AMS on Manaslu Circuit: Symptoms, Prevention, and Emergency Evacuation Options (2027-2028)

AMS on Manaslu Circuit, Altitude sickness is the single greatest health risk on the Manaslu Circuit. More than any other factor—terrain, weather, distance, or fatigue—the lack of oxygen at high elevations determines whether trekkers succeed or fail, stay healthy or become dangerously ill.

The Manaslu Circuit reaches 5,160 meters at Larkya La Pass. At this altitude, the air contains only 50% of the oxygen available at sea level. Every trekker experiences some degree of altitude-related stress. For some, it remains mild. For others, it becomes a life-threatening emergency.

Understanding Acute Mountain Sickness (AMS)—its symptoms, prevention, and treatment—is not optional for the Manaslu Circuit. It is essential knowledge that every trekker must possess before setting foot on the trail. This guide provides comprehensive, practical information to help you recognize AMS early, respond appropriately, and know when evacuation becomes necessary.

For a complete overview of the trek, refer to our Best Manaslu Circuit Trek Guide 2026 and 2027 | Complete Manaslu Trekking Information .

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What is Acute Mountain Sickness (AMS)?

Acute Mountain Sickness (AMS) is the body’s negative response to reduced oxygen levels at high altitude. When you ascend faster than your body can adapt, symptoms develop.

The Science Behind AMS

At sea level, normal oxygen saturation in the blood is 95-100%. At 3,500 meters (typical elevation of Samagaon on the Manaslu Circuit), oxygen saturation drops to 85-90% in healthy individuals. At 5,160 meters (Larkya La Pass), it can fall to 75-80%.

Your body attempts to compensate by:

• Breathing faster and deeper
• Increasing heart rate
• Producing more red blood cells
• Changing blood flow patterns to the brain

These adaptations take time—typically 2-4 days at a given altitude. When you climb faster than your body can adapt, AMS develops.

Who Gets AMS?

Anyone can get AMS regardless of age, fitness level, or previous altitude experience. Being young, fit, or having trekked at altitude before does not make you immune. In fact, young fit men are statistically among the most common AMS victims because they tend to ascend too quickly.

For a deeper understanding of the physical challenges on this trek, consult our Manaslu Circuit Trek Difficulty 2026-2027: How to Prepare for the Challenge .

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Why AMS Risk is Higher on the Manaslu Circuit

The Manaslu Circuit presents specific factors that increase AMS risk compared to some other Himalayan treks.

Rapid Ascent Profile

Unlike the Everest Base Camp trek, which has a more gradual elevation profile, the Manaslu Circuit gains altitude quickly in certain sections. From Samagaon (3,520m) to Dharamsala (4,460m) to Larkya La (5,160m), the ascent rate exceeds recommended guidelines.

Limited Evacuation Options

On the Annapurna Circuit, road access allows vehicle evacuation to lower elevations. On the Manaslu Circuit, no roads exist on the northern and eastern sections. Evacuation requires helicopter or a multi-day walk down—neither ideal for severe AMS.

Remote Teahouse Locations

Teahouses on the Manaslu Circuit are spaced far apart. If AMS develops at Dharamsala (4,460m), the nearest lower village (Samdo at 3,850m) is a 5-6 hour walk away. This distance complicates descent-based treatment.

Weather Constraints

Larkya La Pass weather can deteriorate rapidly. Trekkers may feel pressure to cross on a specific day regardless of symptoms, leading to poor decisions.

For detailed guidance on physical preparation to minimize AMS risk, explore our How to Prepare for Manaslu Circuit Trek: The Ultimate Guide to Fitness, Permits, and Safety .

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Altitude Profile of the Manaslu Circuit

Understanding the altitude profile helps you plan acclimatization. Here are the key elevations on the standard itinerary:

Location	Altitude (meters)	Altitude (feet)	Days from Start
Kathmandu	1,400	4,593	Day 1
Machha Khola	870	2,854	Day 2
Jagat	1,340	4,396	Day 3
Deng	1,865	6,118	Day 4
Namrung	2,660	8,727	Day 5
Lho	3,180	10,433	Day 6
Samagaon	3,520	11,549	Day 7
Samdo	3,850	12,631	Day 9
Dharamsala	4,460	14,633	Day 11
Larkya La Pass	5,160	16,929	Day 12
Bimtang	3,590	11,778	Day 12 (after pass)

Critical Observation

The Manaslu Circuit gains approximately 2,800 meters between Day 2 (Machha Khola, 870m) and Day 7 (Samagaon, 3,520m). This is a rapid ascent by medical standards. The itinerary includes acclimatization days specifically to address this challenge.

For detailed daily breakdowns and alternative itineraries that optimize acclimatization, see our Best Guide to the Manaslu Circuit Trek Itinerary 2026 and 2027: What, Why, and When .

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AMS Symptoms: Recognizing the Warning Signs

Recognizing AMS early is critical. Symptoms can appear within 6-12 hours of reaching a new altitude.

Mild AMS (Common, Not Dangerous)

Mild AMS affects 40-60% of trekkers above 3,500 meters. It is uncomfortable but not dangerous if managed properly.

Symptoms include:

• Headache (most common symptom)
• Fatigue or weakness
• Dizziness or lightheadedness
• Nausea or loss of appetite
• Difficulty sleeping
• Shortness of breath with minimal exertion

What to do: Stop ascending. Rest at current altitude. Hydrate. Take mild pain relievers for headache. Symptoms should improve within 24-48 hours.

Moderate AMS (Warning Sign)

Moderate AMS indicates your body is struggling. Do not ascend further.

Symptoms include:

• Severe headache not relieved by medication
• Persistent nausea with vomiting
• Increasing fatigue making walking difficult
• Shortness of breath even at rest
• Decreased urine output

What to do: Immediate descent of 300-500 meters is strongly recommended. Do not ascend until symptoms completely resolve.

Severe AMS (Medical Emergency)

Severe AMS is a medical emergency. It can progress to HAPE or HACE within hours.

Symptoms include:

• Severe headache unresponsive to medication
• Repeated vomiting
• Difficulty walking or loss of coordination (ataxia)
• Confusion or altered mental status
• Fluid in lungs (gurgling breathing, wet cough)
• Bluish lips or fingernails

What to do: Immediate evacuation to lower altitude. This is life-threatening. Descend or arrange helicopter evacuation without delay.

For comprehensive altitude safety guidance, consult our How to Prepare for Manaslu Circuit Trek: The Ultimate Guide to Fitness, Permits, and Safety .

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The Lake Louise Consensus Score System

The Lake Louise Score is the international standard for assessing AMS. Learn to self-assess or ask your guide to assess you.

Self-Assessment Questionnaire (Score 0-3 for each)

Headache:

• 0 = None
• 1 = Mild headache
• 2 = Moderate headache
• 3 = Severe headache, incapacitating

Gastrointestinal (nausea/vomiting):

• 0 = No symptoms
• 1 = Poor appetite or mild nausea
• 2 = Moderate nausea or mild vomiting
• 3 = Severe nausea or severe vomiting

Fatigue/Weakness:

• 0 = None
• 1 = Mild fatigue
• 2 = Moderate fatigue
• 3 = Severe fatigue, unable to continue

Dizziness/Lightheadedness:

• 0 = None
• 1 = Mild dizziness
• 2 = Moderate dizziness
• 3 = Severe dizziness, near fainting

Difficulty Sleeping:

• 0 = Slept as well as usual
• 1 = Did not sleep as well as usual
• 2 = Woke many times, poor sleep
• 3 = Could not sleep at all

Interpreting Your Score

Total Score	Assessment	Action
0-2	No AMS	Normal trekking
3-5	Mild AMS	No ascent, rest, hydrate
6-9	Moderate AMS	Descent 300-500m recommended
10+	Severe AMS	Immediate evacuation required

Your guide on the Manaslu Circuit should be trained in using the Lake Louise Score. Do not hide symptoms.

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Prevention Strategies: How to Avoid AMS

Prevention is far more effective than treatment. Follow these strategies on the Manaslu Circuit.

Gradual Ascent (Most Important)

The medical guideline is: Do not increase sleeping altitude by more than 300-500 meters per day once above 3,000 meters.

The standard Manaslu Circuit itinerary follows this guideline with built-in acclimatization days at Samagaon and Samdo. Do not skip these days.

Hydration

Dehydration mimics and worsens AMS symptoms. Drink 3-4 liters of water daily.

• Carry two 1-liter bottles
• Drink before you feel thirsty
• Monitor urine color (pale yellow = good hydration)
• Avoid excessive alcohol and caffeine

Proper Nutrition

Eat regularly even if you have no appetite. Carbohydrates are particularly beneficial at altitude because they require less oxygen to metabolize.

• Dal bhat (rice and lentils) is excellent
• Eat small meals frequently
• Bring high-energy snacks (nuts, chocolate, energy bars)

Sleep Low

The rule “climb high, sleep low” is critical. On acclimatization days, hike to a higher elevation during the day (e.g., climb a ridge or hill) but return to lower elevation to sleep.

Avoid Respiratory Depressants

Do not take sleeping pills, strong painkillers, or excessive alcohol. These suppress breathing, which is dangerous at altitude.

Listen to Your Body

Your body signals its condition. Do not ignore headaches, fatigue, or nausea. These are not “normal trekking discomfort.” They are potential AMS warnings.

For detailed difficulty assessment and preparation strategies, see our Manaslu Circuit Trek Difficulty 2026-2027: How to Prepare for the Challenge .

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The Critical Rule: “Climb High, Sleep Low”

This principle is the foundation of altitude acclimatization. Here is how to apply it on the Manaslu Circuit.

What It Means

During the day, you may ascend to high elevations (e.g., climb a viewpoint or pass). At night, you return to a lower elevation to sleep. This stimulates acclimatization without the risk of sleeping at extreme altitude.

How to Apply on Manaslu Circuit

At Samagaon (3,520m):

• Day hike to Manaslu Base Camp (4,400m) or Pungyen Gompa (4,200m)
• Return to sleep at Samagaon (3,520m)

At Samdo (3,850m):

• Day hike to Samdo Ri (5,000m) or the Tibetan border
• Return to sleep at Samdo (3,850m)

Never skip these acclimatization hikes. They are essential for preparing your body for Larkya La Pass.

Why It Works

Sleeping at altitude is more stressful than walking at the same altitude. By climbing higher during the day but sleeping lower, you expose your body to altitude stress during waking hours while allowing recovery during sleep.

For detailed itinerary planning that includes these acclimatization days, see our Best Guide to the Manaslu Circuit Trek Itinerary 2026 and 2027: What, Why, and When .

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Acclimatization Schedule for Manaslu Circuit

A proper acclimatization schedule is built into the standard itinerary. Here is how it works.

Day-by-Day Acclimatization

Day	Location	Altitude	Acclimatization Activity
1-4	Below 2,000m	870-1,865m	Minimal altitude stress
5	Namrung	2,660m	Body begins adjusting
6	Lho	3,180m	First significant altitude
7-8	Samagaon	3,520m	Acclimatization day (hike to 4,200-4,400m, return to sleep)
9-10	Samdo	3,850m	Acclimatization day (hike to 5,000m, return to sleep)
11	Dharamsala	4,460m	Sleep high (challenging night)
12	Larkya La	5,160m	Cross pass, descend to 3,590m

Why Two Acclimatization Days?

The Manaslu Circuit includes two full acclimatization days (at Samagaon and Samdo) because the ascent from 3,500m to 5,160m occurs over only 5 days. Without these rest days, AMS risk would be unacceptably high.

Never Shorten Acclimatization

Some trekkers attempt to save time by skipping acclimatization days. This is dangerous. The most common cause of severe AMS on the Manaslu Circuit is rushing the itinerary.

For complete preparation guidance, explore our How to Prepare for Manaslu Circuit Trek: The Ultimate Guide to Fitness, Permits, and Safety .

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Diamox: Should You Take It?

Diamox (Acetazolamide) is a medication that helps prevent and treat AMS. It does not cure AMS but speeds acclimatization.

How Diamox Works

Diamox makes your blood more acidic, which triggers your body to breathe faster and deeper. This increases oxygen intake and accelerates acclimatization.

Who Should Consider Diamox

• Trekkers with a history of AMS
• Those ascending faster than recommended (not applicable on standard itinerary)
• Trekkers who have had difficulty acclimatizing before
• Anyone concerned about altitude (after consulting a doctor)

Dosage

Standard prophylactic dose: 125mg twice daily (morning and evening)

• Start 24 hours before ascending above 2,500m
• Continue through the trek, including descent
• Consult your doctor for personalized dosing

Side Effects

Common and generally mild:

• Frequent urination (every 1-2 hours, including at night)
• Tingling in fingers, toes, and face
• Changes in taste (carbonated drinks taste flat or metallic)
• Mild nausea

These side effects are not dangerous and resolve when you stop the medication.

Contraindications

Do not take Diamox if you have:

• Sulfa drug allergy (Diamox is a sulfonamide)
• Severe kidney or liver disease
• Cirrhosis
• Pregnancy (consult doctor)

Important Note

Diamox is a prescription medication. Consult your doctor before the trek. Do not obtain it without a prescription. Test for side effects at home before your trek.

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What to Do If Symptoms Appear

If you or a fellow trekker develops AMS symptoms on the Manaslu Circuit, follow this protocol.

For Mild AMS (Headache, mild fatigue, nausea)

1. Stop ascending immediately – Do not go higher until symptoms resolve
2. Rest at current altitude – Take a rest day if needed
3. Hydrate aggressively – Drink 1 liter of water immediately
4. Take mild pain reliever – Ibuprofen or paracetamol for headache
5. Eat something – Even if not hungry, eat simple carbohydrates
6. Monitor symptoms – Check Lake Louise Score every 4 hours

Expected outcome: Symptoms should improve within 24 hours. If they worsen, descend.

For Moderate AMS (Severe headache, vomiting, severe fatigue)

1. Descend immediately – Drop 300-500 meters (1,000-1,500 feet)
2. Continue descending until symptoms improve – This may take several hours
3. Consider Diamox – 250mg twice daily (treatment dose, consult doctor)
4. Do not ascend again – Until symptom-free for 24 hours at lower altitude
5. Monitor for HAPE/HACE symptoms – Watch for wet cough or confusion

For Severe AMS (Confusion, inability to walk, fluid in lungs)

1. Emergency descent – This is life-saving. Descend as fast as safely possible
2. Call for helicopter evacuation – If descent is not possible or symptoms are severe
3. Administer emergency medications – Dexamethasone (if available and trained)
4. Keep the person warm and upright – Do not lay flat if fluid in lungs
5. Supplemental oxygen if available – Some teahouses may have oxygen cylinders

The Golden Rule of Altitude

If you feel unwell at altitude, assume it is AMS until proven otherwise. The only reliable treatment for severe AMS is descent. There is no substitute.

For detailed emergency planning and safety protocols, see our How to Prepare for Manaslu Circuit Trek: The Ultimate Guide to Fitness, Permits, and Safety .

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High Altitude Pulmonary Edema (HAPE)

HAPE is fluid accumulation in the lungs. It is life-threatening and requires immediate evacuation.

Symptoms of HAPE

• Persistent wet cough – Producing pink or frothy sputum
• Gurgling or bubbling sound when breathing
• Severe shortness of breath even at rest
• Extreme fatigue and weakness
• Cyanosis (blue-tinged lips or fingernails)
• Rapid heart rate even at rest

Risk Factors for HAPE

• Rapid ascent (more than 300-500 meters per day above 3,000m)
• Previous HAPE episode (significantly increased risk)
• Upper respiratory infection
• Cold exposure

Treatment for HAPE

HAPE is a medical emergency:

1. Immediate descent – This is the priority. Descend at least 500-1,000 meters
2. Helicopter evacuation – If descent is not possible or symptoms are severe
3. Oxygen – If available, administer at high flow
4. Nifedipine – If available and you are trained to use it
5. Keep the person upright – Do not lay flat

Do not wait with HAPE. It can progress to respiratory failure within hours.

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High Altitude Cerebral Edema (HACE)

HACE is fluid accumulation in the brain. It is the most severe form of altitude illness and is frequently fatal without immediate evacuation.

Symptoms of HACE

• Severe headache – Unresponsive to medication
• Loss of coordination (ataxia) – Unable to walk in a straight line (heel-to-toe test)
• Confusion or altered mental status – Disorientation, unusual behavior
• Hallucinations – Seeing or hearing things that are not there
• Drowsiness or loss of consciousness
• Nausea and vomiting

The Ataxia Test

Ask the person to walk in a straight line heel-to-toe. If they cannot (like a failed sobriety test), they likely have HACE. This is a critical early sign.

Treatment for HACE

HACE is a life-threatening emergency:

1. Immediate descent – This is the only definitive treatment
2. Helicopter evacuation – Essential if descent is not possible
3. Dexamethasone – 8mg immediately, then 4mg every 6 hours (if available)
4. Oxygen – If available, administer at high flow
5. Monitor consciousness – Prepare for possible loss of airway

HACE can progress from first symptoms to unconsciousness in 4-12 hours. Do not delay evacuation.

For detailed difficulty assessment that includes altitude risks, consult our Manaslu Circuit Trek Difficulty 2026-2027: How to Prepare for the Challenge .

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Emergency Evacuation Options on the Manaslu Circuit

Evacuation from the Manaslu Circuit is complex due to the region’s remoteness. Understand your options before you trek.

Option 1: Self-Descent (Walking Down)

For mild to moderate AMS, walking down is the best option.

Advantages:

• Immediate (no waiting for rescue)
• Free (no cost)
• Controlled pace

Disadvantages:

• Requires physical ability to walk
• May take many hours to reach lower altitude
• Not possible for severe AMS (person cannot walk)

Typical descent routes:

• From Samagaon/Samdo: Descend to lower villages (Namrung, Philim, Jagat)
• From Dharamsala: Descend to Samdo (5-6 hours)
• From Larkya La: Descend to Bimtang (3-4 hours) or back to Dharamsala

Option 2: Helicopter Evacuation

For moderate to severe AMS, HAPE, or HACE, helicopter evacuation is the standard.

How it works:

1. Your guide contacts the agency or directly calls helicopter rescue
2. Helicopter is dispatched from Kathmandu or Pokhara
3. Helicopter lands at designated helipad near your location
4. You are flown to Kathmandu for medical care

Cost: USD 3,000 – 6,000 depending on location and weather
Covered by insurance: Yes, if your policy includes helicopter evacuation

Important notes:

• Weather can delay evacuation (sometimes for days)
• Helipads exist at major villages (Samagaon, Samdo, Bimtang)
• Larkya La has no helipad; evacuation from pass area requires walking to nearest helipad

Option 3: Porter-Assisted Descent

If you cannot walk but do not need helicopter evacuation (rare), porters can carry you down.

How it works:

• Porters fashion a makeshift stretcher or carry you
• You descend at walking pace
• May take 1-2 days to reach road access

This is not recommended for severe AMS, HAPE, or HACE. These conditions require rapid descent or helicopter evacuation.

For detailed cost information including potential evacuation expenses, see our Manaslu Circuit Trek Cost 2026-2027: Your Future Budget Planning Guide .

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Helicopter Evacuation: How It Works

Helicopter evacuation is the primary emergency rescue method on the Manaslu Circuit. Here is what you need to know.

When to Call for Evacuation

• Severe AMS with confusion or inability to walk
• HAPE symptoms (wet cough, gurgling breathing)
• HACE symptoms (ataxia, confusion, loss of consciousness)
• Any condition where descent is not possible or not improving symptoms

The Process

1. Your guide initiates the call – They contact the agency or direct rescue number
2. Location is confirmed – GPS coordinates or village name
3. Helicopter dispatches – From Kathmandu or Pokhara
4. Flight time – 30-60 minutes depending on location
5. Landing – At designated helipad (or nearest suitable location)
6. Transport to hospital – You are flown to Kathmandu for medical care

Helipad Locations on Manaslu Circuit

Location	Helipad Status	Notes
Samagaon	Yes	Good condition, large pad
Samdo	Yes	Basic pad, sufficient for evacuation
Bimtang	Yes	Small pad, accessible in good weather
Dharamsala	No	Nearest helipad is Samdo (5-6 hours walk)
Larkya La	No	No landing zone; must descend to Bimtang or Samdo

Weather Constraints

Helicopter evacuation depends on weather:

• Clear skies – Evacuation possible within 1-2 hours
• Cloudy or light precipitation – May be delayed 4-12 hours
• Heavy clouds, rain, or snow – Evacuation impossible until weather clears

This is why descent is always the first recommendation. Do not wait for helicopter if you can walk down.

Insurance Requirements

Your insurance must specifically cover helicopter evacuation on the Manaslu Circuit up to 5,500 meters. Some policies exclude restricted areas or have lower altitude limits. Verify before trekking.

For detailed guidance on insurance and preparation, explore our How to Prepare for Manaslu Circuit Trek: The Ultimate Guide to Fitness, Permits, and Safety .

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Travel Insurance: Non-Negotiable Requirements

Travel insurance is not optional for the Manaslu Circuit. Without proper coverage, a helicopter evacuation could cost you USD 3,000-6,000 out of pocket.

Required Coverage

Your policy must include:

Coverage	Minimum Requirement
Helicopter evacuation	Up to 5,500 meters (6,000m recommended)
High-altitude trekking	Specifically named (not excluded)
Restricted area trekking	Specifically named for Manaslu
Medical treatment	USD 100,000 minimum
Repatriation	Coverage for medical transport home
Trip cancellation	Optional but recommended

What to Check Before Buying

• Read the fine print – Some policies exclude “dangerous activities” including high-altitude trekking
• Check altitude limit – Many standard policies cover only up to 3,000-4,000 meters
• Verify restricted area coverage – Some policies exclude restricted regions entirely
• Confirm pre-existing conditions – Declare all medical conditions honestly

Recommended Insurance Providers

Research and compare policies from reputable providers that specialize in adventure travel and high-altitude trekking. Do not rely on basic travel insurance from your credit card or standard vacation packages.

Documentation

• Carry a printed copy of your policy and emergency numbers
• Give a copy to your guide before starting the trek
• Save emergency numbers in your phone and on paper

For comprehensive cost planning including insurance, see our Manaslu Circuit Trek Cost 2026-2027: Your Future Budget Planning Guide .

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Communication and Rescue Infrastructure

Understanding communication options helps in emergencies.

Mobile Network Coverage

Location	NTC Coverage	Ncell Coverage
Kathmandu to Jagat	Good	Good
Jagat to Samagaon	Intermittent	Poor to None
Samagaon	Moderate	None
Samdo	Weak	None
Dharamsala	None	None
Larkya La	None	None
Bimtang	None	None
Dharapani (exit)	Good	Moderate

Recommendation: Get a Nepal Telecom (NTC) SIM card for the Manaslu Circuit. NTC has significantly better coverage in the Manaslu region.

Satellite Phones

Your guide should carry a satellite phone or have access to one. Confirm this with your agency before booking.

Satellite phone rental: USD 10-15 per day in Kathmandu

Emergency Numbers

Save these numbers before departure:

• Your trekking agency (24-hour emergency line)
• Your guide’s mobile number
• Helicopter rescue service numbers (your agency will provide)
• Your insurance emergency assistance number

Teahouse Phones

Some teahouses have landline or satellite phones. They are available for emergency use (fees apply). Your guide will know which teahouses have phones.

For month-specific weather conditions that affect communication and rescue, consult our Best Month-by-Month Manaslu Circuit Trek Weather and Temperature Guide .

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Frequently Asked Questions (FAQs)

Final Thoughts: Respect the Altitude

The Manaslu Circuit is one of the world’s most spectacular treks, but the altitude commands respect. Every year, trekkers become seriously ill on this route because they ignored symptoms, skipped acclimatization days, or felt pressure to “keep up” with their group.

You can avoid this fate by following three simple principles:

1. Listen to your body – Headaches, fatigue, and nausea are not normal trekking discomfort. They are potential AMS warnings.
2. Never skip acclimatization – The itinerary includes rest days for a reason. Use them. Hike high during the day; sleep low at night.
3. Descend when symptoms worsen – Pride and ambition have no place in altitude medicine. When in doubt, go down.

The mountains will still be there tomorrow. Your health and safety come first.

For additional resources to support your planning:

• How to Book Your Manaslu Circuit Trek: Best Step-by-Step Guide for 2026 and 2027 – Complete booking walkthrough
• How to Prepare for Manaslu Circuit Trek: The Ultimate Guide to Fitness, Permits, and Safety – Fitness, permits, and safety guide
• Best Guide to the Manaslu Circuit Trek Itinerary 2026 and 2027: What, Why, and When – Detailed day-by-day route planning
• Manaslu Circuit Trek Difficulty 2026-2027: How to Prepare for the Challenge – In-depth challenge analysis
• Manaslu Circuit Trek Cost 2026-2027: Your Future Budget Planning Guide – Comprehensive budget breakdown
• Best Month-by-Month Manaslu Circuit Trek Weather and Temperature Guide – Month-by-month climate insights
• Best Manaslu Circuit Trek Guide 2026 and 2027 | Complete Manaslu Trekking Information – Your foundational resource