Asthma at altitudes

Dear Mt Doc,
My wife and I have been planning a 7 day trek in Peru, which involves acclimating for 2 days at 11,500″ (Cuzco) before ascending to just over 15,000, then descending to Machu Picchu. She has been treated for asthma for years. She is 59 years of age and quite active and fit, and is keen to do this trip. Your advice would be appreciated.


Thanks for your question. There is no strong evidence that asthma itself is affected by altitude and anecdotally some asthmatics may actually improve.

If your wife’s asthma is well controlled then she will be running on a normal level of blood oxygen and therefore the asthma should not contribute to an increased risk of hypoxia.

What is you wife’s asthma triggered by? Cold? Exercise? Allergens?

There is a theoretic risk that, if it is triggered by cold/dry air then she may get more wheezy doing the same level of exercise at altitude than she would at lower levels, however if she exercises without problems on a cold, dry winters day at home then this is unlikely to be a problem. A lot of asthmatics wheeze is triggered by allergens and there are actually less of these at altitude – less dust, pollen etc   – so that theoretically these asthmatics might actually have an improvement in symptoms.


The key points are

– should make sure her asthma is as well controlled as possible – this includes medication and general fitness.

– she should keep her medication with her all the time – not carried with the porter.

– she should be aware of the signs of altitude illness or worsening asthma and should not hesitate to turn around and descend if any problems occur.


It is important that you stick to the guidelines of not ascending more than 300-500m/day sleeping altitude.


On a personal note I am an asthmatic whose asthma is triggered by cold, exercise and allergens. I have very well controlled asthma ( long term steroids and beta agonists) and I have never had any problems with my asthma at altitude (including in Peru) however I have had AMS!


I hope this helps



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Health certificates

I have been asked to provide a medical certificate for treekking in tibet to say I am able to walk at 6000 metres. However my gp will only write a general health status letter and says cannot be specific about altitude etc.  Just wanted to check if such a certificate is possible to obtain.

Many thanks



Your GP is correct that it is not possible to be specific about someones health at altitude. No one can guarantee how a person is going to deal with altitude no matter how fit and healthy they are at sea level, so what the trekking company is asking for is impossible. The only thing your GP can give is an honest general health assessment. I would be interested to know the name of the company?
  Dr Kitty Duncan. altitude.org

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