Travel and wilderness medicine · London
Altitude medicine consultation - London.
A pre-travel medical review for anyone heading above 2,500 m - Everest Base Camp, Kilimanjaro, Aconcagua, high-altitude ski, expedition or work. Personalised risk assessment, acetazolamide and rescue medication, HAPE and HACE prevention, and a written itinerary-matched plan.
What altitude medicine covers
Anyone sleeping above 2,500 m benefits from a plan.
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Trekking above 2,500 m
Everest Base Camp, Kilimanjaro, Machu Picchu, Annapurna Circuit, Aconcagua approach - written plans matched to your itinerary and rate of ascent.
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Mountaineering expeditions
Alpine 4,000ers, technical climbs, guided 6,000 m and 7,000 m peaks with staged acclimatisation and rescue medication.
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Ski resorts above 3,000 m
Colorado, Andes, Himalaya heli-ski. Short trips with limited acclimatisation window - prophylaxis is often the right call.
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Work at altitude
Miners in Chile and Peru, telescope and observatory staff, high-altitude scientific research, film and survey crews.
Altitude illness spectrum
AMS is common. HACE and HAPE are emergencies.
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Acute Mountain Sickness (AMS)
Headache with nausea, fatigue, poor sleep and loss of appetite above 2,500 m. Common, usually self-limiting with rest and no further ascent.
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High-Altitude Cerebral Edema (HACE)
Ataxia (unsteady walking), confusion, altered consciousness. A medical emergency. Descend immediately, dexamethasone, oxygen.
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High-Altitude Pulmonary Edema (HAPE)
Breathlessness at rest, dry then productive cough, pink frothy sputum, cyanosis. A medical emergency. Descend, oxygen, nifedipine.
Risk factors
What raises your personal risk.
- Rapid ascent - flying or driving directly to sleeping altitude above 3,000 m
- High sleeping altitude - the peak of the day matters less than where you sleep
- Previous episode of AMS, HAPE or HACE
- Dehydration and heavy exertion in the first 48 hours
- Cold exposure and inadequate rest
- Alcohol, opioids or other sedatives at altitude
- Obstructive sleep apnoea, pulmonary hypertension or significant cardiorespiratory disease
Assessment
What the consultation actually covers.
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Full medical and medication history
Cardiovascular fitness, respiratory conditions, prior altitude exposure and how you tolerated it.
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Itinerary and ascent profile review
Day-by-day sleeping altitude, rest days, evacuation options and the highest point of the trip.
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Comorbidity check
Asthma, sleep apnoea, hypertension, arrhythmia, pregnancy, diabetes and any interacting medication.
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Written personalised plan
Acclimatisation schedule, prophylaxis, emergency kit, symptom thresholds and evacuation triggers.
Prevention strategies
Acclimatise slowly - the single biggest factor.
- Above 3,000 m, aim for no more than 300 m of sleeping-altitude gain per day and add a rest day every 3-4 days
- "Climb high, sleep low" wherever the itinerary allows it
- Avoid alcohol and sedative sleeping tablets in the first 48 hours at altitude
- Hydrate steadily - 3-4 litres a day - and eat carbohydrate-rich meals
- Consider prophylactic acetazolamide when a fast ascent is unavoidable
- Never ascend further with symptoms of AMS - rest, and descend if they worsen
Medications and emergency kit
Prophylaxis and rescue - carry both.
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Acetazolamide (Diamox) 125-250 mg twice daily
Started 24 hours before ascent above 2,500 m for AMS prevention. Continued for the first 2-3 days at altitude or until acclimatised.
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Dexamethasone 4 mg every 6 hours
Emergency treatment for HACE and severe AMS. Buys time to descend, does not replace descent.
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Nifedipine 20-30 mg slow-release, twice daily
For HAPE-prone individuals as prevention, and as emergency treatment alongside descent and oxygen.
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Sildenafil or tadalafil
Second-line HAPE prevention for those with a documented history, discussed on a case-by-case basis.
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Anti-emetic and strong analgesic
For symptomatic relief of AMS headache and nausea - ibuprofen or paracetamol plus ondansetron.
Indicative pricing
What a private altitude consultation costs in London.
| Item | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Initial altitude medicine consultation with risk assessment and prescription | £150-£280 | 30-45 min | Same visit |
| Comprehensive expedition medicine consultation with emergency kit and written plan | £250-£450 | 60 min | Same visit |
| Combined altitude + travel vaccination package | £280-£550 | 60-75 min | Same visit |
| Emergency kit (acetazolamide, dexamethasone, nifedipine, anti-emetic) | £45-£120 | - | Same visit |
Where to go in London and the UK
Clinics with genuine altitude-medicine experience.
- Fleet Street Clinic Travel Health, London
- Hospital for Tropical Diseases and London School of Hygiene & Tropical Medicine Travel Clinic
- Nomad Travel Clinics (nationwide)
- MASTA Travel Health
- Wilderness Medicine Society trained GPs and expedition doctors
- Fell Foot Trekking Medicine and independent expedition medicine practices
When to seek urgent care abroad
If symptoms worsen, descend. Everything else is a bridge.
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Descend 500-1,000 m immediately
The single most effective treatment. Do not wait until morning if symptoms are worsening.
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Portable altitude chamber (Gamow bag)
Used by expedition guides to simulate descent when physical descent is impossible.
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Supplemental oxygen
Available at higher tea houses and expedition camps. Bridges to descent or evacuation.
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Medical evacuation
Helicopter for HAPE or HACE. Ensure your insurance covers altitude-related evacuation to the peak altitude of your trip.
Related
Related treatments and tests.
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Travel vaccination and malaria clinic
Yellow fever, typhoid, hepatitis A, rabies and malaria prescribing.
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Dive medical (HSE / SPUMS)
Fitness-to-dive certificates for recreational and commercial diving.
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Aviation medical Class 1 / 2
CAA and EASA pilot medicals.
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CPEX / CPET testing
Cardiopulmonary exercise testing to quantify fitness for altitude and expeditions.
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Asthma
Optimising control before high-altitude and cold-air exposure.
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Sleep apnoea
A significant risk factor at altitude - assessment and CPAP travel planning.
Frequently asked
Altitude medicine, honestly answered.
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Do I really need Diamox for Kilimanjaro?
Most people climbing Kilimanjaro on the standard 6-7 day itineraries benefit from prophylactic acetazolamide. The ascent profile is fast for the altitude reached (5,895 m), and rates of AMS above 50% are typical without prophylaxis. A 125 mg twice-daily dose, started the day before ascent, materially reduces incidence and severity.
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Will private travel insurance cover altitude illness and evacuation?
Standard policies rarely cover trekking above 2,500 m and almost never cover helicopter evacuation from high altitude. You need a specialist policy from a provider such as True Traveller, BMC, Global Rescue or Ripcord, with a stated altitude ceiling that matches your itinerary peak.
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I have sleep apnoea - can I still go to altitude?
Yes, in most cases, but it needs planning. Untreated obstructive sleep apnoea worsens the hypoxia of altitude and increases AMS risk. We assess CPAP travel logistics, discuss acetazolamide (which improves both central and peripheral apnoea at altitude) and set clear symptom thresholds.
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What altitude cover should my insurance state?
Match your policy ceiling to the highest point you sleep at, not the highest point you reach in daylight, and add a safety margin. Everest Base Camp trekkers need cover to at least 6,000 m; Kilimanjaro to 6,000 m; Aconcagua to 7,000 m; and technical 7,000 m peaks to 8,000 m.
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Is it safe to go to altitude while pregnant?
Short trips up to around 2,500 m are generally considered safe in an uncomplicated pregnancy. Above that, and for any pregnancy with complications, we advise against sustained exposure. Acetazolamide is not recommended in pregnancy, which further limits options.
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I take medication for a chronic condition - what changes at altitude?
Several conditions need active planning: hypertension often worsens transiently; anticoagulation risk is higher; asthma inhalers should be doubled up as spares; insulin dosing may change with exertion and cold; and any sedating medication should be reviewed. We reconcile every medication against your itinerary.
Plan your trip properly
Book an altitude medicine consultation before you fly.
Same-week London appointments. Itinerary-matched written plan, prescription, and an emergency kit you can pack. We are independent, so the recommendation is impartial.