Annapurna Circuit Trek itinerary: the ultimate guide
The Annapurna Circuit trek was once one of the most popular hikes in Nepal. In about a month it was possible to walk around the Annapurna mountain peaks. This trek was famous for its ethnic villages, natural beauty and easy access from Kathmandu or Pokhara.
But the Annapurna Circuit trek has changed tremendously in recent years. There was a time that the further up you went, the more isolated the villages were. It took people days on foot to reach the nearest city, the nearest school or the nearest health care post. For tourists, this remoteness was part of the charm.
Ongoing road construction now connects most villages on the Annapurna Circuit with the outside world. Jeeps drive up and down on dusty roads, changing the landscape for good while tourists planning a trek in Nepal are wondering whether the Annapurna Circuit trek is still worth it.
Why choose the Annapurna Circuit trek
Despite the new roads going up the Marsyangdi and Kali Gandaki valleys, the Annapurna Circuit trek is still very much worth it. Although many things have changed with the new road, a lot also remains the same. People are just as friendly, the villages just as authentic and the mountain views just as spectacular.
In short, it is still a very beautiful trek with a huge variety in landscapes, villages and people. The road itself is nothing more than a dirt track and actually carries relatively little traffic. In addition, there are plenty of alternative side trails to bypass it all together. The NATT trails set up by Prem Rai and Andrees de Ruiter are well marked and follow the traditional circuit, but avoid the road as much as possible.
The Annapurna Circuit trek requires a certain amount of time, but most of the hike is easygoing. Gradual climbs and well marked trails with frequent restaurants and lodges to take a break. What makes it challenging is the tough day you climb the Thorung La Pass and the altitude after Manang.
To prevent altitude sickness it is important to give yourself enough time to acclimatize. Don’t go up too fast and take some days to rest. The better your body has adjusted to the height, the easier the climb up to Thorung La will be.
This was my first trek in Nepal and even though many others followed such as the Langtang Trek, Poon Hill trek and The Gokyo lakes trek, I still consider myself an amateur hiker. Thorung La was difficult, but I made it. If I can do it, you can too as long as you prepare well.
Annapurna Circuit trek itinerary
The classic Annapurna Circuit trek itinerary started in Besisahar where you climbed up the Marsyangdi valley towards Manang, crossed the Thorung La Pass, visited Muktinath and Jomsom and then walked down the Kali Gandaki valley towards Beni. This took about 20 – 30 days
The roads give you more flexibility in where to start or end the trail as well as how much time you take. Jeeps go as far up as Manang on the Marsyangdi valley side and Muktinath on the Kali Gandaki valley side.
Clockwise or anti Clockwise ?
The Annapurna Circuit Trek is a loop with different starting and end points. The first thing to decide is whether you hike clockwise starting at the Kali Gandaki valley or anti clockwise starting at the Marsyangdi valley.
The general advice and also my recommendation is to hike anti clockwise from east to west. This is the easier and safer direction to go. The Marsyangdi valley offers a more gradual climb and Manang is a great village to acclimatize well before attempting Thorung La.
The Thorung La Pass is at 5416 meters high and altitude sickness is a serious risk. From Manang to Thorong La there are several more villages like Yak Kharka (4020 m) and Letdar (4230 m) to stop and acclimatize or get help if you do suffer from altitude sickness. Thorung Phedi (4450 m) and High Camp (4850 m) are the last lodges before the pass.
From west to east the last village is Muktinath (3750 m) and a few basic lodges at Charabu (4210 m). After the last lodge it is a very long and steep ascent to Thorung La with nothing in between. Taking this approach is not only more difficult and requires you to be very fit, it is also potentially dangerous. You go high quickly and without proper acclimatization small things like bad weather or an injury can become very problematic.
How much time?
The roads have made it possible to do the Annapurna Circuit trek in much less time than the original 20 – 30 days. Still, the Annapurna Circuit trek is an area where slow travel is very rewarding. The villages on the way are very interesting and a destination in their own right. Furthermore, there are lots of side trips to escape the crowds.
Another reason to take it slow on the Annapurna Circuit Trek is again the altitude. Yes it is possible to take a jeep all the way to Manang (3520), but you will not only miss out on lots of beautiful scenery, you will also increase your risk of getting altitude sickness.
Looking at the distances and trekking times it looks possible to trek from Manang to Thorong La in less than two days, but again, this would be very foolish. Experts advise to not ascend more than 300 – 400 meters per day once you are above 3000 meters high.
On the Annapurna Circuit trek this advice translates in at least one acclimatization day in Manang and another acclimatization day in Letdar before spending the night at Thorung Phedi. I followed exactly this advice and still struggled with the altitude when crossing the Thorung La pass.
Even if you are short on time, you need to acclimatize. You could do the Annapurna Circuit trek in 2 weeks if you decide to fly from Jomsom back to Pokhara. If you have more time, walking down the Kali Gandaki valley is definitely worth it. Although road construction has had a big impact here, I still enjoyed the villages of Marpha and Tukuche as well as the scenery from Tukuche to Letdar and Ghasa.
Where to start the Annapurna Circuit trek
With jeeps now going all the way to Manang, where to start the Annapurna Circuit trek has become a big question. I already mentioned that going straight to Manang isn’t the best idea for several reasons. In fact, my favorite trekking days were from Chame to Pisang and Pisang to Manang.
Some trekkers still decide to follow the original trek route and start at Besisahar. Because I had recently done the Poon Hill trek through the lower foothills of the Annapurna’s I decided to take a jeep up to Syange.
Others start at Bhulbhule or Chame. To help you decide it is maybe good to know that the road is most busy between Besisahar and Bhulbhule although there is an alternative NATT trail as well.
From Kathmandu there are direct buses all the way up to Bhulbhule. The direct bus is a great option if you like to start in Bhulbhule. After Bulbulhe If you prefer to start later on, it is better to take a bus to Besisahar and then change to local jeeps that go all the way to Syange, Chame or even Manang.
My personal advice is to start no further than Chame. The scenery after Chame is very beautiful.
Where to end the Annapurna Circuit
A lot of hikers end their Annapurna Circuit trek in Jomsom from where you can fly back to Pokhara. A comfortable option if you are short on time, but you will miss out on the beauty of the Kali Gandaki valley.
Marpha and Tukuche are very scenic traditional villages worth a visit. Furthermore, the hike from Tukuche to Lete and Ghasa is very beautiful. I hiked in the Kali Gandaki valley twice. The first time I ended my hike in Tatopani. A small village with warm water pools. The second time I ended my hike in Ghasa.
From both towns it is possible to take a jeep down to Beni. There you can change on a bus to Pokhara.
My Annapurna circuit trek itinerary
In this Annapurna Circuit trek itinerary I mention every day the amount of time it took me from start to finish. I am a slow hiker though. I like to take frequent breaks to enjoy the beautiful views. If you are a fit hiker, you can probably do it in less time
Day 1: Bus from Kathmandu to Besisahar/Syange
I started my Annapurna Circuit trek itinerary from Kathmandu where I took a bus to Besisahar. The original start of the trail. After a long and bumpy bus ride of 8 hours in a crowded bus I was happy to arrive for a late lunch.
I was curious about the new road all the way up to Manang. As I had recently done the Poon Hill trek I already saw the lower foothills of the Annapurnas in all its beauty and decided to skip the first two days of trekking by taking a jeep to Syange.
At the jeep station I quickly found a jeep that was slowly filling up. Jeeps leave mostly in the early mornings. It was already late in the afternoon and now it took at least two hours before the jeep had enough passengers and cargo.
It is only 30 kilometers from Besisahar to Syange, but the jeep journey took over 3 hours. I soon regretted my decision not to walk. The first part to Bhulbule was quite ok, but after that the road got really bad and scary.
I am glad I had a careful driver that knew what he was doing and took it slow. Not all drivers are like that in Nepal. There was even an extra person that frequently got out to check the road or to remove stones. Just as it got dark I saw the lodges of Syange.
Logistics: Direct buses to Besisahar (7 – 8 hours) and Bhulbule (8 – 9 hours) leave everyday from the Gongabu bus station (new bus park or Machapokhari) in Kathmandu. Get there early as it is a chaotic bus station and buses leave between 6 – 8 AM in the morning. It is best to reserve your tickets a day in advance at the bus station or at a travel agency in Thamel.
For destinations further up the trail (Syange, Ghermu, Chame, Pisang, Manang) take a bus to Besisahar. Jeeps leave from the jeep bus station in Besisahar. There is a dual price system with foreigners paying slightly more.
Personally, I would start walking in Bhulbule and certainly not go much further than Syange by jeep. After Bhulbhule the road is not in a very good condition and the journey will be adventurous to say the least.
Day 2: Syange – Tal
16 kilometers, 8 hours
I always feel excited on my first day of hiking. Being in the mountains with the fresh air feels invigorating. After an early breakfast I left Syange and immediately entered a narrow gorge where I shared the road with porters carrying chickens and goats.
Walking on the jeep road wasn’t as bad as I had imagined and there was little traffic. The scenery was nice with waterfalls on the other side of the road and the Marsyangdi river below.
The Marsyangdi river kept me company for the rest of the day. I had lunch in Chamye after which it was a steep climb over boulders up to Tal.
Insider tip: there is an alternative NATT trail from Ghermu to Jagat that bypasses the road. It is much longer and I heard the path is very narrow and close to the edge. With my fear of heights I decided to stay on the road.
Day 3: Tal – Danaque
11 kilometers, 5 hours
From Tal you can choose to make it a long day to Chame (20+ kilometers) or split it up in two days and spend the night somewhere in between.
I left Tal to see how far I would come today. Till Dharapani the trail was very quiet and scenic with several waterfalls. At Dharapani the trail joined the road again. Both Dharapani and Bagarchap are nice villages with lots of restaurants.
At Bagarchap I had my first Annapurna views and I stopped for lunch. I already knew Chame would be too far for me, but I could still hike a bit more and decided to continue to Danaque. A nice village with a Mani wall and prayer wheel.
Insider tip: It is possible to take an alternative NATT trail from Dharapani to Bagarchap up to the village of Odar. It adds 2 hours to your trekking time and is a steep 200 meter climb up and down again.
Day 4: Danaque – Chame
12 kilometers, 6 hours
Today started with a steep and long climb through the forests from Danaque to Timang. A difficult beginning, but the rewards were beautiful mountain views once I reached the top. After Timang the ascent became more gradual and passed the occasional village.
I noticed more and more Buddhist influences like mani walls, prayer wheels and chortens. The mountain views too became more beautiful as I approached Chame. A lively village right next to the Marsyangdi river.
Day 5: Chame – Pisang
14 kilometers, 7 hours
The part from Chame to Pisang was simply spectacular. Panoramas on the snow capped peaks of the Annapurna’s all day as I hiked along the Marsyangdi river. The increase in altitude is also visible as pine forests give way to open fields with sweeping views.
This was one of my favorite days on the Annapurna Circuit trek. Parts of the road were carved out of the side of the mountain and high above the river. With my fear of heights this was a bit of a challenge, but I made it.
When I arrived in Pisang it was tempting to stay in lower Pisang. I heard the views are much better from Upper Pisang though and so they were.
Day 6: Pisang – Manang
18 kilometers, 8 hours
Pisang to Manang was another beautiful day on the Annapurna Circuit trek. The trail is a gentle climb with beautiful views all around you. I enjoyed every minute of my hike, but also started to feel the effects of the altitude.
From Pisang to Manang you can choose to hike the easier lower trail or a more spectacular higher trail. Because I woke up with a slight headache I didn’t want to add 3 more hours to my hiking trail and choose the lower option on the road.
I am sure the higher trail offers even better views, but for me it was a good decision to take it easy. By the time I was in Manang (3540 m) I was having mild symptoms of Altitude sickness.
Day 7: Manang acclimatization
In Manang I had a much needed acclimatization day. My first night in Manang was a night of insomnia, vivid dreams and a mild throbbing headache that got only less in the early hours of the next day.
Manang is a small village, but there are lots of side trip possibilities. The strenuous hike to the ice lake is very popular, but I did not feel fit enough. Another popular hike is to Chongkor viewpoint where you can see a glacial lake. There are also several gompa’s in the area you can visit.
I went to the Chongkor viewpoint to see the lake and then visited the excellent information session about altitude sickness from the Himalayan Rescue Association. They give this for free every day at 3 pm.
Day 8: Manang (3540) – Yak kharka (4020)
10 kilometers, 5 hours
My second night in Manang I slept well and most of my mild symptoms of altitude sickness were gone. I therefore decided to continue to Yak Kharka. An elevation increase of 500 meters.
The climb was hard. Although the obvious symptoms were gone, I was more easily out of breath and every step seemed to take a lot of energy. The next village, Gunsang, was only 3 kilometers away but I took a long tea break.
With a cup of tea and the sun warming me up in the chilly morning air I still felt so lucky to be here. The views on the Annapurnas and the flocks of birds flying by were all so beautiful.
After Gunsang the landscape changed again to high altitude fields with shrubs and grazing goats. The trail climbs slowly to over 4000 meters high. Technically, the path is very easy, but my body was struggling more than ever.
I was glad to see the cluster of lodges at Yak Kharka. Yak Kharka translates as yak pastures and therefore it was no surprise to see a few yaks wandering around.
Day 9: Yak kharka (4020) – Letdar (4230)
2 kilometers, 2 hours
I slept well at Yak Kharka and woke up full of energy. However, after only 20 minutes of hiking I felt tired and out of breath. Luckily I had already made the wise decision to stay in Letdar.
Letdar is less than 2 kilometers from Yak Kharka and it is a very easy hike, but I can feel my body needs an extra night to adjust to the altitude.
Day 10: Letdar (4230) – Thorung Phedi (4540)
6 kilometers, 4 hours
With an extra night at Letdar I felt more prepared to continue to Thorung Phedi (4540). It was an easy hike except for a scary part where there is a risk of landslides. Thorung Phedi is right after that.
It is possible to continue to High Camp (4850). The last lodge before Thorung La, but the general advice is not to sleep here, because of the altitude. It does make for a great afternoon hike to help acclimatization
Day 11: Thorung phedi – Muktinath
15 kilometers, 10 hours
The day you cross Thorung La will be the most beautiful, but also most difficult day on the Annapurna Circuit Trek.
Most people start early as the weather is less windy in the morning. I started around 4 AM. The ascent to high camp was difficult and I definitely felt the altitude. At High Camp I was in doubt whether I should stay one more night here before attempting the pass.
After a quick cup of tea I pushed myself on to continue. It was difficult. Every few steps I was out of breath and had to stop. My head started hurting again and I felt very tired. There were many false summits and I started to wonder whether I should turn back.
After 4 hours I finally saw the bundle of prayer flags that is Thorung La at 5416 meter. I felt pure joy that I made it, but at the same time absolutely miserable because of the altitude. After a quick selfie I did not even want to stop for a cup of tea. All I wanted was to go to a lower altitude.
The first hour I happily hiked down and started to feel better by the minute. Then I realized that the 1600 meter descent to Muktinath is actually more difficult than the ascent. My knees started hurting, my muscles trembling.
It was a very long day. Looking down I could see Muktinath in the distance. Ít just didn’t seem to come closer. After 4 hours I arrived at a cluster of lodges called Charabu. If they weren’t full I would probably have stayed here.
After a quick dahl bath I had to continue to Muktinath. The last bit was the most difficult. I stumbled into the first lodge I saw, had dinner and went to bed.
Day 12: Muktinath – Kagbeni
12 kilometers, 4 hours
In Muktinath I woke up feeling all my muscles from the steep and long descent yesterday. Slowly I got out of bed. This is my third time in Muktinath. A small village home to an important Vishnu temple popular among Indian and Nepali pilgrims.
As jeeps now go all the way from Pokhara to Muktinath it is a busy town and a culture shock after the desolate stretch of barren rocks that I walked through yesterday. I brought a short visit to the temple and then walked straight to Jharkot.
Jharkot is a traditional village with mud and stone houses. The signs of animist religions that predate Hinduism and Buddhism give a clue to its old age. Rather than just passing by I would recommend to take a look and wander through the narrow streets for a bit.
After Jharkot it is a beautiful hike down to Kagbeni. Another traditional village that is at the border of Lower and Upper Mustang. Mustang was once an independent kingdom that played a big part in the salt trade between Tibet and Nepal.
Beyond Kagbeni lies Upper Mustang. A remote region that remains isolated and protected from mass tourism by expensive permits. Kagbeni is as far as you can get and gives a good sense of the unique culture of Upper Mustang that is still very close to that of Tibet.
Kagbeni is an interesting mix of new hotels and restaurants catering to tourists as well as medieval monasteries and ancient fortress ruins. The 15th century red monastery stands out between the whitewashed mud homes.
The Red House Lodge was one of the most interesting places where I stayed. It has its own 350 year old buddhist chapel and the best dried yak meat (yak sukuti).
Day 13: Kagbeni – Marpha
17 kilometers, 6 hours
The hike from Kagbeni to Jomsom follows the riverbed of the Kali Gandaki river. The Kali Gandaki valley lies in the rain shadow of the Annapurna mountains and therefore the landscapes are quite unique.
Barren desertlike mountains that differ in color. Different shades of brown, gray and yellow contrast sharply with the deep blue sky, white snow capped peaks and green farm fields.
South of Kagbeni starts Lower Mustang. An area home to the Thakali people that also played an important role in the salt trade. Between Kagbeni and Jomsom there is not much but spectacular landscapes.
Jomsom is the first Thakali village. Because of its airport it is very well developed and touristic. This is where most people end their Annapurna Circuit trek and take a plane back to Pokhara.
If you do decide to continue on foot it is much better to stay in Marpha. A more authentic Thakali village with an old monastery and the so-called apple capital of Nepal. I was not a big fan of the local dried apples, but the apple pies here were delicious.
Day 14: Marpha – Tukuche
7 kilometers, 3 hours
I thought Marpha was one of the most interesting villages on the Annapurna Circuit trek. Marpha alone is a reason why you should not stop at Jomsom.
Marpha is a true Thakali village and you can see that people have done much effort to preserve their traditional architecture and culture. Iconic are the flat mud roofs that are used to store stacks of firewood. The roofs are also used to dry the apples and other food items.
Rather than leaving in the morning to start hiking I spent some time exploring the village. There is a monastery in the center of the village as well as above the hill with beautiful views. You can also visit the apple gardens and taste apple products at the apple distillery.
The Thakali people are famous for their cuisine. Tibetan dishes like Thukpa (noodle soup) and Tsampa (barley porridge) are popular. But most famous are the Thakali sets. A more luxurious version of dahl bath with all kinds of extras like fermented spinach (gundruk) and pickles (aachar). I couldn’t resist having one for lunch before hitting the trail again.
Tukuche is only 7 kilometers away, but another picturesque Thakali village that is very well worth the detour from the main road. When I arrived they were filming a Nepali movie song and it seemed all the children of the village were out and about to see what was happening. I also enjoyed the show and decided to stay in Tukuche for the night.
Day 15: Tukuche – Ghasa
20 kilometers, 9 hours
After Tukuche the landscape started to become more green again with trees and bushes. Tukuche was the last lively Thakali village on the trail. The other villages were small with just a few lodges. They seemed rather empty and not that inviting.
I decided to hike all the way to Ghasa. It was a long day, but because it was downhill it was not that difficult. Right before Ghasa is a hanging bridge high above the river. I knew it was coming and with my fear of heights a scary experience.
Day 16: Ghasa – Tatopani
15 kilometers, 6 hours
This was going to be my last day of hiking on the Annapurna Circuit trek. Back to the lower altitudes of the Annapurna’s, the landscapes reminded me a lot of the Poon hill trek. Lush and green and also more warm and humid.
Yesterday’s day was maybe a bit too long for my liking, but the last kilometers of today I felt sad it would be over soon. Tatopani has several warm water pools annd they felt like a freat reward after 17 days on the road.
Day 17: Tatopani – Beni/Pokhara
From Tatopani I took the jeep to Beni. The road became more busy and there were not a lot of ways to avoid it. It is also possible to hike to Ghorepani and connect with the Poon Hill trek.
The Annapurna Circuit Trek Travel tips
Annapurna Circuit Trek Permits
For the Annapurna Circuit trek you need two permits.
TIMS card: The Trekkers information management card is necessary for almost all treks in Nepal. You can get your TIMS card at the Tourism Board office at Bhrikuti Mandap in Kathmandu. Bring your passport and two passport size photos. The TIMS card costs 2000 nepalese rupees.
Annapurna Conservation Area permit: For the Poonhill trek you also need a national park entrance permit. I recommend you to get it as well at the Tourism Board Office at Bhrikuti Mandap in Kathmandu. This costs 3000 nepalese rupees.
Independent or guide
The Annapurna Circuit trek is moderately difficult, but easy to do without a guide. The trails as well as the NATT trails are well marked. Unless you go off season there will be enough other hikers on the trail to keep you company.
I hiked the Annapurna Circuit alone and did not experience any problems. When hiking alone I always make sure not to hike after sunset and listen carefully to my body. At Manang I did feel mild symptoms of altitude sickness and took two acclimatization days as well as an extra night in Yak Kharka and Letdar.
If you are alone and not that experienced you might want to consider joining a guided trek or hiring a guide, porter or porter guide.
In Nepal there is a clear distinction between a porter and a guide. A guide shows you the way and can tell you more about the history and the culture of the places you visit. A porter will only carry your luggage. Despite their heavy burden they often walk far in front of you and might have reached the lodge when you are only midway. A porterguide is less common, but does both.
In Pokhara I can recommend the 3 sisters adventure trekking that works to empower women and trains women to become trekking guides in Nepal.
Accomodation on the Annapurna Circuit
Along the Annapurna Circuit trek there is plenty of accomodation and teahouses to choose from. They are basic and can’t be booked online beforehand. There is a first come first serve basis and some lodges are fully booked by big tour groups.
There are enough lodges that there will always be a bed for you somewhere. I trekked the Annapurna Circuit twice in spring and in November and never had any problems finding a place to stay.
The prices of accomodation is incredibly cheap, sometimes even free, but they do expect you to order dinner and breakfast at their establishment. Things like hot showers and WIFI are getting more common, but are sometimes at an extra cost.
Food on the Annapurna Circuit trek
The good thing about tea house treks in Nepal is that however basic lodges might be, the food is often quite good if you stick to Nepali cuisine. Yes, many lodges try all kinds of international dishes to attract tourists, but in my opinion often not the best choice.
When trekking in Nepal I eat Dahl bath at least once a day. This national dish of rice with lentils knows a huge variety in how it is prepared. Different vegetable curries from fermented spinach to roasted cauliflower and different pickles to spice it up. Not one dahl bath is the same. Other Nepali foods to try are Tibetan bread, Thukpa and Momo’s.
The Annapurna’s are a multicultural area with local foods as well. In Kagbeni it is possible to find yak meat on the menu. Marpha is the apple capital and has the best apple pies as well as dried apples. In the south are the Gurungs with specialities like dried meats (sukuti) and fermented leaf curries (gundruk).
When to go
The best time to go trekking in Nepal is Spring and autumn.
January and February are too cold with lots of snow on the trail. The Thorung La Pass will be closed due to heavy snowstorms and a risk of avalanches. By March/April the pass reopens again, but you can still expect snow at the higher altitudes.
April and May are the warmer months before the monsoon and a very good time for the Annapurna Circuit Trek. The blooming flowers and rhododendrons are a highlight in this period. At the lower altitudes it can already become hot, dusty and humid while the higher altitudes are comfortable.
June, July and August are the monsoon months. The Marsyangdi valley up to Manang sees lots of rainfalls. The trails will be muddy with lots of leeches, but the landscapes will be lush and green. The Kali Gandaki valley is in the rain shadow and sees much less rain.
September, October and November are the most popular months for trekking. Autumn brings clear blue skies and mild temperatures before the cold sets in in December. Autumn is also a festive season with the celebration of Dashain and Tihar. Nepal’s biggest festivals.
Regardless of the seasons, the weather conditions at Thorung La can change rapidly and there is always a chance of unstable weather, cold and snow storms. It is important to check the weather forecast before crossing Thorung La. A freak storm in October 2014 killed several trekkers as they got stuck in bad weather and snow.
The Annapurna Circuit trek involves a serious risk of altitude sickness. Crossing the Thorung La Pass at 5416 meters high requires proper acclimatization. To allow yourself enough time to do so, it is best to trek anti clockwise from east to west.
Experts advise to not ascend more than 300 – 400 meters per day once you are above 3000 meters high. Pisang (3310) is the first village above 3000 meters and that is why it is not wise to take a jeep straight to Manang at 3540 meters high. Those first days of walking at the lower altitudes are not only beautiful, but helps your body adjust to the increasing altitude.
For the Annapurna Circuit trek, the general advice is to spend at least one acclimatization day in Manang and another day in Letdar before spending the night at Thorung Phedi. I followed exactly this advice and still struggled with the altitude when crossing the Thorung La pass.
The key to prevent altitude sickness is to take it slow, give your body enough time to adjust to the height and to drink enough water. Diamox is a medicine that might help your body to acclimatize, but will not cure altitude sickness once you have severe symptoms. In that case, the only remedy is to go down to a lower altitude as soon as possible.
Mild symptoms may include being tired and more easily out of breath. More severe symptoms of high altitude sickness are headache, dizziness, trouble sleeping, breathing problems, loss of appetite, nausea and vomiting.
Severe symptoms indicate you are developing high altitude cerebral edema (HACE) or high altitude pulmonary edema (HAPE). Both conditions are fatal if you do not get to a lower altitude on time.
Take these symptoms seriously and watch out for symptoms in others, even in your nepali guides or porters. It is a misconception that they cannot get altitude sickness. The health clinic in Manang gives daily information sessions about altitude sickness that I can highly recommend.
Annapurna Circuit Trek Books and Guides
Cicerone and trailblazer both have excellent and comprehensive guides about treks in Nepal with detailed guides about the Annapurna. Another option is the Lonely Planet’s trekking in the Nepal Himalayas guide.
The Himalayan Map house published the guidebook from Prem Rai and Andrees de Ruiter who developed the NATT trails on the Annapurna Circuit trek.
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