Here’s the question nobody likes to say out loud before a trip to the Andes: will the altitude get me?
Honest answer? It might give you a bit of a wobble. It rarely ruins anything, though, and with some planning it usually barely registers. Let’s go through it properly.
The numbers, quickly
Lima sits near sea level. Cusco is around 3,400 metres. The Sacred Valley is lower, roughly 2,800 to 2,900 metres in towns like Ollantaytambo and Urubamba. And Machu Picchu, which surprises people, is lower still at about 2,430 metres. So the city is the high point, not the famous ruins.
It isn’t about fitness
This is the part that catches strong, active people off guard. Being fit doesn’t decide who gets altitude sickness, and being less fit doesn’t doom you either. Marathon runners get headaches. Plenty of people who never exercise feel fine. The one thing that does seem to matter is whether you’ve had it before. So if you have, tell us.
Go down before you go up
The best trick is also the simplest: order. Instead of landing in Cusco and heading straight into town, many travellers start in the Sacred Valley first, sleeping a few hundred metres lower, then come up to Cusco once their body has had a little time. The CDC notes that spending two to three nights at moderate altitude, around 2,450 to 2,750 metres, before going higher is markedly protective. The valley sits a touch above that, but the idea holds: climb in steps, not in one jump.
Your first day, the easy way
Slow down. Really. Walk like someone with nowhere to be, because you are.
- Drink water, more than feels necessary.
- Eat light. A big heavy lunch can sit badly up here.
- Go easy on the wine the first night. It’s tempting. Wait a day.
- Rest in the afternoon, even if you feel great.
- Coca tea is a local habit and many visitors find it comforting. It’s no substitute for pacing yourself, though.
What it feels like
Mostly a headache, a bit of nausea, some dizziness, feeling tired, sleeping badly. Often you notice it first thing in the morning. If that’s you, don’t go higher. Rest, drink water, tell your guide, and let your body catch up. For most people it fades within a day or two.
The signs that matter
Rare, but worth knowing. If someone becomes confused, can’t walk in a straight line, gets short of breath even while resting, or develops a wet, persistent cough, that isn’t «just altitude.» It means getting down to a lower height and seeing a doctor, soon. Don’t wait it out. A good guide knows this and won’t hesitate.
A word about medication
Some travellers use a prescription medication such as acetazolamide to help their body adjust. It isn’t for everyone, and it’s not something to borrow from a friend. If you’re thinking about it, talk to your own doctor before you leave, especially if you have a heart, lung or other health condition.
How we plan around it
We start gently. The first days are built around easy walking, good sleep, and a proper dinner, nothing that asks your lungs for too much too soon. Some Cusco hotels can also arrange extra oxygen in the room, which is worth asking about.
So, tell us about yourself. Past trips at height, health conditions, and how you usually feel at altitude. Write to us, and we’ll set up a video call to shape a plan that fits you and gets you to the good part of the trip feeling well.
