There are seven main factors that affect the incidence and severity of Kilimanjaro altitude sickness ...
1. Rate of ascent
2. Altitude attained
3. Length of exposure
4. Level of exertion
5. Hydration and diet
6. Inherent physiological susceptibility
7. Use of oxygen systems or drugs
The following three techniques are commonly used to assist acclimatisation
High water intake : A fluid intake of 4 to 5 litres per day is recommended. Fluid intake improves circulation and most other bodily functions, but does not increase fluid leakage from the body. Thirst should not be an indicator of proper fluid intake, if your urine is clear then you are drinking enough.
Walk slow : Pace is a critical factor on all routes. Unless there is a very steep uphill section your breathing rate should be the same as if you were walking down a street. If you cannot hold a conversation you are walking too fast. Breathing through the nose for the first 2 days of the trek will limit the pace. Walk "softly" allowing your knees to gently cushion each pace. "Pole pole" ... slowly slowly ... is the phrase that will echo around your head as it is repeated to you by the Kilimanjaro guides.
Walk high sleep low : If you have enough energy and are not feeling the effects of altitude, then you might take an afternoon stroll further up the mountain before descending to sleep. All our routes already include these recommended acclimatisation walks whenever possible.
Diamox : Diamox is a drug which can be taken to assist the body by improving the efficiency with which oxygen can be absorbed from the thin air. There is no disputing the efficacy of the drug. There is however a big debate as to whether and how Diamox should be used. There are three ways to use Diamox when trekking Kilimanjaro ... The first way is to use it as a preventive throughout the trip starting from the day before the climb. The conventional argument against doing this is that it conceals the symptoms of body under-performance, thus increasing the chances of a failure if one does occur being catastrophic.
The second way is to "listen to your body" until day 3 (6 day climbs) or day 4 (7 day climbs) and then, if you are not demonstrating any severe symptoms, to take Diamox as directed above to boost your performance at higher camps. The argument against is the same as previous. The third way is to only use Diamox as a treatment for altitude illness. This is reasonable, but severe symptoms can only be treated by removal from altitude. We carry enough Diamox in our medical boxes for the second and third options. This should not be taken as an indication of our advocating this course of action. The choice is yours and we suggest that you consult your doctor and do some background reading on the subject if you remain unsure. We estimate that most climbers will take Diamox in some form during the climb.
Diamox has a proven medical dosage of 750mg. That is not to say that a lesser dosage will not work, but that for the manufacturers need this dosage to prove its efficacy 100%. In our experience 500mg seems to work. More importantly, you don't need to pee ALL the time with this dosage, only most of the time. Quite a lot of clients are still recommended only 125mg or 250mg by their doctors. If, as the medical literature states, Diamox does not disguise serious symptoms of altitude sickness, then the consideration of whether or not to take it is more to do with the trekker's individual attitude towards taking drugs as preventatives. Ultimately it is your choice and we will work around your decision. There is little doubt that taking Diamox will significantly increase your chances of summiting.
Last more general comment. Doctors in general practice back home may have very little idea about Diamox, therefore the advice that climbers get varies enormously. If you really want to get the full information, then ask your doctor to refer you to a specialist.
Simulated altitude training : There are also certain centres around the world which are able to provide training facilities which simulate the effects of altitude. It is very rare for trekkers to use such a facility, but if you happen to have one close by, why not?