Can I just take medicine and keep going?

No. Medication like Diamox only helps your body acclimate; it is not a replacement for rest. If your symptoms include dizziness, confusion, or a wet cough, these are signs of HACE or HAPE—descend immediately.

Does being fit mean I won't get altitude sickness?

Not at all. Altitude sickness does not discriminate based on fitness level. In fact, very fit people often fall ill because they walk too fast, not allowing their bodies time to adjust.

What is the most important sign to watch for?

A headache that does not respond to paracetamol or ibuprofen is the hallmark sign of altitude sickness. Treat it as a warning that you must stop your ascent.

Preventing Altitude Sickness in the Himalayas

Prevent altitude sickness by strictly following a 'climb high, sleep low' rule and ascending no more than 300 to 500 meters of sleeping elevation per day once you pass 3,000 meters. Maintain consistent hydration of 3 to 4 liters of water daily and avoid alcohol or sedatives, which depress respiratory function.

Plan a conservative itinerary. Avoid flying directly to high-altitude airstrips like Lukla (2,860m) if possible. If you must, build in two mandatory rest days at that altitude before proceeding higher. Never plan a trek that gains more than 500 meters of elevation in a single sleep session.
Hydrate aggressively. Drink at least 3 liters of water or tea per day. Dehydration masks the early symptoms of AMS (Acute Mountain Sickness) and forces the heart to work harder. Monitor your urine; it should be clear or light yellow.
Master the 'climb high, sleep low' method. During rest days, hike to a higher point than your current camp for 1-2 hours to stimulate your body to produce more red blood cells, then return to your lower camp to sleep. This is the most effective way to acclimatize.
Monitor your symptoms daily. Use the Lake Louise Scoring System to track symptoms like headache, nausea, and fatigue. If you score above a 3, stay at your current altitude for an extra 24 hours. If symptoms persist or worsen, descend immediately by at least 500 meters.
Carry Acetazolamide (Diamox). Consult your doctor about taking 125mg of Diamox twice daily starting 24 hours before your ascent. It helps your body breathe more effectively at night, but it is not a cure—it only masks symptoms, so do not use it to 'push through' illness.

Can I just take medicine and keep going?: No. Medication like Diamox only helps your body acclimate; it is not a replacement for rest. If your symptoms include dizziness, confusion, or a wet cough, these are signs of HACE or HAPE—descend immediately.
Does being fit mean I won't get altitude sickness?: Not at all. Altitude sickness does not discriminate based on fitness level. In fact, very fit people often fall ill because they walk too fast, not allowing their bodies time to adjust.
What is the most important sign to watch for?: A headache that does not respond to paracetamol or ibuprofen is the hallmark sign of altitude sickness. Treat it as a warning that you must stop your ascent.