The body needs time to acclimate to higher altitude. However, the time it takes to adapt varies from person to person.
Ascend at a moderate rate, averaging 1,000 feet a day in net elevation gain. If you are doing double carries, this may mean establishing camps at 2,000-foot intervals so that you carry one day and move camp the next, for a net gain of 2,000 feet every two days. If the suitable campsites are 3,000 feet apart, you can carry one day, move camp the next, and rest the third day, for a net gain of 3,000 feet every three days. Try not to overdo your efforts until you've become well acclimated, and schedule rest days after big pushes.
Hydration is critical in avoiding altitude sickness. Rather than relying on a figure for daily liquid consumption, such as 4 quarts per person, monitor your urine output and color. A good rule of thumb is that urine should be copious and clear, while dark urine indicates you're not drinking enough water.
Above 18,000 feet, most people begin to deteriorate physically regardless of acclimatization. Minimize the stays at high altitudes and periodically return to lower altitudes to recover. The old advice is good: Climb high, sleep low. The body acclimates much faster during exertion than during rest, and recovers more quickly at a lower altitude. Expedition-style climbing takes advantage of these concepts in carrying loads to a high camp, returning to lower altitude to recover, then ascending again.
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