High Altitude Trekking

Hi All.
Newbie here.
I’m planning to trek to Everest Base Camp, and was wondering if there are any thal minors on here who have done it, or done other treks at 5000+ metres above sea level.
I’ve seen a couple of older threads on this forum broaching the subject, however I was wondering if there had been any newer attempts at it.
I’ve contacted the International Society of Mountain Medicine and asked if they had any advice for any thalassemia minor’s for such an adventure. Below are their responses:
Anyway, hoping for some success stories for anyone on here to boost my confidence.

Dr. No. 1 –
I travelled with a group on a trek to Tengboche some years ago and one of the members had Thal minor. She was pretty athletic at sea level and did really well till we arrived in Namche The afternoon we arrived she was fine but by morning she was tired, anorexic and "not herself" Over the course of the "acclimatization day" the other group members did better and improved but this person was much slower to acclimate and had lower Sp02. Unwilling to turn back she made it up to Tengboche against advice and stayed the night there and descended to Namche the next day with some improvement and became significantly better on the way back to Lukla
In summary - much slower to acclimate - prob not ideal with the usual commercial group schedules, Maybe have a Sat monitor and a responsible companion / group leader able to monitor and apply AMS scoring and diagnosis

Dr. No. 2
Hi all, I have experience of one colleague with Th minor who participated to a research project at the Pyramid Lab. At sea level, her Hb was 10.8. We followed a very slow ascent profile spending 3 nights at 3500 m (Namche Bazar) and 3 nights in Pheriche (4200 m) before arriving at 5050 m. She has the same good acclimatization as the others and her SpO2 (that we monitored continuously) was not lower. Undoubtedly, the ascent profile assured a good acclimatization and I have no idea how it would be with a faster rise. Probably Dr. 1. is right: be careful to usual commercial groups schedules

Dr. No. 3
There are no publications about thalassemia minor (probably beta?) and altitude,
reflecting probably the lack of problems, as it is a common condition, especially in Mediterranean populations. These persons are usually asymptomatic (and many don’t know their condition). They may be slightly anemic, so better to look at Hb level before travel to HA. But usually they don’t have iron deficiency, so there is no indication (or even a contra-indication) to give them iron supplementation. For trekking to Everest Base Camp, minor differences in Hb level or Hb oxygen affinity (increased HbF) compared to other participants will probably not make a significant difference in acclimatization or performance. (Discussion could be different in case of expedition to higher altitude and for longer time, but again we don’t have data).

Dr. No. 4

Having no experience of treating thalassemia minor at altitude, I just guess what will occur to him or her. In normal persons hemoglobin and hematocrit rise at altitude because of increased erythropoietin, but his or her product of red blood cell will not rise rapidly or at all. He or she seem to need more time for acclimatization, so the team should elevate altitude to stay more slowly than usual. His or her Lake Louise score will be the good standard.

It would be of great benefit if you could be at high altitude for at least 3 weeks before you start the trek. After 3 weeks, the hemoglobin level rises to compensate for less oxygen at the high altitude. You already have plenty of RBC's, but this will raise your actual hemoglobin level, enabling your body to transport more oxygen. This affects everyone, including thals, enough to the extent that fake healers in some countries will send majors to high altitude to "cure" them by raising the Hb a couple points. While this will help a minor, it does little for a major.  In addition, I would say you must have an emergency oxygen supply with you. And yes, your party should pace themselves according to your ability to keep up.

For those of you who are interested in doing this, I completed Everest base camp successfully (5360m above sea level) and also got to the summit of Kala Pattar (5550m above sea level).

Some notes:
* Both my travel doctor and my GP didn't think the thalassemia was an issue.
* I went on a custom trek with an extended itinerary, 16 days in total (12 days up, 4 days down).
* My GP prescribed me with a drug called Diamox which helps people to acclimatise to high altitudes. I used it on the last two days going up - this was more because my SP02 readings on the pulse oximeter were a bit low so I wanted the extra assurance - not so much because I was feeling unwell.