High altitude problems like hypoxia, acute mountain sickness, high altitude cerebral edema, pulmonary edema, insomnia, tiredness, lethargy, lack of appetite, body pain, dementia, and depression may occur when a person or a soldier residing in a lower altitude ascends to high-altitude areas. These problems arise due to low atmospheric pressure, severe cold, high intensity of solar radiation, high wind velocity, and very high fluctuation of day and night temperatures in these regions. These problems may escalate rapidly and may sometimes become life-threatening. Shilajit is a herbomineral drug which is pale-brown to blackish-brown, is composed of a gummy exudate that oozes from the rocks of the Himalayas in the summer months. It contains humus, organic plant materials, and fulvic acid as the main carrier molecules. It actively takes part in the transportation of nutrients into deep tissues and helps to overcome tiredness, lethargy, and chronic fatigue. Shilajit improves the ability to handle high altitudinal stresses and stimulates the immune system. Thus, Shilajit can be given as a supplement to people ascending to high-altitude areas so that it can act as a “health rejuvenator” and help to overcome high-altitude related problems.

Shilajit is a Sanskrit word meaning “Conqueror of mountains and destroyer of weakness” and ‘Winner of rock’.[24] Its other names are Silajit and Silaras in Sanskrit,[15] Shilajita Mumiyo, Mineral pitch, Asphalt, Jew's pitch, Mineral wax, or Ozokerite in English. [25–28] Shilajit is a pale-brown to blackish-brown exudate in the form of a smooth and clean gum that comes out of the mountains in the months of May-July.[25,27,29,30] Charaka Samhita describes Shilajit as “Stones of metal like gold” while Sushruta Samhita describes it as a “A gelatinous substance.”[25,27] Rasarangini and Dwarishtarang also claim that Shilajit is an exudate of a latex gum-resin of plants.[10] This substance is known as Çilájatu and cures all distempers of the body”.[25,27] It is found in the lower Himalayan hills at altitudes between 1000 to 5000 meters in Uttarakhand, Himachal Pradesh, Kashmir, and Arunachal Pradesh.[23] It is also found in Afghanistan, Nepal, Bhutan, Pakistan, China, Tibet, and the former U.S.S.R.[11,15,23] Shilajit is composed of humus and organic plant materials that have been compressed by layers of rocks.[12,26,31] The humus consists of 60-80% organic matter, is bitter in taste, and has an odor like cow's urine.[11,12,18] It contains dibenzo-alphapyrones and related metabolites, small peptides, humic acid, some lipids, uronic acids, phenolic glucosides, amino acids, and fulvic acid.[10–13,32,33] It also contains more than 84 minerals including copper, silver, zinc, iron, and lead in their ionic forms.[12,13,18] Shilajit is processed by several drug manufactures and marketed in capsule form for human consumption.[18,34,35] It is a natural medicine with a long history of human use for healing and performance-enhancement in diabetes and the urinary, immune, digestive, cardiac, and nervous systems.[13,15–18,21,22,25,26,31,34,35] Thus, Shilajit is an ayurvedic medicine with many properties and is capable of treating almost all kinds of body ailments.[25–27,31,36,37]

Shilajit amplifies the benefits of other herbs by enhancing their bioavailability in the body.[16] It contains more than 84 types of minerals, including the main ingredient, fulvic acid,[12,13,18] and provides most of the essential minerals to the body.[13,16] Fulvic acid acts as a carrier molecule in the human system, helps in the transportation of nutrients into the deep tissues, and removes deep-seated toxins from the body.[19] Shilajit helps in energy production, reduces the recovery period of injured muscles, bones, and nervous system,[14,15,18] and is used in the treatment of fractures. [13,15,18] Hence, it reduces the degradation of muscles and bones, and increases their strength at high altitudes. Shilajit also has the ability to overcome physical as well as mental stress[17,18,34] due to which it is used in the treatment of tiredness, lethargy, cold etc. which are common problems at high altitudes. Bucci (2000)[14] and Frawley et al., (2001)[17] have reported that the consumption of Shilajit with milk constitutes one of the strongest natural supplements with the potential to eliminate all kinds of weakness. Fulvic acid helps in the absorption of iron into the body, making it bioavailable to bone marrow stem cells for blood formation[16,25] and hence, Shilajit can be very helpful in coping with hypoxia-like conditions in the body. Apart from its blood-purifying property, Shilajit also enhances the oxygen-carrying capacity of the blood. [16,25] It helps in improving blood circulation and its diffusion into tissues, and maintains the necessary oxygen levels in the body during hypoxia.[17] Dash (1991)[16] has reported that Shilajit is a good detoxifier, helping in the elimination of toxins from the body, and its regular use stops the production of toxins in the body. Hence, Shilajit is also used in the treatment of carbon dioxide poisoning in hilly areas.

The major problem associated with high altitudes is acute mountain sickness (AMS). The symptoms of AMS are gastrointestinal distress, constipation, diarrhea, nausea, vomiting, headache, anorexia, breathlessness, dry nose, tiredness, giddiness, palpitation, cough, lethargy, dyspnea, edema, dizziness, fatigue, disturbed sleep, and disinclination to work.[1,38] Various scientists have experimentally proved that Shilajit can be used effectively for the treatment of gastrointestinal distress,[15,16] headache, weakness[17,18,25,34] anorexia, heart problems,[16] dehydration, insomnia, dyspnea,[15,16] moist cough,[39] and pain.[40] Hence, it can be very beneficial for the treatment of AMS. Insomnia is another common problem of high altitudes—it develops due to hypoxia, stress, anxiety among other causes. Shilajit acts as an antistress,[18,34,41] antianxiety,[23] antiepileptic,[17] and adaptogenic agent[18,42] and has also been found to be useful in the treatment of the insomnia.

HAPE is a major problem at high altitudes, which develops due to oxygen deficiency as well as low atmospheric pressure.[43–45] In HAPE, fluids are accumulated in the lungs of the body and some of the symptoms are shortness of breath, chest pain, fever, lethargy, cough, and cyanosis.[1] Being a diuretic agent, Shilajit removes the excess fluid from the lungs as well as the body,[17,34] which makes it very effective in the treatment of HAPE-like conditions and edema.[17] Shilajit has analgesic and anti-inflammatory effects and is thus useful for different painful conditions of the body.[24,40,46] Shilajit is also found to be very beneficial in rheumatoid arthritis, osteoarthritis, and gout[13,22,40] as it nourishes the joints and reduces the inflammation and pain.[13,22,47] Dash (1991)[16] has also reported that Shilajit can be useful in the treatment of dyspnea.

Gastrointestinal distress (lack of appetite, constipation, diarrhea, nausea, vomiting) is another major problem seen at high altitudes[1] and dehydration is a common problem faced by mountaineers. Shilajit is an important drug that helps in the digestion and absorption of food in the gastrointestinal tract (GIT)[25,51] and is also useful for the treatment of nausea, vomiting, and digestive disorders.[15–17] Being an excellent source of nutrients, it used as a tonic and helps in the better utilization of food.[16,51] It stimulates the pancreas to secrete insulin and maintains an equilibrium of catabolism and anabolism in the body[13,17,25,34] It also has a laxative property in the human body.[25] Frawley (1989)[34] suggested that the Shilajit could also act as a gastric tonic whereas Goel et al., (1990)[46] revealed that Shilajit increases the carbohydrate/protein ratio and decreases the gastric ulcer index. The fulvic acid and 4-methoxy 6-carbomethoxybiphenyl present in Shilajit decrease acid-pepsin secretion, cell shedding, and also act as ulcer protectives.[40,41] Thus, Shilajit can be very useful to cope with common high-altitude problems like gastrointestinal disorders and dehydration.

The high intensity of solar radiation, particularly, the high intensity of UV radiation, also affects people at high altitudes.[4] The reflection of UV and solar radiation is quite high in snowbound areas compared to the plains.[3] Hence, the risk of sunburn, skin, and eye diseases, even skin cancer, is more at high altitudes.[1] Shilajit can be useful for the treatment of skin and eye disorders due to its photoprotective action.[17,34]

Shilajit contains active organic molecules such as fulvic acid along with minerals (in their ionic forms). The fulvic acid helps in the transportation of these minerals into cells for maintaining and restoring their electrical potency, which prevents their decay and death. Shilajit helps in metabolism and promotes energy production in the body. It maintains an equilibrium of catabolism and anabolism, enhances the absorptive and detoxifying capacity of the body, and stimulates the immune system and blood formation in the body.

The recommended dose of Shilajit for maintenance of optimal health is 300-500 mg/day. Shilajit powder taken with milk twice a day will ensure optimal blood levels and therapeutic efficacy.[27,28,34] It is slowly metabolized and reaches a maximum level in the blood after 12-14 hours of consumption.

Shilajit is safe for everyone and has been found to be quite safe for up to 3 g/kg body weight in mice.[50] It should not be used with horse gram, meat of pigeon, Solanum nigrum (black nightshade). [25,27,39] Raw and unprocessed Shilajit should not be used as it contains a significant amount of free radicals and has been found to be contaminated with different fungal organisms such as Aspergillus niger, A. ochraceous, and Trichothecium roseum.