Altitude Sickness in China
How to handle altitude in Lhasa, Shangri-La, Tibet and western China: symptoms, acclimatisation, medication, oxygen, insurance and when to descend.
Last reviewed October 23, 2026 · policies change — confirm the official sources before travel
Large parts of western China sit above 3,000 metres, and Lhasa’s airport is at 3,600 metres — higher than many travellers have ever slept. Altitude sickness is not about fitness: fit, young travellers get it too. The rules that work are simple: ascend slowly, take a rest day, drink water, skip alcohol, and descend if symptoms worsen. This guide covers the main high-altitude destinations and the practical plan for each.
Key points
The details that matter
What altitude does
Above about 2,500 metres, the air holds less oxygen, so your body works harder. Most people adapt over a few days, but the process cannot be rushed. Acute mountain sickness (AMS) is common at 3,000–4,000 metres and feels like a hangover: headache, nausea, fatigue, dizziness and poor sleep. It is not a sign of weakness. The danger is when it progresses to high-altitude cerebral edema (HACE) or high-altitude pulmonary edema (HAPE), which can be fatal. The single most effective treatment is to descend.
The main destinations
Lhasa sits at 3,650 metres and is reached by a flight or the Qinghai–Tibet railway; both can bring on symptoms. Shangri-La in Yunnan is 3,160 metres, usually reached by road from Lijiang (2,400 m), which helps acclimatisation. Tagong and Litang in western Sichuan are around 3,700–4,000 metres. Qinghai Lake is 3,200 metres. Huanglong is 3,500 metres at the top. Everest Base Camp is 5,200 metres and should only be visited after several days of acclimatisation. Jiuzhaigou is lower (2,000–3,100 m) and easier.
- Lhasa: 3,650 m — rest on arrival day
- Shangri-La: 3,160 m — road ascent helps
- Tagong/Litang: 3,700–4,000 m — take it slowly
- Everest Base Camp: 5,200 m — only after acclimatisation
- Jiuzhaigou: 2,000–3,100 m — lower risk
Acclimatisation plan
If you fly to Lhasa, do nothing on arrival day. Sleep, drink water, eat lightly and avoid alcohol. Day two: a gentle walk around the old city, no climbing. Day three: Potala Palace or Sera Monastery, with rest breaks. Do not take a long drive to a higher pass on day one. If you are going to Everest or western Tibet, build in at least three to four nights above 3,500 metres before going higher. A gradual road ascent is better than a flight, but it takes time.
Medication and oxygen
Acetazolamide (Diamox) is the most commonly used preventive medicine; it is prescription-only in many countries and has side effects, so discuss it with a doctor before you travel. Ibuprofen or paracetamol helps headaches; anti-nausea medication can help. Oxygen cylinders and oxygen bars are widely available in Lhasa and tourist areas, but they treat symptoms without aiding acclimatisation — do not rely on them to push higher. Portable oxygen can be useful for sleep or emergencies. If symptoms are severe, descend and seek medical care.
When to descend
Descend if symptoms worsen despite rest, or if you develop confusion, loss of coordination, breathlessness at rest, or a cough with frothy sputum. Do not wait for morning if someone is getting worse at night. A descent of 500–1,000 metres often resolves AMS quickly. In remote areas, evacuation can be expensive and slow; insurance with helicopter or high-altitude evacuation is worth it. Hotels and tour guides in Tibet can arrange oxygen and transport, but they are not medical professionals.
Tibet permits and tours
Foreign visitors need a Tibet Travel Permit arranged through a licensed Tibetan travel agency; independent travel is not allowed, and you must travel with a guide and vehicle. Apply about 20–30 days ahead, more in peak season. Additional permits are needed for Everest, Kailash and border areas. Permits were suspended during Tibetan New Year in February 2026; check current dates. Even if you enter China visa-free, the Tibet permit is separate. Do not book flights to Lhasa before the permit is confirmed.
What works in practice
Fly in, rest, then sightsee — not the other way round
Drink more water than you think you need; skip alcohol for 48 hours
Pack layers — high-altitude sun is strong and nights are cold
Carry sunscreen, lip balm and sunglasses
Discuss acetazolamide with your doctor before travel
Check that your insurance covers altitude and evacuation
Mistakes to avoid
Scheduling a full tour on the day you land in Lhasa
Drinking alcohol on the first night
Assuming fitness prevents altitude sickness
Relying on oxygen bars instead of acclimatising
Booking Tibet without a permit and guide
Frequently asked
Is Lhasa safe for everyone?
Most healthy travellers adapt, but altitude affects people differently. If you have heart, lung or severe medical conditions, ask a doctor before travelling. Give yourself a rest day on arrival.
Do I need altitude medicine?
Not everyone does. Acetazolamide can reduce symptoms but is prescription-only and has side effects. Discuss it with a doctor, especially if you have lung or kidney conditions.
Can I visit Tibet independently?
No. Foreign visitors need a Tibet Travel Permit arranged through a licensed agency and must travel with a guide and vehicle. Apply 20–30 days ahead.
What should I do if I feel sick?
Rest, hydrate, and do not ascend further. If symptoms worsen — confusion, breathlessness at rest, loss of coordination — descend and seek medical help immediately.
Sources
Official and first-party sources used for the time-sensitive details on this page.
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