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Altitudes over 3,000 metres can be a problem. If you're flying into Ladakh, you'll benefit from a restful couple of days to allow your body to get used to the reduced oxygen. If you notice any early-warning symptoms (headache, nausea, sleeping problems, dizziness, general uneasiness), descend at least 300 to 500 metres and rest.
In your first few days at altitude you should drink at least 3-4 litres of liquids each day and consider asking your GP about medicines such as Diamox (acetazolamide).
Extremes of temperature aren't uncommon. The temperature can rise or fall in a very short space of time. Take plenty of layers in winter - even on hot days, the night-time temperatures can be very low, and be prepared for very hot days during the summer when you're out trekking.
Vaccinations aren't required for Ladakh, but you should ask at your local travel medical centre for up-to-date advice on travel to India. Malaria isn't a problem above 2,000 metres, so you don't need any precautions while you're in Ladakh, but you should take advice from your GP about travelling through other parts of India on your way here.
Dehydration at these high altitudes can be a serious problem, especially while you're acclimatising. Don't assume that you're OK if you aren't thirsty. Drink water or tea regularly and aim for at least 2 litres a day once you have acclimatised.
You should always talk to your GP before making any long-distance journeys, and consider buying a traveller's health book for more detailed advice.
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