Altitude Sickness and Trek Challenges on the Manaslu Circuit

  • Last Updated on Jun 27, 2025

The Manaslu Circuit Trek is one of the off the beaten trekking path located in the west Central Part of Nepal. Most of the parts of trekking trail falls in the Manaslu Conservation area offering a brief look on to the rare flora and fauna in the Manaslu region. Varieties in landscapes, diversity, cultural immersion, and rough trekking path are the main central attraction during the Manaslu Circuit Trekking. This is moderately challanging trekking route in the Himalayas of Nepal. As you have to pass high elevation pass i.e. Larky La Pass at an altitude of 5106 meters, there is a high chance of suffering from altitude sickness.

The Circuit Trek is famous for its beauty and its challenges. It circles Mount Manaslu (8,163 m), the eighth highest mountain in the world. You walk through small villages, thick forests, and high mountain passes. It’s not an easy walk with long days, rough paths, changeable weather, and thin air all make it tough. In this blog, I’ll talk about what makes this trek hard and give simple ideas to help you handle it.

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What Makes the Manaslu Circuit Expedition Challenging?

The Manaslu Circuit Expedition is relatively known as the moderately difficult trekking route in the Himalayas of Nepal. It is one of the best alternative to the major two famous treks in Nepal i.e. Everest Base Camp Trek and Annapurna Base Camp Trek. The trek to Manaslu Circuit is considered difficult due to various factors. Some of the factors making the Manaslu challanges are discussed below:

Altitude

One of the big challenge is the altitude. You start around 600–700 m above sea level. You slowly climb through forests and villages. By Namrung (3,350 m), the air feels thinner. Then you go to Samagaun (3,530 m) and Samdo (3,860 m). From Samdo, you head to Dharmsala (4,460 m), also called “Pyramidal Camp.” This is where you rest before crossing Larkya La Pass at 5,160 m. Above 5,000 m, the air has almost half the oxygen you get at sea level. You might get headaches, feel tired, dizzy, or lose your appetite. Going down after the pass can still be tricky your body needs time to adjust. If you rush up too fast, you risk altitude sickness, which can be more than just a headache it can knock you flat for a day or two.

Challenging landscapes and trail Conditions

The path to the Manaslu Circuit is not a smooth sidewalk. Imagine scrambling over loose rocks, sidestepping slippery sections, and sometimes climbing or descending steep switchbacks with only a thin rope or rail for balance. After a few hours, your ankles and knees will remind you they’re working hard. You’ll want sturdy boots with good grip and maybe trekking poles to steady yourself. Even then, muddy patches or sudden drop offs can catch you off guard, so it’s easy to feel exhausted at the end of each day.

Longer walking days and duration

You’ll find yourself on the trail for 7–9 hours (including breaks) almost every day. It is not the kind of walk where you pop into a cafe for lunch; you carry snacks in your pack, and lunch might be a simple dal bhat in a small tea house. Starting at sunrise, you wll hike until late afternoon or early evening. When your legs start to ache and the sun’s getting lower, stopping just feels like the right thing to do. You learn to break the day into chunks.

Physical Demands

Beyond just walking, your muscles, joints, and feet take a beating. Your legs are lifting your pack uphill, controlling your descent downhill, and balancing on uneven ground all day. Even if you’re generally fit, your knees and ankles will ache. Blisters are common maybe not right away, but by the end of a long day, those hot spots under your toes will remind you to check your boots and socks. And carrying 10–12 kilos of gear (water, extra clothes, snacks) adds up. Expect to stretch a lot at night and maybe ice any swollen spots you notice

Remoteness

Once you’re a few days into the circuit, cell service vanishes and “real” towns disappear. Tea houses become your little hubs tin roof huts where you sleep on a thin mattress and eat whatever dal, rice, or noodles they have. If something goes wrong (a twisted ankle or a sudden fever), getting help can mean waiting for a helicopter or trekking out for hours. There’s no coffee chain or clinic around the corner, so you learn to take whatever “medicine” is on hand rest, ginger tea, and hope. This remoteness can be exhilarating (it feels like you’re the only people for miles) but also intense if you’re not used to being out of touch.

Taken together, these factors (thin air, rough trails, long hours, unpredictable weather, physical wear and tear, mental grit, and true back country isolation) make the Manaslu Circuit one of those treks you’ll remember forever and probably tell everyone back home about. But if you go in prepared both mentally and physically, with good gear, patience, and a sense of humor you’ll realize these “challenges” are also what make the trail special. Stay flexible, listen to your body, and pack enough layers to handle sun, rain, wind, and cold within the same day. 

How Hard Is the Manaslu Circuit Hike?  

The Manaslu Circuit Hike is one of the trickiest and challenging trek around Mt. Manaslu. On this trail, most days you’ll be walking six to eight hours. Some days can go up to ten hours if you need to reach a safe place before the weather turns bad. The paths are often rocky and steep. You might be on narrow trails with loose stones under your feet. In spring or late autumn, snow can make things slippery. Sometimes you cross rivers on simple bamboo or wooden bridges. If you only hike gentle hills back home, this is a big step up. Good fitness and some previous trekking help a lot.

Getting Used to the Altitude

To avoid altitude sickness, many trekkers follow “climb high, sleep low.” That means you hike up to a higher point during the day, then return to a lower place to sleep. This helps your body adapt slowly. People often take a rest day at Samdo or Dharmsala before trying Larky La. On rest days, do short walks, drink lots of water, and eat simple, healthy food. Staying hydrated is very important at higher altitudes, you lose water faster. Some trekkers carry acetazolamide (Diamox) after talking to a doctor. This can help you adjust, but it’s not a magic fix. It should be a backup, not the main plan.

Trail and Weather Challenges

The Manaslu Circuit takes you through forests, rice fields, alpine meadows, glaciers, and rocky areas. In spring (March to May), lower parts are warm, but higher parts may still have snow. Fresh snow can hide the trail, making it hard to find your way. In autumn (September to November), skies are clear, but after mid-November, early snow is possible. During the monsoon (June to August), landslides and leeches in lower areas are common. Streams can swell, and paths get muddy or blocked. Crossing rivers on logs or simple bridges is part of the trip but dangerous when water is high. Even if the sun is shining, the UV rays are stronger at high altitude. Good sunglasses are a must. Temperatures can swing a lot: a sunny midday hike might feel okay, but once you stop or the sun goes down, it gets very cold.

Weather conditions at mountains are unpredictable. One minute it’s sunny and clear, and the next, clouds roll in, and it’s raining (or snowing) hard. In spring or fall, you can usually predict good weather in the mornings, but afternoon storms still happen. You might put on a rain jacket, then take it off ten minutes later when the sun pops out again. In the high passes, wind can get icy, and the temperature can plunge in minutes. It’s a constant dance of “layers on, layers off,” and carrying waterproofs that you hope you won’t have to unzip and pack up every single day.

Getting Fit Before the Trek

With long days and rough ground, being in good shape helps a lot. You don’t need to be an athlete, but you should be able to walk 20 km on uneven ground with a 10–12 kg backpack. In the weeks before the trek, try doing at least three long hikes each week. If you live near hills, practice there. If not, climb stairs or use a treadmill with an incline. Strengthen your legs, core, and back to avoid injuries. Cardio workouts like running, cycling, or swimming boost your stamina. And practice carrying your loaded backpack so your body gets used to the weight.

Mental and Emotional Hurdles

It’s not just your body that will be tested. Nights in basic teahouses or tents sometimes without hot showers can be tough. You might also feel your head starting to wander: “How many more hours?” “Is that the pass yet?” Long stretches without much variety just mountains and trails mean boredom and self doubt can creep in. You’ll deal with nagging little things: Did I pack enough food? Am I getting slower than the others? When the trail feels endless and you’ve been walking since dawn, you have to remind yourself: “One more step, one more mile.” Finding small things to focus on like watching yaks graze or chatting with a local guide helps break the day into manageable pieces.

For days, you might see very few people or shops. From Lho to Samdo, there are long stretches with no villages. If you like cozy hotels or many food choices, you’ll feel out of your comfort zone. Before the pass, you might worry about the weather or wonder if you have enough strength. Feeling low at 5,000 m is normal. Mental toughness comes from knowing why you’re here. Many say the stunning Himalayan views make every hardship worth it. Setting small goals like “just reach the next teahouse” can keep you going.

Managing Altitude Sickness on the Trail

Watch for signs of acute mountain sickness (AMS). If you get a headache, feel nauseous, or have trouble sleeping, slow down and rest. Drink more water. If you start vomiting, have a bad headache, or can’t catch your breath, it’s time to go down. Some guides carry oxygen bottles or portable hyperbaric bags (Gamow bags) for emergencies. Avoid alcohol and smoking they worsen dehydration and breathing. Eat small meals rich in carbs (rice, noodles, bread) for energy. Sometimes a warm bowl of soup is all you need to feel better and eat more.

Simple Tips for a Safer Trek

  • Hire a Local Guide or Porter as a guide knows the trail and weather and porter carries your load so you can walk more easily.
  • Get the Right Permits as the Manaslu area is restricted. You need a Manaslu Conservation Area Permit and a TIMS (Trekkers’ Information Management System) card. This keeps the area protected and you safe.
  • Pack Smartly in layers: a base layer, a fleece, and a down jacket. Good trekking boots with ankle support are a must. Pack extra socks, a warm hat, and gloves.
  • Watch the Weather as Mountain weather can change fast. If you see clouds building in the afternoon, think about stopping early. You don’t want to be stuck on Larky La in bad weather.
  • Listen to your body if you feel dizzy, have a headache that won’t go away, or your walking feels off, stop and rest. Pushing yourself too hard can lead to serious problems.

Conclusion

The Manaslu Circuit Trekking is an adventure for a lifetime. It’s tough long walking days, rocky trails, changing weather, and high altitude all make it hard. But that’s also what makes it special. With good preparation both physical and mental; and smart altitude tricks, you can do it safely. Every step shows you new Himalayan views, old villages, and wild, untouched land. If you accept the challenge, the Manaslu Circuit will leave you with a proud feeling and memories that stay with you forever.

Although tricky and challenging the 10 days Manaslu circuit trek offers adventurers a glimpse into the rare Himalayan cultures and traditions of Nepal. It is a perfect chance to challenge yourself to the new Himalayan expenditure. With proper planning and preparation, you will enjoy the majestic beauty of the Manaslu region in a safe and comfortable way. 

Suman Aryal

Suman Aryal

With over 15 years of experience in the tourism sector of Nepal, Suman is the Managing Director of Dream Heaven Adventure. His passion for trekking has taken him to nearly all of Nepal's popular regions, making him an authorized trekking and tour operator.

Suman has a particular affinity for traveling to the Himalayas, where he has gained deep knowledge about the region's religion, culture, and history. As a part-time blogger, Suman shares his research on the cultural and religious diversity of Nepal, providing his personal touch with insights from his decade-long experience. He also enjoys answering readers' queries with his expert knowledge and personal touch.