
  • The body produces more red blood cells to carry oxygen
  • Pressure in pulmonary capillaries is increased, “forcing” blood into parts of the lung which are not normally used when breathing at sea level
  • The body produces more of a particular enzyme that causes the release of oxygen from hemoglobin to the body tissues

Again, AMS is very common at high altitude. It is difficult to determine who may be affected by altitude sickness since there are no specific factors such as age, sex, or physical condition that correlate with susceptibility. Many people will experience mild AMS during the acclimatization process.

The symptoms of Mild AMS include:

  • Headache
  • Nausea & Dizziness
  • Loss of appetite
  • Fatigue
  • Shortness of breath
  • Disturbed sleep
  • General feeling of malaise

While hiking, it is essential that you communicate any symptoms of illness immediately to Karibu Adventures Guides.

The signs and symptoms of Moderate AMS include:

  • Severe headache that is not relieved by medication
  • Nausea and vomiting, increasing weakness and fatigue
  • Shortness of breath
  • Decreased coordination (ataxia)

Continuing on to higher altitude while experiencing moderate AMS can lead to death.

Severe AMS results in an increase in the severity of the aforementioned symptoms including:

  • Shortness of breath at rest
  • Inability to walk
  • Decreasing mental status
  • Fluid build-up in the lungs

Severe AMS requires immediate descent of around 2,000 feet (600 m) to a lower altitude. There are two serious conditions associated with severe altitude sickness; High Altitude Cerebral Edema (HACE) and High Altitude Pulmonary Edema (HAPE).

Both of these happen less frequently, especially to those who are properly acclimatized. But, when they do occur, it is usually in people going too high too fast or going very high and staying there. In both cases the lack of oxygen results in leakage of fluid through the capillary walls into either the lungs or the brain.

Effects of exposure to low atmospheric pressure

1. Low oxygen saturation

At high altitudes and low pressures, each breath takes in less oxygen, and transfers less to the blood. Blood with low levels of oxygen is said to be poorly saturated. Having slightly low oxygen saturation can lead to fatigue and feeling breathless. Severe low oxygen saturation can cause impaired mental functions, reduce your decision making ability, and have other dangerous effects. All our guides have pulse-oxymeters to check your oxygen saturation daily.

2. Cerebral oedema

Severely reduced air pressure can cause fluid to collect in the sinuses and air cavities in the skull. Initially it presents as a mild headache, but can eventually cause disorientation, coma and even death. Cerebral oedema can present very suddenly, and is an extremely serious medical issue.

3. Pulmonary oedema

This is caused by reduced air pressure in the lungs. Fluid sometimes begins to seep from the lung tissues into the air spaces of the lungs, making breathing even more difficult. This often presents like pneumonia, and is most likely to occur during sleep.

How to recognize AMS

AMS does not present as a slow, gradual worsening of lesser altitude-related symptoms like breathlessness or headache. It is in fact generally a rapid, dramatic onset of symptoms that can render a person unable to walk or take care of themselves at all.

Our guides are trained to recognize AMS and apply the appropriate first aid. They will monitor your blood oxygen saturation and evaluate your overall acclimatization, but it is vital that you monitor and report your condition accurately, for everyone’s safety.

Other Kilimanjaro health problems

Coughs and colds on Kilimanjaro

These are common on Kilimanjaro. Aspirin can be taken for a cold; lozenges containing anaesthetic are useful for a sore throat, as is gargling with warm salty water. Drinking plenty helps too. A cough that produces mucus has one of a number of causes; most likely are the common cold or irritation of the bronchi by cold air which produces symptoms that are similar to flu.It could, however, point to altitude sickness.

A cough that produces thick green and yellow mucus could indicate bronchitis. If there is also chest pain (most severe when the patient breathes out), a high fever and blood-stained mucus, any of these could indicate pneumonia, requiring a course of antibiotics. Consult a doctor.

Exposure on Kilimanjaro

Also known as hypothermia, this is caused on Kilimanjaro by a combination of exhaustion, high altitude, dehydration, lack of food and not wearing enough warm clothes against the cold. Note that it does not need to be very cold for exposure to occur. Make sure everyone, particularly your porters, is properly equipped.

  • Symptoms of exposure on Kilimanjaro

These include a low body temperature (below 34.5ºC or 94ºF), poor coordination, exhaustion and shivering. As the condition deteriorates the shivering ceases, coordination gets worse making walking difficult and the patient may start hallucinating. The pulse then slows and unconsciousness and death follow shortly.

Treatment involves thoroughly warming the patient quickly. Find shelter as soon as possible. Put the patient, without their clothes, into a sleeping-bag with hot water bottles (use your water bottles); someone else should take their clothes off, too, and get into the sleeping bag with the patient. Nothing like bodily warmth to hasten recovery.

Frostbite on Kilimanjaro

The severe form of frostbite that leads to the loss of fingers and toes rarely happens to trekkers on Kilimanjaro.You could, however, be affected if you get stuck or lost in particularly inclement weather. Ensure that all members of your party are properly kitted out with thick socks, boots, gloves and woolly hats.

The first stage of frostbite is known as ‘frostnip’. The fingers or toes first become cold and painful, then numb and white. Heat them up on a warm part of the body (eg an armpit) until the colour comes back. In cases of severe frostbite the affected part of the body becomes frozen. Don’t try to warm it up until you reach a lodge/camp. Immersion in warm water (40ºC or 100ºF) is the treatment. Medical help should then be sought.

Gynaecological problems on Kilimanjaro

If you have had a vaginal infection in the past it would be a good idea to bring a course of treatment in case it recurs.

Haemorrhoids on Kilimanjaro

If you’ve suffered from these in the past bring the required medication with you since haemorrhoids can flare up on a trek up Kilimanjaro, particularly if you get constipated.

Snow blindness on Kilimanjaro

Though the snows of Kilimanjaro are fast disappearing, you are still strongly advised to wear sunglasses when walking on the summit – particularly if you plan on spending more than just a few minutes up there – to prevent this uncomfortable, though temporary, condition.

Ensure everyone in your group, including porters, has eye protection. If you lose your sunglasses a piece of cardboard with two narrow slits (just wide enough to see through) will protect your eyes. The cure for snow-blindness is to keep the eyes closed and lie down in a dark room. Eye-drops and aspirin can be helpful.

Sunburn on Kilimanjaro

Protect against sunburn on Kilimanjaro by wearing a hat, sunglasses and a shirt with a collar that can be turned up. At altitude you’ll also need sunscreen for your face.

Care of feet, ankles and knees on Kilimanjaro

A twisted ankle, swollen knee or a septic blister on your foot could ruin your trek up kilimanjaro so it’s important to take care to avoid these. Choose comfortable boots with good ankle support. Don’t carry too heavy a load. Wash your feet and change your socks regularly. During lunch stops take off your boots and socks and let them dry in the sun. Attend to any blister as soon as you feel it developing.

Blisters on Kilimanjaro

There are a number of ways to treat blisters but on Kilimanjaro prevention is far better than cure. Stop immediately you feel a ‘hot spot’ forming and cover it with a piece of moleskin or Second Skin. One trekker suggests using the membrane inside an egg-shell as an alternative form of Second Skin. If a blister does form you can either burst it with a needle (sterilized in a flame) then apply a dressing or build a moleskin dressing around the unburst blister to protect it.


You can lessen the risk of a sprained ankle on Kilimanjaro by wearing boots which offer good support. Watch where you walk, too. If you do sprain an ankle, cool it in a stream and keep it bandaged. If it’s very painful you’ll probably have to abandon your trek and return to your hotel. Aspirin is helpful for reducing pain and swelling.

Knee problems

These are most common after long stretches of walking downhill – such as the long descent from the summit of Kilimanjaro. It’s important not to take long strides as you descend; small steps will lessen the jarring on the knee. It may be helpful to wear knee supports and use walking poles for long descents, especially if you’ve had problems with your knees before.Read more

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