Getting High in the Land of the Incas: How to Avoid Altitude Sickness in Peru


It's on the bucket list of outdoor enthusiasts for good reason. You can find just about any activity there for outdoor lovers - from sand boarding in arid deserts, hiking the famous Inca trail, or climbing Machu Picchu. You can explore the islands of Lake Titicaca with a home stay on Amantani or the unique weaving culture of Taquile. Or leisurely explore the monastery of Arequipa, one of Peru’s most walkable Colonial cities, or nearby Colca Canyon. Or — you can laze your day away in a hammock on some of the best beaches in South America (everyone needs a break now and then).

Wherever you go in Peru, you'll be traveling in high elevations you may not be used to. And you may not exactly feel yourself from the lack of oxygen.

At 10,800 feet, Cuzco has a higher altitude than many cities in Peru

At 10,800 feet, Cuzco has a higher altitude than many cities in Peru

Altitude Sickness in Peru


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 with some of the most breathtaking high altitude hikes. All of these treks are accessible to the average adventure traveler, 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.

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 dangerous - even 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 right from the airport. Especially if this is your first time to Peru. Be smart, and prepare, with these easy tips to avoid altitude sickness in Peru.


What causes Altitude Sickness?

A clear head is needed when hiking Huayna Picchu, 1,000 feet higher than the ruins of Machu Picchu

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 crossing the street or you'll be run over by cars, but that's another story for another day)! 


For example, here’s the altitude of some U.S. cities:

  • New York City lies at 13 feet (yes, 1-3) above sea level

  • Los Angeles is at 126 feet

  • Miami is 11 feet, and

  • Anchorage, Alaska is 144 feet.

By comparison, here is Peru:

  • The altitude of Cusco is 10,800 feet. That's over twice the altitude of Denver, Colorado, the Mile High City (5,280 feet)!

Most visitors to Peru fly into Lima, then on to Cuzco in the Sacred Valley. But there are several things you can do to prepare for altitude, even just by rearranging the order in which you visit certain areas. Read on to see what I mean.

He's pretty high at Rainbow Mountain - 17,060 feet above sea level

He's pretty high at Rainbow Mountain - 17,060 feet above sea level

Machu Picchu Elevation and Other Peru Altitudes

Peru Cities - Height in Feet / Meters

  • Lima elevation - 5,080 ft / 1,550 m

  • Cusco elevation - 10,800 ft / 3,300 m

  • Ollantaytambo elevation - 9,150 ft / 2,790 m

  • Machu Picchu elevation - 8,040 ft / 2,450 m

  • Puno elevation - 12,420 ft / 3,860 m

  • Arequipa elevation - 7,740 ft / 2,380 m

  • Lake Titicaca elevation - 12,420 ft / 3,860 m (Isla Amantani - 13,300 ft / 4,053 m)


Altitude Sickness Symptoms (What to Expect & When)

Me and my new friend Christian at the summit of Isla Amantani (elevation 13,400 ft) at the temple of the Earth Mother, Pachamama

 Typically, altitude sickness symptoms 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:

  • headache

  • nausea and vomiting

  • dizziness

  • tiredness

  • 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. 

How to Prepare for High Altitude in Peru

Coca tea leaves are everywhere in Peru

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.


3. Hydrate

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. Chew or Drink Coca

You may have read about coca tea effects and how it's used to avoid altitude sickness in Peru. While coca comes from the same plant from which cocaine is derived, it is not cocaine. Coca has none of the habit-forming effects of cocaine, 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. 

Steep some leaves in hot water for a soothing tea anytime of day

Steep some leaves in hot water for a soothing tea anytime of day

When it comes to breathtaking landscape and fascinating culture, Peru is like no place else in the world. There are so many reasons to visit whether you’re a nature lover, history hound, culture vulture, outdoor seeker, or Inca explorer. It’s not important why you go. Just be prepared when you do, and make the most of your trip to Peru.

Have you been to Peru? I'd love to hear your suggestions/remedies for altitude adjustment in the comments below. 

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