Preventing Altitude Sickness when Climbing Kilimanjaro

It's not lack of fitness that prevents people from reaching the summit of Mount Kilimanjaro, it's altitude sickness.
Let me repeat: It is altitude sickness that prevents people from reaching the top of Africa!

Whether you reach the top of Kilimanjaro depends on how you cope with the altitude more than anything else.
And how you cope with the altitude is not a matter of random luck!

There are many things you can do to avoid the symptoms of acute mountain sickness when climbing Kilimanjaro.
(Acute mountain sickness is the scientific name for what we usually refer to as altitude sickness.)

Most of what we talked about so far (weather at different times of the year, route selection, tour operator selection, ...) affects how your body copes with the altitude.
That's why all those decisions are important. In the end it comes down to altitude.

Does altitude sickness strike at random?

When you research altitude sickness you often read that it affects people randomly, regardless of age or fitness level.

You may also come across data giving percentage numbers for how many people develop dangerous altitude sickness symptoms at certain heights, and the numbers may look scary.

You have to understand how researchers get these numbers:

Scientific studies of altitude sickness are done by taking a number of people from sea level to a certain altitude and then measuring how they react.

Yes, they react randomly, and yes, if you take someone from sea level directly to 3500 metres (or 3000 ft) then there is a good chance that they won't feel too sprightly at the end of the day.

The difference during a Kilimanjaro climb is that hopefully you will NOT take yourself from sea level to 3500 metres that fast.

The key to preventing altitude sickness on Kilimanjaro is taking your time. 
Altitude sickness is not just a result of the absolute height you are at, it also depends how quickly or slowly you got there!

Even though our susceptibility to extreme altitude varies and is impossible to predict, we do know that the body adjusts to it eventually. Some people will adjust sooner, some will require more time.

Apart from our innate ability to cope with altitude, which varies between people, there are other factors that can affect that abiltiy temporarily in each of us: Sleep, hydration, nutrition, stress ...

And that means that there are many things you can do before and during a Kilimanjaro climb that will lessen the risk of developing altitude sickness symptoms.

Choose the right route for your Kilimanjaro climb

Most people book their Kilimanjaro climb well ahead, and this is where you can make the first mistake.

There are several climb routes up Kilimanjaro, and there is a huge number of operators. A Kilimanjaro climb is expensive, so it's tempting to look for the cheapest deal.

The cheapest Kilimanjaro climbs are also the shortest. Every day on the mountain will add a few hundred dollars to the price. It is possible to book a five day or even four day climb, and it would be a mistake to do so.

No responsible operator should be offering four day climbs to people who have no previous experience at high altitude trekking and are not acclimatized.

The (admittedly highly unreliable) statistics from the registration books at Mount Kilimanjaro National Park indicate that of all climbers on five day routes, only a little over a quarter reach the summit!

All the five day routes offer an opportunity to add an extra day for acclimatization. Do spend the money on that extra day!

If you want to increase your chances of reaching the summit further, consider choosing one of the longer routes.

(Though this is only recommended for people who are used to camping out. If you aren't and if you don't like it or don't sleep well in a tent, then a longer Kilimanjaro trek can have a negative effect.)

If you have no previous altitude acclimatization (I talk below about how you can achieve that) then taking enough time is the most important thing you can do to increase your summit chances.

Choose the right operator for a Kilimanjaro climb

When you compare prices for Kilimanjaro climbs you will find huge differences between operators. Again there is the temptation to look for a cheap deal.

But on Kilimanjaro you will get what you pay for.

The quality of your guides, of your equipment, of your food, all that is reflected in the price. And it will determine the quality of your nutrition and your sleep.

But all that also affects how your body copes with the altitude, so it influences your chances of reaching the summit.

Operators who cut costs at every corner do not have your best interest in mind. They only want you to book with them, they do not care if you reach the top and they do not care if it will be an experience that you'll want to remember.

There is something else to keep in mind: The low budget "cowboy" operators not only have lower success rates, there is also a bigger risk that something goes seriously wrong. And on Kilimanjaro that can mean that someone dies.
Yes, altitude disease can quickly become deadly.

Book with a quality operator. To find out more about how to find those, what to look for and what prices to expect, see the pages about the cost of a Kilimanjaro climb and Kilimanjaro tour operators.

Preparing for a Kilimanjaro climb

Most people prepare for Kilimanjaro with fitness training. While getting reasonably fit makes sense, gym work outs or sprinting up flights of stair etc. will not prepare your body for the demands of a Kilimanjaro climb.

You do need to get your body used to walking (as slowly as you like) for several hours in hilly country, for several days in a row. Any fitness training beyond that will not increase your chances to reach the summit.

Again: It's the altitude that will get you, not your lack of fitness.

So if you can, expose your body to some altitude before you tackle Kilimanjaro:

If you are living somewhere near mountains, climb them! If there is a chance to overnight at higher altitude, do it. (Note that for this to make a difference it needs to happen right before your Kili climb.)

Some people do acclimatization treks on Mt. Kenya or Mt. Meru before they climb Kilimanjaro. We did and can recommend it, but only for people with some previous trekking experience. Otherwise it may backfire by exhausting you too much. The two climbs really do need to happen back to back for this to work.
Read more about it here: Meru and Kilimanjaro.

There are other options: some operators offer cultural tours in the Kilimanjaro foothills, there are walking safaris in the crater highlands ...

The Ngorongoro crater rim is over 2200 metres high and even the crater floor is at 1700 metres. If you think of doing a safari while in Tanzania, why not plan it so you can spend a night or two on the crater rim before transferring to Kili?

Look at where you will be spending the night(s) before your climb. Some agencies will put you up in Moshi, some in Marangu. Moshi lies at 890 m, Marangu at 1800 m.

No matter where you will be staying, definitely fly in a few days early!

Anything that taxes your body will make it more susceptible to the altitude.
Give your body time to adjust to the different climate, the food, to recover from the strains of a long haul flight and to get over the jet lag if you came from a different time zone.

Arriving early can improve your chances of reaching the summit by five percent or more.

What to do during a Kilimanjaro climb

Pole pole!

That is Kiswahili for "slow and steady" and you will hear it day in, day out.

It's the single most important thing to keep in mind during the climb. I can tell you now, no matter what you expect, you will be surprised when you see just HOW slowly your guides make you walk. Everything on Kilimanjaro happens in slow motion.

You walk so slowly, the first days it seems ridiculous. You may even feel you just CAN'T possibly walk THAT slowly. (If you have that problem, make sure to breathe through your nose only. That may slow you down.)

Soon you will notice some changes. You stop for a photo and catching up with your group leaves you breathless. Drinking from your camel back while walking becomes an effort. The slow, slow speed does not seem so slow any more.

Whatever happens, do avoid exertion at all cost. Falling behind the group? So what? That's why bigger groups have several guides.

Do not be tempted into speeding up because others are walking faster.
Serious altitude sickness is more common in groups than it is during private climbs!
In a private climb, you set the pace. In a group, the fastest climbers tend to pull the others along.

Another group overtaking? Let them! You will pass their crumpled bodies soon enough.

There is NOTHING to gain on Kilimanjaro by being the first.

Do you know which group has the lowest success rate? Young males between 20 and 30, exactly the people you think would do the best.

But they overestimate the role of fitness and underestimate the mountain. They feel they have to lead, they want to be the best, they like showing off, they don't like being overtaken.

Being strong and fit also makes it very easy to walk too fast because it does not feel fast or strenuous.

Do you know that older people have a good success rate? They are wiser than that. And many of them just aren't fit enough to make the mistake of walking too fast.

You need to be able to walk for a long time. You do NOT need to be able to walk uphill fast!
In fact, you must not walk uphill fast. Not on Kilimanjaro. Never. Slow and steady. Always.

Fitness can be a trap. You don't feel the strain but your body uses lots of oxygen all the same. And the lower your blood oxygen levels drop, the higher the chances that you develop symptoms of altitude sickness.

Ok, I think you got the message. Pole pole!

A few more tips on climbing Kilimanjaro and avoiding altitude sickness

The first point is very important for avoiding altitude sickness and your guides will likely keep reminding you:

Keep drinking! It's VERY easy to dehydrate at altitude without noticing. The air is very dry so you breathe off more moisture. Also, your body adjusts to the high altitude by eliminating more water. Keep replacing it.

Also make sure you eat plenty! Most people lose their appetite at altitude, but the cold weather and the long days mean your body burns through a lot of calories. Keep replacing them. You will need them. High carbohydrate foods are better than fatty foods. (Any good tour operator will have considered that in their shopping and meal planning.)

And keep warm! The correct gear is a must, not just because shivering isn't nice and hypothermia dangerous, but also because staying dry and warm will lessen your risk of succumbing to altitude sickness.

Keep your day pack light. Only take what you really need. Every extra kilo needs extra oxygen to carry.

And last but not least, avoid alcohol, tobacco, and most definitely do not touch sleeping tablets! Or you may not wake up again.

And that's about it. Even if you are not in a position to afford extra preparation for the altitude (e.g. a Mt. Meru climb), if you are healthy, adapted to long days on your feet, if you pick a good route and tour operator, arrive at a good time of the year and a couple of days early, and if you take on board all the above tips, you have a very good chance of making it to the summit.


If you want to learn more about alitude sickness, its symptoms, how to prevent them, what to do if you develop them and more, I have a dedicated page explaining altitude sickness.

Final Words

If you started where I suggest you start (see the top menu) and went through all the steps in sequence, then you have reached the finish line. You know everything you need to know to climb Kilimanjaro successfully.

And if you take everything I said on board, if you make good decisions and do the preparation, then you have a very good chance indeed to be successful.

But there is one last thing I want you to be clear about:
This will not be easy.

Summit day will be hard. Possibly the hardest thing you have done in your life.
You will not have slept enough, you will feel the altitude for sure, you will feel weak, probably slightly (or not so slightly) nauseous, with a slight (or not so slight) headache.
Your desire for the summit will have evaporated. It will have. It is a result of the lack of oxygen.
You could call it an insiduous symptom of altitude sickness.

Despite all that you will have to find the will to keep putting one foot in front of the other. For hours.
Don't fall for what your brain is trying to tell you! No, you don't want to turn around!
It's easier to deal with that when you know it's coming, so don't kid yourself. Prepare for it mentally.

This website has two pages where I talk about training and physical preparation.
That part of your preparation is your chance to also get used to the mental demands this climb will place on you.
It's another reason why previous trekking or mountaineering experience is so helpful.
Keep that in the back of your head and start preparing. :)

I wish you all the best!


Overview: What it takes to climb Kilimanjaro

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