Why the first days matter
Leh is about 3,500 metres. Oxygen availability is lower from arrival. Rest and a gentle second day help the body adjust before higher passes and sleeping points.
Warning symptoms
Headache, nausea, unusual fatigue, dizziness and poor sleep can occur. Worsening symptoms, breathlessness at rest, confusion or loss of coordination require urgent medical assessment and descent.
What not to do
Do not fly in and drive directly to Pangong. Do not use strenuous exercise or a high pass to test yourself. Youth and fitness offer no immunity. Discuss medication with a qualified clinician.
Safer route design
Sleep in Leh for two nights, use gentle Indus Valley sightseeing and ascend gradually. Carry insurance covering intended altitude and evacuation.
Confirm weather, roads, permits, prices and local instructions near departure.