How to prevent altitude sickness when visiting Machu Picchu and Cusco

Most people that go on vacation to Peru, will visit Machu Picchu and Cusco, which are located high in the Andes mountains. Cusco is located at 3,400 meters whilst Machu Picchu is at a lower altitude of 2,430 meters. There are 2 ways to reach Cusco; by road or by air. The best way of preventing altitude sickness, is to travel by bus, as your body will steadily become acclimatized to the lack of oxygen as you travel up the Andes. However, the bus journey from Lima is around 20 hours, so most people prefer to take a plane instead. Taking the plane will increase the chances of altitude sickness, as your body won’t have a chance to fully acclimatize until you get off the plane in Cusco and relax for the first couple of days.

Oxygen levels in Cusco are know to drop by 5-6%, which is enough to make some people feel the effects of altitude sickness, so it is important to follow the advice below to help you enjoy your trip to Machu Picchu and Cusco.

Types and Symptoms of Altitude Sickness

There are 3 main types of altitude sickness:

Acute Mountain Sickness (AMS)

This is a mild form of altitude sickness that could be associated with a hangover or after having bad food. Symptoms could be any of the following:

  • Headache
  • Dizziness
  • Nausea
  • Fatigue
  • Shortness of breath when exerting yourself
  • Insomnia

If anyone has any of these symptoms, it is important to descend to a height where the symptoms subside. Ideally, you should stay at a lower height for a day to acclimatize.

High Altitude Pulmonary Edema (HAPE)

HAPE is a build-up of fluid on the lungs and can be very dangerous if precautions are not taken.
It usually develops within 2-3 days at altitudes above 2,500 meters above sea level (Cusco is 3,400 meters). Symptoms can include:

  • Coughing
  • Breathlessness with little exertion or even at rest
  • Rapid heart rate
  • High body temperature
  • Confusion
  • Feeling of suffocation

If anyone has any of these symptoms and believe that it could be HAPO, then immediate descent to lower ground is required and they will need to go to a medical facility for follow up treatment.

High Altitude Cerebral Edema (HACE)

HACE is known to be the most severe type of altitude sickness and results in the swelling of the brain tissue from leaking fluid. It is very rare to suffer from this and only around 1% of people that ascend to above 3,000 meters suffer from HACE. Some symptoms include:

  • Headache
  • Loss of coordination
  • Loss of memory
  • Hallucinations
  • Coma
  • Loss of consciousness

If you or anyone in your group thinks that they could be suffering from HACO, it must be treated as a medical emergency and must be taken to a medical facility for treatment immediately.

Things to do to help reduce the risk of altitude sickness

Acclimatize at a lower altitude before you ascend higher
Not everyone can easily follow this advice and not everyone necessarily has to, but it is recommended that if you fly into Cusco that you take a day to get acclimatized to the altitude or even better, take a bus or taxi to the Sacred Valley, which is around 600 meters lower than Cusco and acclimatize there.

Drink plenty of water
The main reason for this is to help you distinguish between being dehydrated or suffering from altitude sickness, as the symptoms can be similar e.g. you can suffer from headaches with both. So make sure you drink more water than you normally do and stay hydrated. You can also drink sports drinks that contain electrolytes, which help you to stay hydrated as well.

Take it easy
It can be tempting to push yourself when you are on an adventure, but be careful about over exerting yourself.

Avoid alcohol and smoking
Even though that ice cold Pisco Sour might be tempting, you should really try to avoid any alcohol for the first couple of days from when you arrive. Alcohol and smoking can make the symptoms of altitude sickness worse.

Drink coca tea or chew coca leaves
There is no scientific evidence that this helps to prevent altitude sickness, but the locals in Peru swear by them. They are legal in Peru, but are illegal in other countries, so be careful about bringing any back home with you.


Take some medication

Acetazolamide can be taken up to twice a day and you should start taking it a couple of days before you travel to Cusco and keep on taking it when you are ascending. Please consult your doctor about this.
For the majority of people, altitude sickness doesn’t last for long and is not going to affect their trip. Don’t let this article frighten you into not going to Cusco and Machu Picchu, as it is very unlikely that you will have major problems. Just make sure to follow the advice here, as best as you can and you should be able to enjoy your trip to Machu Picchu without the effects of altitude sickness.If you are unsure about anything, then please consult with your doctor who can give you more advice.

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