Altitude Sickness in Peru: How to Combat it in 6 Steps

23 de February de 2025 Peru

Altitude sickness in Peru, with its breathtaking landscapes and ancient wonders, is a dream destination for many travelers. From the mystical Machu Picchu to the vibrant city of Cusco, the country offers a diverse range of experiences. However, the high-altitude regions of Peru, including cities like Cusco and Arequipa, can pose a challenge for visitors who are not acclimated to such elevations. Altitude sickness, also known as acute mountain sickness (AMS), is a common concern for those exploring the Andean highlands. In this article, we’ll discuss what altitude sickness is and provide a practical 6-step guide on how to fight it and ensure a more enjoyable Peruvian adventure.

Altitude Sickness in Peru: The Importance of Gradual Acclimatization

Traveling to Peru’s breathtaking highlands—home to iconic destinations like Cusco, the Sacred Valley, and Lake Titicaca—is a once-in-a-lifetime experience. However, many visitors arrive unaware of the potential effects of altitude sickness, or soroche. One of the most effective ways to prevent it is through gradual acclimatization—allowing your body time to adjust to the thinner air at high elevations.

What Is Altitude Sickness?

Altitude sickness occurs when you ascend too quickly to elevations above 2,500 meters (8,200 feet), where oxygen levels are significantly lower. Common symptoms include headache, nausea, dizziness, fatigue, shortness of breath, and insomnia. In most cases, these symptoms are mild and temporary—but they can affect your ability to enjoy your trip if not managed properly.

Why Gradual Acclimatization Matters

When your body is exposed to high altitude, it needs time to adapt to the lower oxygen levels. Gradual acclimatization helps your system adjust naturally, reducing the risk of developing severe symptoms and allowing you to feel more comfortable and energized.

How to Acclimate Gradually in Peru

Here are practical tips to help you acclimate while traveling in the Peruvian Andes:

1. Start Low and Climb Slowly

If your itinerary allows, begin your journey at a lower altitude. For example, instead of flying directly to Cusco (3,399 m / 11,152 ft), consider spending your first days in the Sacred Valley (around 2,800 m / 9,200 ft), which is lower and more manageable for most travelers. From there, gradually work your way up.

2. Spend a Few Days Acclimating

Give your body at least 24–48 hours to adjust before engaging in intense physical activity or moving to higher elevations like Puno or the Salkantay and Ausangate treks.

3. Take Rest Seriously

Even walking or climbing stairs may feel more strenuous. Prioritize rest and limit physical exertion during your first days at altitude. Listen to your body and don’t overexert yourself.

4. Stay Hydrated and Eat Light

Drink plenty of water to avoid dehydration, which can worsen symptoms. Opt for light meals rich in carbohydrates to give your body easy-to-use energy. Avoid alcohol and heavy foods during the first few days.

5. Use Coca Tea or Coca Leaves

Local remedies like coca tea (mate de coca) can help stimulate oxygen flow and relieve discomfort. These are widely available in hotels and cafes throughout the Andes.

6. Consider Altitude Medication

For travelers with known sensitivity to altitude or a tight travel schedule, consult your doctor before the trip. Preventative medication like acetazolamide (Diamox) may be recommended.

Places to Acclimate in Peru

Sacred Valley: A beautiful area with Inca ruins and charming towns at a gentler altitude.
Arequipa: At 2,335 m (7,660 ft), it’s an ideal stop before ascending further.
Ollantaytambo: A great base in the Sacred Valley before heading to Machu Picchu or Cusco.

Altitude Sickness in Peru: Stay Hydrated to Stay Healthy

Peru’s stunning landscapes—towering Andean peaks, the mystical city of Machu Picchu, and the high plains of Lake Titicaca—are unforgettable. But for many travelers, the high altitude can bring an unwelcome challenge: altitude sickness. Also known as soroche, it can cause symptoms like headache, nausea, fatigue, and dizziness. One of the most effective and simple ways to prevent and ease altitude sickness is to stay hydrated.

Why Hydration Is Key at High Altitudes

As you ascend to higher elevations, the air becomes thinner and drier. Your body loses fluids faster through respiration and urination—even if you don’t feel like you’re sweating. Dehydration worsens the effects of altitude sickness by reducing oxygen flow in the blood and increasing fatigue, dizziness, and headaches.

That’s why proper hydration is essential for anyone traveling to destinations like Cusco (3,399 m / 11,152 ft), Puno (3,827 m / 12,555 ft), or the Colca Canyon (3,500+ m / 11,500+ ft).

How to Stay Hydrated in the Andes

1. Drink Water Frequently

Don’t wait until you feel thirsty. Aim to drink at least 2 to 3 liters of water per day. Small, regular sips throughout the day are more effective than drinking a lot all at once.

2. Limit Alcohol and Caffeine

Alcohol and caffeinated drinks like coffee or energy drinks can act as diuretics, leading to increased fluid loss. Try to limit these beverages, especially during your first 48 hours at high altitude.

3. Carry a Refillable Water Bottle

Always have water with you, especially during tours or hikes. Many hotels and restaurants in tourist areas offer filtered or boiled water for refilling your bottle.

4. Eat Hydrating Foods

Fruits like oranges, watermelon, and apples can help supplement your fluid intake and provide essential nutrients. Soups and broths are also great options.

5. Add Electrolytes

If you’re engaging in physical activity, sweating, or feeling weak, consider adding electrolyte tablets or drinks to your hydration routine. They help your body absorb water more efficiently and maintain energy levels.

Signs of Dehydration at High Altitude

Watch for symptoms such as:

Dry mouth and lips
Dark yellow urine or infrequent urination
Headache
Dizziness or confusion
Muscle cramps

These may indicate that your body needs more fluids—don’t ignore them.

Hydration Supports Acclimatization

Drinking enough water helps your body acclimate more efficiently. It promotes oxygen circulation, improves digestion (which slows at altitude), and can reduce the severity of altitude sickness symptoms. Combined with other precautions like gradual ascent and rest, hydration is one of your best defenses in the high Andes.

Altitude Sickness in Peru: Avoid Intense Physical Activity at First

Traveling to Peru’s high-altitude destinations like Cusco, the Sacred Valley, and Lake Titicaca is a once-in-a-lifetime adventure. However, these beautiful places sit at elevations above 3,000 meters (9,800 feet), where altitude sickness—known locally as soroche—can affect even the most experienced travelers. One of the most important ways to prevent it is to avoid intense physical activity during your first days at altitude.

Why Is Physical Activity Risky at High Altitude?

At higher elevations, the air contains less oxygen. Your body needs time to adapt to this change, a process called acclimatization. Pushing yourself physically too soon—whether it’s hiking, climbing stairs quickly, or carrying heavy luggage—can lead to or worsen symptoms of altitude sickness.

Common symptoms include:

Headache
Dizziness
Nausea
Shortness of breath
Fatigue
Difficulty sleeping

These can all intensify if your body is stressed by physical exertion before it has adjusted to the altitude.

Tips for Taking It Easy Upon Arrival

1. Rest the First Day

Plan your arrival in cities like Cusco or Puno with a light itinerary. Take your first day to rest, walk slowly, and let your body adjust.

2. Walk Slowly, Breathe Deeply

Even walking around town or climbing stairs can feel harder at high altitude. Walk at a relaxed pace and take breaks often. Don’t rush—enjoy the scenery!

3. Delay Hikes and Strenuous Tours

If you’re planning hikes like the Inca Trail or Rainbow Mountain, spend a couple of days acclimatizing before you begin. Most tour operators recommend staying at high altitude for at least 48 hours before starting physically demanding activities.

4. Let Others Help With Luggage

If possible, avoid carrying heavy bags or suitcases during your first day. Use hotel staff or porters when available to lighten the physical load on your body.

5. Stretch and Breathe

Gentle stretching and controlled breathing can help improve circulation and oxygen intake without stressing your body.

Give Your Body Time

Avoiding intense physical activity during the first 24 to 48 hours at altitude gives your body the chance to adjust naturally. Once you’ve acclimated, your body will be better equipped to enjoy hikes, ruins, and mountain views without discomfort.

Altitude Sickness in Peru: Try Coca Leaves or Coca Tea

Peru’s majestic landscapes—Cusco, the Sacred Valley, Lake Titicaca, and Machu Picchu—sit at high elevations, often above 3,000 meters (9,800 feet). While these destinations are breathtaking, the thin air can lead to altitude sickness, known locally as soroche. Fortunately, the Andes have their own time-tested remedy: coca leaves and coca tea. Used by indigenous cultures for centuries, these natural options can help alleviate the effects of altitude.

What Is Coca and Why Is It Used?

Coca leaves come from the Erythroxylum coca plant, native to the Andean region. For thousands of years, Andean people have chewed coca leaves or brewed them into tea to combat fatigue, hunger, and the symptoms of high altitude.

Coca contains natural alkaloids that:

Help improve oxygen absorption
Boost energy and alertness
Aid digestion
Relieve mild headache and nausea

Though coca is the raw plant used in the production of cocaine, the leaves themselves (when used in traditional ways) are not harmful or addictive, and their use is completely legal and culturally accepted in Peru.

How to Consume Coca Safely

1. Drink Coca Tea (Mate de Coca)

One of the easiest and most popular ways to consume coca is by drinking coca tea. Most hotels and restaurants in high-altitude areas offer it complimentary. It has a mild, herbal flavor and is best enjoyed warm. Drink it slowly, especially upon arrival at high altitude.

2. Chew Coca Leaves

Locals often chew fresh coca leaves by placing a small wad inside the cheek and gently sucking or chewing them to release the alkaloids. Sometimes, a small amount of llipta (an alkaline substance) is added to help activate the properties of the leaf.

Chewing coca:

Is ideal for hikes or long walks
Helps sustain energy during tours
Can be a more direct method than tea for some people

3. Try Coca Candies or Lozenges

If you’re not fond of chewing leaves or drinking tea, coca-infused candies or lozenges are a convenient alternative. They’re available at local stores and help gently ease symptoms over time.

Are There Any Side Effects?

Coca is generally safe for most travelers. However:

Avoid consuming it before bedtime, as it can act as a mild stimulant.
Those with heart conditions or high blood pressure should consult a doctor before using coca.
If you’re flying back to a country with strict drug laws, do not attempt to bring coca leaves or tea with you, as they may be considered illegal outside of Peru.

A Cultural and Medicinal Ally

Using coca leaves or coca tea is more than just a remedy—it’s a way to connect with Andean tradition and ancestral wisdom. It’s a natural, gentle way to support your body’s adaptation to high altitude while respecting local culture.

Altitude Sickness in Peru: Eat Well, But Keep It Light

Traveling through Peru’s high-altitude destinations—like Cusco, the Sacred Valley, or Lake Titicaca—is a thrilling experience. But these elevations, often over 3,000 meters (9,800 feet), can trigger altitude sickness, also known as soroche. One key way to reduce your symptoms and help your body adapt is to eat well, but choose light, easy-to-digest meals, especially during your first few days at altitude.

How Altitude Affects Digestion

At higher altitudes, your body receives less oxygen and redirects energy to vital functions—like breathing and circulation. This means your digestive system slows down, making it harder to process heavy, greasy, or rich meals. Eating large or fatty meals can lead to bloating, nausea, or discomfort, especially if you’re already feeling the effects of altitude.

Tips for Eating at High Altitude

Eat Small, Frequent Meals

Instead of three large meals, try eating smaller portions throughout the day. This helps your body digest more easily and keeps your energy levels steady.

Focus on Carbohydrates

Carbohydrates are easier to digest at high altitude and provide a quick source of energy. Opt for rice, bread, potatoes, pasta, and fruits—staples in Peruvian cuisine.

Choose Light, Warm Foods

Soups, broths, grilled vegetables, and boiled potatoes are gentle on the stomach and warming for the body, which helps with circulation. Try Peruvian classics like caldo de gallina (chicken soup) or chuño soup made with Andean freeze-dried potatoes.

Avoid Heavy and Greasy Meals

Fried foods, red meat, and rich sauces can be difficult to digest at high altitude. Save those dishes for when you’ve fully acclimatized.

Limit Dairy and Raw Foods

Dairy products and raw salads may upset sensitive stomachs, especially if your digestion is already slowed. Choose cooked vegetables and avoid unfamiliar dairy products early on.

Don’t Skip Meals

Even if you feel tired or nauseous, try to eat something light. Fueling your body is essential for energy and oxygen transport.

Hydration Matters Too

In addition to eating light, drink plenty of water. Staying hydrated aids digestion and helps reduce symptoms of altitude sickness. Herbal teas, especially coca tea, can also help with both digestion and acclimatization.

Local Superfoods to Try

Peru is home to many high-altitude superfoods that are gentle and nourishing:

Quinoa – High in protein and easy to digest
Kiwicha (amaranth) – Great for energy
Muña tea – Aids digestion and reduces bloating
Choclo (giant corn) – Served boiled and easy on the stomach

Altitude Sickness in Peru: Consult Your Doctor and Consider Preventive Medication

Peru’s breathtaking landscapes—from the ancient ruins of Machu Picchu to the high plains of Lake Titicaca—sit at elevations where the air is thin and oxygen levels are lower. For many travelers, especially those coming from sea level, the rapid shift in altitude can lead to altitude sickness, or soroche. One of the most important steps you can take before your trip is to consult your doctor and consider preventive medication to reduce the risk and severity of symptoms.

Why Talk to a Doctor Before Your Trip?

While altitude sickness can affect anyone, certain factors may increase your risk:

A history of altitude sickness
A rapid ascent to elevations over 2,500 meters (8,200 feet)
Underlying health conditions (especially heart or lung issues)
Tight travel schedules with little time to acclimate

By speaking with your doctor ahead of time, you can assess your personal risk and develop a plan to prevent or manage symptoms.

Common Medications for Altitude Sickness

1. Acetazolamide (Diamox)

This is the most commonly prescribed medication for preventing and treating altitude sickness. It works by:

Helping your body adjust more quickly to altitude
Increasing breathing rate and improving oxygen delivery
Reducing symptoms like headache, dizziness, and fatigue

How to use it:
Doctors typically recommend starting the medication 1–2 days before ascending and continuing it for 2–3 days at high altitude. Dosage varies, so always follow your doctor’s instructions.

2. Ibuprofen or Acetaminophen

These over-the-counter pain relievers can help manage headaches and mild discomfort caused by altitude. While they don’t prevent altitude sickness, they can make symptoms more tolerable.

3. Dexamethasone

This corticosteroid is used for more severe cases of altitude sickness, especially when other medications aren’t effective or if a rapid ascent is unavoidable. It is usually prescribed for short-term use under medical supervision.

Natural Remedies to Complement Medication

While medication can be very effective, it’s often combined with local natural remedies for best results:

Coca tea or coca leaves – Traditionally used in the Andes to reduce symptoms
Muña tea – A digestive and respiratory aid
Hydration and rest – Crucial to recovery and prevention

Important Considerations

Do not self-medicate. Always consult a healthcare professional before taking any medication.
Inform your doctor of existing conditions. Especially if you have asthma, heart disease, or are pregnant.
Know the signs of severe altitude sickness. Symptoms such as shortness of breath at rest, chest tightness, confusion, or vomiting require immediate medical attention.

Plan Smart, Travel Safely

If you’re planning to visit high-altitude areas in Peru—like Cusco (3,399 m / 11,152 ft), Puno (3,827 m / 12,555 ft), or the Rainbow Mountain—it’s worth being prepared. Preventive medication, combined with gradual acclimatization and self-care, can significantly improve your experience.

Altitude sickness should not deter you from exploring the wonders of Peru’s high-altitude regions. By following these six practical steps – acclimatizing gradually, staying hydrated, consuming high-calorie foods, avoiding strenuous activity initially, considering medication, and knowing when to seek medical attention – you can significantly reduce the risk of altitude sickness and ensure a more enjoyable and healthy adventure in the Andean landscapes. Always prioritize your well-being and take the necessary precautions to make the most of your Peruvian journey.

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