10 Ways to Avoid Altitude Sickness in Cusco and Machu Picchu

You’re scared. I know. I was too. Before heading to Peru, I obsessively scoured the Internet for information about how to prevent altitude sickness in Cusco.

I even read a couple of articles about people who died from altitude sickness (or complications from it).

This almost led me to cancel my trip to Cusco and Machu Picchu.

That was silly for a few reasons:

#1Cusco and Machu Picchu are amazing places worth at least one visit in your lifetime.

#2 You can never predict altitude sickness; you may not even get it. Physical fitness, age, and gender have no bearing on whether you will get altitude sickness. However, people at higher risk for feeling its effects are those with heart problems or lung problems. Those with sleep apnea may also experience worse problems at high altitude; if you have a CPAP machine, it is important to bring this. But first, be sure to check that it is built to operate at high altitude (yes, machines can be affected too!)

#3 There are many ways to treat it.

What is Lima, Peru’s elevation?

Almost everyone who is visiting Machu Picchu will take this route:

Land in Lima, Peru > Fly to Cusco > Take a train/hike to Machu Picchu

Lima is NOT at high altitude, but it was insanely difficult to find the exact elevation of Lima. It seems it ranges quite a bit depending on where you are in Lima.

But, according to FreeMapTools, the elevation of the Jorge Chavez International Airport is about 82 feet (25 meters) or 113 feet (34.4 meters) according to Wikipedia. Either way, it’s not high altitude and you should not feel sick due to its elevation.

Altitude sickness really becomes an issue on your next stop: Cusco.

What is Cusco’s altitude?

Cusco’s altitude is 11,152 feet (3,399 meters).

What is Machu Picchu’s altitude?

Machu Picchu’s altitude is significantly lower at 7,972 ft (2,430 meters).

At what elevation does altitude sickness kick in?

Altitude sickness generally starts affecting people at 8,000 feet or higher, so Machu Picchu isn’t really the potential problem—Cusco is. Everyone who goes to Machu Picchu must pass through Cusco. Flights land here. Buses from Lima stop here.

What is Altitude Sickness? (AKA Acute Mountain Sickness, or “Soroche” as it’s called in Cusco)

At high elevations—above 8,000 feet—the air is “thinner,” meaning there is less pressure, so while the oxygen percentage remains the same, the air is less dense, so each breath you take contains less oxygen than what you’re used to.

To counteract this, your body will, at first, need to breathe faster and pump blood more rapidly in order to take in the same amount of oxygen it is accustomed to receiving. For many people, this comes as a shock to the body, causing various symptoms.

Symptoms of Altitude Sickness

• Dizziness, lightheadedness
• Headaches
• Nausea
• Vomiting
• Diarrhea or constipation
• Difficulty breathing
• Heart racing

Acute mountain sickness is one form of altitude sickness. (Chronic mountain sickness is another, but occurs after many years at high altitude.)

Important Notes Before You Keep Reading

• There isn’t really a “cure” for altitude sickness, other than descending back down to a normal elevation.
• I am not a doctor so the following is not medical advice.

*This post contains affiliate links, which means if you choose to buy products through the links I provide, then I receive a commission at no extra cost to you. Links are to products similar to the ones I personally used in Cusco.

How the High Altitude in Cusco Has Affected Me

I’m from Florida—flat, sea-level Florida—so high altitude just isn’t in my blood. Prior to April 2014, I had never been at altitudes as high as Cusco. Therefore, I felt I was a prime candidate for altitude sickness (although, again, you never truly can predict it).

Now I’ve been in Cusco since April, on and off. I’ve arrived in Cusco three separate times; in other words, I visited here for 10 days, went to Buenos Aires for 10 days, came back to Cusco, went to the U.S. for two weeks, then came back again. Each time I arrive in Cusco, it gets easier to acclimate.

The first arrival, I had a pounding headache for five days, though it wasn’t so bad that I couldn’t do activities. I think I took Tylenol a couple of times to relieve the headache. I also drank coca tea during my first visit, but haven’t since (there’s no proof it actually works). Thankfully, my symptoms have never been worse than that.

Below are the many ways to treat altitude sickness in Cusco, including natural ways.

#1 Take it easy.

This is seriously the easiest—and most ignored—piece of advice for avoiding altitude sickness.

Remember, your body is trying to get accustomed to the lower amount of oxygen it’s getting; therefore it is of utmost importance that you take it easy the first few days you are in Cusco.

Don’t go on hikes or long walks. Don’t put any excess stress on your body—it’s already working overtime to oxygenate your blood!

#2 Take deep breaths.

Again, your body is trying to get oxygen, but there is less of it available in each breath. So take deep breaths to try to get more air in.

#3 Avoid alcohol.

The reasons for this are debated, but certain studies show that the effects of alcohol are enhanced at high altitude (i.e. You get drunk more easily).

Also, alcohol may exacerbate the effects of altitude sickness. Hold off on the Pisco Sours for the first couple of days you’re in Cusco.

#4 Drink lots of water.

This may not alleviate altitude sickness exactly, but sometimes it’s hard to tell the difference between altitude sickness and dehydration, and high elevations tend to be very dry, meaning you need more water for proper hydration.

#5 Acclimate at a lower altitude, and ascend slowly.

This piece of advice is sometimes hard to follow because it means changing your trip plans. A lot of people recommend that the second your plane lands in Cusco, you should take a taxi or colectivo to the Sacred Valley, about an hour outside of Cusco, where the elevation is about 2,000 feet lower. This allows you to acclimate at a somewhat lower altitude, and then move back up to Cusco when your body is more used to high altitude.

The other option is to take a 21-hour bus ride from Lima to Cusco. Some people think the Lima-Cusco bus is a better option because it allows you to ascend slowly over the course of 21 hours—however, the bus route is very curvy and mountainous, so you will likely get very car sick if you’re prone to motion sickness.

#6 Take Diamox.

In the U.S., Diamox (generic name: acetazolamide) is a prescription drug often used to treat glaucoma; however, it can also treat altitude sickness.

You need to take it 24 hours before arriving in Cusco, though, and a side effect of the drug is that you’ll probably need to pee more frequently—not very convenient when you’re traveling. I brought Diamox with me, but have never used it.

#7 Bring chlorophyll drops. (Yep, chlorophyll as in the green stuff from plants.)

This one took me by surprise! I had never heard of this treatment until I met a couple on the train from Machu Picchu to Cusco. They told me they had brought a small bottle of chlorophyll drops they’d bought at a natural health store back in the States, and they put a few drops in their water every day and never suffered any ill effects from the altitude.

The idea behind this natural treatment is that the chlorophyll may increase the amount of red blood cells in your system; the more red blood cells there are, the more opportunities there are for oxygen to be absorbed, thereby reducing the effects of altitude sickness.

On my second trip to Cusco, I brought these Vitamin Shoppe Liquid Chlorophyll Drops and mixed a few drops in with my water—it turned my teeth green, but it wasn’t bad at all.

I never got sick from the altitude on the second trip (other than a mild headache), so maybe it helped! If you’re worried about green teeth or the taste of the drops, you can get chlorophyll soft gel caps instead. I really like using natural remedies, so I felt good about taking chlorophyll drops instead of Diamox.

Click here to check the latest prices on chlorophyll drops for a natural altitude sickness remedy!

#8 Buy Oxishot.

These are plastic tubes filled with oxygen! They’re sold in almost every pharmacy in Cusco. However, many people claim it’s a gimmick. Yes, it contains real oxygen, but it’s such a small amount that it probably will have no effect on you. Your best bet is to go to a hotel or hospital that has real tanks of oxygen.

#9 Go to a 5-star hotel, or the emergency room, and get hooked up to oxygen.

If your altitude sickness reaches emergency status, of course, go to the hospital!

If it’s not an emergency, but you’d like an oxygen tank, many 5-star hotels keep them on-hand for guests.

#10 Take Ginkgo Biloba extract

Another natural herbal remedy besides chlorophyll is Ginkgo Biloba—and this one I have scientific research to back up!

A 2008 study on the prophylactic effects of Ginkgo Biloba found that participants who took 80 mg of the extract every 12 hours 24 hours before ascending to high altitude had significant reduction in their Acute Mountain Sickness in comparison with those who took acetazolamide (Diamox) or the placebo.

The researchers concluded that the results supported the use of Ginkgo Biloba to prevent altitude sickness, stating: “24 hours of pretreatment with G biloba and subsequent maintenance during exposure to high altitude are sufficient to reduce the incidence of AMS in participants with no previous high-altitude experience.”

So if you want science-backed altitude sickness treatment that’s all natural, get yourself some Ginkgo biloba extract! This one specifically comes in 80 mg capsules.

Bonus! Bring a Blood Oxygen/Pulse Meter

You know those little “finger pulse oximeters” they put on your fingertip when you’re in the hospital?

Thanks to my super smart and always prepared dad, I brought one of these with me, and it’s been great at helping me monitor myself (and others) to see if I’m getting to “emergency” status.

• Basically, your SPO2 (blood oxygen level) shouldn’t fall below 90%. In Florida, mine is normally 99%. When I first got to Cusco, it fell to 69%! This is serious. I just lay down for a few hours and breathed deeply, and I was fine.You can also use this to keep track of your heart rate. In Florida, my resting heart rate is usually in the low 70s. In Cusco, it’s usually in the 80s.
• Click here to get a blood oxygen meter to check your levels while in Cusco!
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• Conquer Cusco’s Altitude—and Have Fun!

• While you shouldn’t let the fear of altitude sickness cancel your trip, you should also take any symptoms of altitude sickness seriously. As long as you listen to your body and take precautions, you should be fine.

• *Note: This is probably pretty obvious, but I am not a doctor, so this post should not be used as a substitute for medical advice. Before heading to Cusco, you need to visit a doctor to get vaccinations anyway, so while you’re there, check with him/her about the different options for treating altitude sickness.

Check out my other Machu Picchu posts!

How Much a Trip to Machu Picchu Costs: Breakdown of My Itinerary

15 Things You Should Know Before Visiting Machu Picchu

How to Avoid Traveler’s Diarrhea in Peru

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