9 Tips For Acclimating In Cusco, Peru So You Don't Get Altitude Sickness

As a New Yorker who went from 33 ft above sea level to 11,200 ft above sea level, it's a miracle I survived Cusco illness-free.

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So you're going to Cusco! Or considering it, I assume. Maybe you're planning to hike Machu Picchu or Rainbow Mountain. Or maybe you just want to see some llamas and alpacas.

Arielle Calderon

Well, I just went to Cusco, and while I nearly passed out from hiking Machu Picchu, I surprisingly didn't get altitude sickness! It's actually pretty unpredictable if you'll get it or not, but there are some things you can do to help acclimate!

Arielle Calderon

First of all, WTF is altitude sickness and is it really that bad?

Arielle Calderon

Altitude sickness (called soroche in South America) is a group of general symptoms triggered by walking or climbing high elevation too quickly. This occurs when the body doesn't have enough time to adapt to lower air pressure and lower oxygen levels. According to Cleveland Clinic, age, sex and general health do not seem to make a difference in risk for altitude sickness. However, people with lung or heart disease may be told to avoid high altitudes. People who live at lower elevations and are not used to higher altitudes and people who have had altitude sickness previously seem to have a higher risk for altitude sickness.

Symptoms include headaches, shortness of breath, nausea, vomiting, fatigue, and lightheadedness. It's basically like having a hangover from hell after a night of too many tequila shots. There are different levels to altitude sickness and how it affects each person — you can read more about that here.

So how high is Cusco, actually?

Arielle Calderon

Pretty freakin' high. Please reference my handy chart above, but NYC (where I permanently live) is 33 ft above sea level, while Cusco is 11,200 ft above sea level. I thought Denver, CO was supposed to be bad, but dang. And if you're in Cusco planning to hike Rainbow Mountain, that's EVEN HIGHER than Cusco (and Matterhorn in Switzerland).

Symptoms of altitude sickness usually develop between 6 — 24 hours after reaching altitudes more than 3,000m (9,843 feet) above sea level.

Basically, you do NOT want to get altitude sickness. Especially if you're planning to hike and explore. So here are some tips on how to avoid or help with high elevation.

Disclaimer: I am not a doctor. Please make an appointment with your doctor if you have legitimate concerns before traveling to high elevations.

1. Ask your doctor for altitude sickness pills, and start taking them a day before you land in Cusco.

Arielle Calderon

I made an appointment to get a prescription (called Acetazolamide) and my doctor recommended I take them starting the night before, and then 1-2 per day as needed. Obviously follow only what your physician says.

They also sell these ALTI Vital pills in all the pharmacies in Cusco, so if you don't have time to visit your doctor, maybe this is an option for you.

Warning: A side effect of Acetazolamide is that it might make your hands and fingers tingle. I did not know this at first and was panicking the entire weekend trip.

2. Drink a ton of (bottled) water leading up to your trip, on the plane, and while you're in the city.

Arielle Calderon

First thing to know about Peru is that the water is NOT drinkable. Please do not drink the tap water.

Cleveland Clinic recommends you drink 3-4 quarts of water per day, which is about 5-7 standard 20 oz water bottles per day. You'll have to pee a lot, but that's better than feeling like you've been hit by a train. Hydration is key!

3. Load up on coca leaves and coca products to help thwart headaches.

Arielle Calderon

Yes, cocaine can be extracted from coca leaves. But no, it will not make you "high" or drugged out. Coca leaves in their natural form are a mild stimulant compared to coffee. But when it comes to altitude sickness, the coca leaf is often regarded as a must-have as it helps suppress pain and fatigue. Both my Airbnbs provided leaves, you can find coca products in all pharmacies, and you can likely order coca tea at most restaurants in Cusco.

4. Take it easy when you land in Cusco and try not to do anything too strenuous.

Arielle Calderon

Your body needs AIR and relaxation. I know most people going to Cusco are on vacation and want to do *all the things*, but you need to chill for a bit. Give your body some TLC. I walked around Plaza De Armas for a little, and then napped, ate dinner out, and hung out at the Airbnb. Slow and steady wins the race.

5. If you're planning to do Machu Picchu or Rainbow Mountain, make sure you acclimate in Cusco for at least a couple days to let your body adjust.

Arielle Calderon

Ok here's the thing: Machu Picchu is actually at a LOWER altitude than Cusco. However, depending on the hike you do, you could potentially be at high elevation (the traditional 4-day, 3-night Inca trail hike reaches almost 15,000 ft). And if you're doing Rainbow Mountain, that's 6,000 ft above Cusco.

Imagine you get to Cusco, get altitude sickness, and then have to hike a mountain the next day? It's just safer to give yourself some time. If you plan to exercise in any capacity, relax and acclimate first. Don't push it.

6. If you find yourself getting altitude sickness, try to go down to a lower elevation.

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A route some people take is going down to Sacred Valley and exploring Ollantaytambo and Pisac. They are at a lower elevation than Cusco, and you also get to see more Inca sites.

7. Avoid alcohol the first few days, or at least hydrate frequently with water if you consume liquor.

Arielle Calderon

Really I would say just don't drink alcohol. Maybe go out your last night in Cusco, but don't go crazy when you arrive. Alcohol dehydrates you, and that's about the last thing you want at higher elevations.

8. Eat light, but have a sufficient amount of calories. And your diet should consist of 70% carbs.

Arielle Calderon

That's right. Carb it up, people! Basically, eat your potatoes. There's over 3,000 varieties of them in Perú.

9. If you're really desperate and need air, try an OxiShot.

Twitter: @oxishotperu

It's a can of oxygen you can take when you arrive in Cusco. You can find it at most pharmacies.

Arielle Calderon is a writer temporarily based in Latin America participating in Remote Year. If you have any tips on cool places, events, or things to eat in Perú, Colombia, or Mexico, email her at [e-mail] or DM her on Instagram.