Re the JMT, I understand that if you start at the north end you are at a lower altitude so can acclimatize more gradually. Do expect that you won’t be able to hike nearly as far as you normally do for the first few days.
The two methods of high altitude acclimatization are (1) Climb high and sleep low for the first few days, gradually raising the altitude for both, or (2) Don’t climb more than 1,000 feet per day between sleeping places. Symptoms of acute mountain sickness are more apt to develop during sleep. Severe (as opposed to “normal”) headache or difficulty breathing constitute a medical emergency (high altitude cerebral edema or pulmonary edema, respectively)–descend immediately and seek medical help ASAP.
grannyhiker