It's on the bucket list of many outdoor enthusiasts for good reason. Just about any activity enjoying the natural environment can be found there - from sandboarding in arid deserts, lazing in a hammock beachside (everyone needs a break now and then), hiking the famous Inca trail to Machu Picchu, discovering the many walkable Colonial cities, or trekking the Colca Canyon.
The one thing that all of these places in Peru have in common is high altitude - typically much higher than you'll find in the rest of the world. Peru claims some of the highest elevations in South America that are easily accessible to the average visitor, and the potential for altitude sickness is very real. It can wreak havoc on your trip if you don’t adjust to it properly before you set out. And if you're not fully adjusted and find yourself on the Inca Trail or hiking Huayna Picchu for example, one wrong turn from being lightheaded or out of breath can most certainly be fatal. So don't derail your train trip to Machu Picchu being stuck in an oxygenated hotel (or hospital) by insisting on starting your journey straight from the airport. Be smart. be prepared, and you'll have the time of your life.
What causes Altitude Sickness?
Altitude illnesses are basically caused by a lack of oxygen and your body’s response to this stress. The main cause is going too high, too fast without acclimating to the lower oxygen level. In the "Mile High City" of Denver, Colorado for instance, there is 17% less oxygen in the air than at sea level. At 8,000 feet, there is 25% less and at 14,000 feet about 40% less oxygen than at sea level.
If you live in an area that is 500 feet or less in altitude, I guarantee you’ll feel the effects of higher altitude when you arrive in Peru just by briskly crossing the street (and in Cuzco, I mean briskly or you'll be run over, but that's another story for another day!)
Let me give you an example of U.S. cities: New York City lies at 13 feet (yes, 1-3) above sea level and Los Angeles is at 126 feet. Miami is 11 feet, and Anchorage, Alaska is 144 feet. In Cuzco, Peru, where most people fly into from Lima to visit the Sacred Valley, the elevation is 10,800 feet. That's over twice the altitude of Denver (5,280 feet)!
What to Expect and When to Expect it
Typically, symptoms of altitude sickness occur between 6 and 24 hours of reaching a higher elevation and are generally worse at night. Some hotels may provide oxygen to guests who are experiencing symptoms. If you experience any of these, ask for help through your hotel, hostel, or guide. Generally, once symptoms appear, the best solution is heading to a lower elevation. Mild symptoms may include:
- nausea and vomiting
- loss of appetite
- upset stomach
- feeling unsteady
- shortness of breath
- increased heart rate
- difficulty sleeping
- generally feeling unwell
Even if you're in excellent physical condition, this really has no bearing on how you will acclimate to high altitude. Nor does your age, gender, or overall fitness level. Everyone adjusts to altitude differently and not everyone has difficulty. But why take the chance? There are several things you can do that will help significantly with acclimatization so your trip starts off on a good note.
1. Acclimatize for 3 days at the start of your trip.
Spend a few days in Lima, Cuzco - or even better, Ollantaytambo - allowing your system to adjust to the higher elevation. I suggest Ollantaytambo if you plan to explore the Sacred Valley or Machu Picchu because it lies at 9,150 feet, a lower elevation than Cuzco and therefore a more gradual adjustment. Plus, it’s closer to Machu Picchu if you plan to take the train there.
TIP: My suggestion? Fly into Cuzco and hire a guide to drive you the few hours to Ollantaytambo. You'll relax and enjoy the first amazing scenery of your trip.
2. Yoga Breathe
Even if you don't actively practice yoga, breathe from a position of awareness. Sit straight and take long, deep breaths, slowly oxygenating your body. It calms the mind, expands the lungs, steadies the heartbeat, and promotes oxygen flow to the brain.
Acclimatization is often accompanied by fluid loss, so you need to drink lots of water to remain properly hydrated (at least 3-4 quarts per day). Bring along some packets of Emergen-C to add needed electrolytes to your water, or drink sports drinks such as Gatorade. Electrolyte-enhanced waters benefit your body with added potassium and sodium which help your body absorb it more quickly. And speaking of drinking...
4. Drink coca tea!
You may have read about coca tea being the plant from which cocaine is derived, and this is true. But it is not cocaine. It has none of the habit-forming effects of the drug, and is very effective in helping your system adjust to altitude.
Coca tea is to Peru as coffee is to the rest of the world. And it's everywhere. Drinking it as a tea is easy on your stomach, tastes mildly floral like a good green tea, and is very soothing. Chewing the leaves (as the locals do) will also help adjust to altitude, and may give you a mild tingling sensation in your cheek.
Altitude Reference Table for Peru Cities
City / Height (Ft) / Height (Meter)
Lima - 5,080 ft / 1,550 m
Cusco - 10,800 ft / 3,300 m
Ollantaytambo - 9,150 ft / 2,790 m
Machu Picchu - 8,040 ft / 2,450 m
Puno - 12,420 ft / 3,860 m
Arequipa - 7,740 ft / 2,380 m
Lake Titicaca - 12,420 ft / 3,860 m (Isla Amantani - 13,300 ft / 4,053 m)
Have you been to Peru? I'd love to hear your suggestions/remedies for altitude adjustment. If you haven't been - when are you going? Check out my other posts on Peru!