Staying Healthy at High Altitude in Cusco and Machu Picchu

Combat altitude sickness by spending your first 48 hours in the Sacred Valley instead of downtown Cusco and staying hydrated with at least 3 liters of water daily. Consult your doctor about acetazolamide (Diamox) prescriptions before you leave home to proactively manage symptoms.

1. Acclimatize in the Sacred Valley. Avoid staying in Cusco city (11,152 ft) on your first night. Take a taxi directly to the Sacred Valley (Ollantaytambo or Pisac, roughly 9,000 ft). The lower elevation allows your body to adjust before you tackle the higher altitude of the city or the Inca Trail.
2. Manage your intake. Avoid heavy meals and alcohol for the first 72 hours. Your digestion slows down at high altitude; stick to light meals like soups or quinoa. Limit coffee, as it contributes to dehydration.
3. Use local remedies cautiously. Drink coca leaf tea (mate de coca) offered at most hotels; it is a mild stimulant that helps with headaches. However, do not over-consume if you have heart conditions or are sensitive to caffeine.
4. Monitor for danger signs. If you experience a persistent cough, fluid in the lungs, or confusion, descend immediately. These are signs of HAPE or HACE (High Altitude Pulmonary/Cerebral Edema) and require emergency medical evacuation.

Does everyone get altitude sickness?

No, but it is unpredictable. Fitness levels do not protect you; even elite athletes can suffer if they ascend too quickly.

Is bottled oxygen worth it?

Yes, many hotels in Cusco offer supplemental oxygen canisters for rent. If you feel lightheaded, a few minutes of oxygen can make a significant difference.