Pack altitude medicine and patience

You'll be high in Tajikistan. Very high. You'll likely go through 4,000 m+ (13,000') mountain passes and sleep at elevations most of us grimy lowlanders aren't used to, especially if you take the Pamir Highway. Altitude sickness is a very real issue at these levels, and tourists must exercise caution. And, no, you're not a wimp if you suffer altitude sickness; it may strike anyone, regardless of fitness level, at heights above 2000 meters.

Altitude sickness is a severe problem. Some visitors know firsthand since they nearly died from it in the Pamir. It is critical to stay hydrated. If you know from previous experience that you are particularly prone to altitude sickness, stock up on Diamox; you may take it 24-48 hours before ascending to prevent altitude sickness. Diamox, on the other hand, should be avoided if you are allergic to sulfa drugs.

Finally, patience is required. When increasing in height, you must take your time to adjust. Don't rush from Dushanbe to Murghab in one continuous trip; instead, arrange several days of rest between each leg of your travel to allow your body to adjust to the change.