Why altitude matters here
Altitude sickness is a key consideration on the Annapurna Circuit because the route goes above 5,000 m. Symptoms include headache, nausea, dizziness, fatigue and sleep disturbance.
How the itinerary handles it
The ascent is gradual. Sleeping elevations run from Chame at 2,710 m to Pisang at 3,300 m, Ngawal at 3,650 m, and Manang at 3,519 m, where you stay two nights. Then come Yak Kharka at 4,110 m and Thorong Phedi at 4,600 m before the pass. The pass day itself reaches 5,416 m, with the Muktinath sleeping elevation still to be confirmed.
The rest day
Day 7 is for acclimatisation, with a short hike to one of Bhojo Gumba, Gangapurna Lake, Ice Lake or Melereppa Cave. With energy to spare, you can walk to Vraga, where the Himalayan Rescue Association explains Acute Mountain Sickness.
What to do
Guides monitor health daily and emphasise hydration, nutrition and pacing. Tell your guide promptly if symptoms appear, so they can adjust the plan. The pass day starts around three in the morning and takes 8–9 hours on foot, so arrive at Thorong Phedi rested.
Effort and preparation
There are 10 trekking days, with the longest walks on Days 10 and 12 (8–9 and 7–8 hours). No fitness programme is set out here. Ask The Himalayan Guides if you have questions about preparation.
What is not covered
This briefing gives no medication or hydration targets. Medical, evacuation and travel insurance are not included and should be arranged personally; see the insurance card