Cusco is situated 11,400 feet above sea level. Machu Picchu is situated about 9,000 feet above sea level. Therefore altitude sickness is a concern for everyone planning a trip there. While planning my trip, I tried to get as much information as I could about how to stay feeling my best and avoid getting ill.

While I found a few useful tips online, the best info I learned was from a mix of how I personally felt on the trip and what made me actually feel better there, tips from my trip’s tour guide, and tips from friends who did the trip before. I put everything I learned together for you here so you can access all these tips at once. I hope you find it useful.

Preparation

• Rest up – Rest up as much as you can for a few days before the trip to Cusco, as the altitude can take it out of you and be very tiring. Therefore, getting some extra rest before going will prepare your body to be able to handle the extra stress on it better. Sleep an extra hour or two a night if you can, and relax as much as possible.
• Eat light – The altitude can affect your stomach, and it slows down the process of digestion a lot. Therefore, eating light meals for a few days before going helps prepare your stomach. Also eating light while there helps, as the digestive system takes a lot longer to process food that high up.
• Hydrate before the trip – For a few days before your trip, make a point of drinking more water than usual. If you usually drink two litres a day, up your intake to three, as getting to the higher altitude already well hydrated will help avoid being affected as much.
• Lower or cut alcohol before the trip – Either lower or completely pause your intake of alcohol for a few days before the trip. Alcohol dehydrates and can cause dizziness so keeping clear of it just before this trip can help prepare your body.

Less booze

• Alcohol in Cusco – Don’t drink alcohol while in Cusco if you have any adverse effects from the altitude. Its best to stay away from it on the first night to check how you are, as one drink has the equivalent effect of about three drinks at this height – like on a plane. Its common to earn a hangover from just one drink, so don’t invite that on your precious time in Machu Picchu. Also, your cheeks can get very red and hot from just one drink.

Water is your friend

• Bring water for the plane – Water (and soft drinks) are allowed on the plane to Cusco and on all domestic flights within Peru. Take water with you to sip on the plane. If you are well hydrated, you will be affected less.
• More H20 – Drink 1.5 to 2 times more water at this height than you usually would. So if you usually drink two litres, drink 3-4 litres each day of the trip. Also, sip water, don’t chug it.

Top tip: Coca leaf products

• Coca tea – Coca tea is made from the leaves of the coca plant Yes, this is where cocaine comes from, but the leaves are an entirely different part of the plant which have absolutely no connection to it. Coca tea will be available at any hotel you stay at, and almost all restaurant and bars in Cusco will have it too. When you arrive, drink several cups of it as soon as you can to help you acclimatize.
• Coca leaves – When you arrive at Cusco airport, there is a large basket with coca leaves in it offered complimentary to newly landed visitors. Take a handful and chew a few slowly. Cusco hotels have the leaves offered in baskets next to hot water to make coca tea. Anytime you are offered the leaves, take some with you, as they are useful to chew throughout your time at high altitudes, not just at the very start.
• Coca tea and caffeine – Coca tea is a stimulant and its effect is like coffee or mate, with much higher caffeine content in it than other teas, so it should be drank when you’d usually have coffee and not too late as it can keep you awake. Coca tea is great in the morning or at lunchtime, but as a general guide, don’t drink it after 4pm.
• Mixing medications – Some medications don’t mix well with coca tea. If you are taking certain prescription medications for conditions such as heart issues, you cannot drink coca tea. Check with your doctor before traveling if you are on any heart medication. If you are on any other medication, it’s probably advisable to check too.
• Coca tea alternatives –
  • Muna tea – If you are on medication that you can’t drink coca tea with, or if it is too late in the day and you need something to help with altitude sickness, Muna tea is an excellent alternative. Cusco hotels and restaurants also provide this. This is an antiseptic, mint tea, which also helps with stomach issues.
  • Manzanilla tea – This is good if the altitude is making you feel queasy, and for an upset stomach, or if you its too late in the day for coca tea. This is also available in hotel rooms and in all restaurants in Cusco. This is a floral tea that tastes more like chamomile and is used throughout Latin countries as a general all round “feel better” tea.
• Coca products – Coca candies, toffees and cookies also help with the effects of the altitude. They are available to buy at the airport, all markets and shops in all the towns in the area, and only cost about one to two dollars for a packet.

Be cautious with medication

• Altitude sickness medicine as prevention – If you think you are very likely to be affected by altitude sickness, and your doctor agrees, you can be prescribed medication as a precaution for this. If you are concerned, see your doctor.
• Altitude sickness medication and coca tea – If you are taking prescribed altitude sickness medication, you should not drink coca tea as they can adversely affect each other.
• Asthma – If you suffer from asthma at all, even if only very mild symptoms bring your inhalers on the trip and keep them with you at all times. The thinner, less oxygenated air can make you wheezy and out of breath very easily, so be safe.

Take it easy on yourself:

• Put your feet up – When you arrive in Cusco, put your feet up, literally. This helps with irrigating the oxygen in the blood, so is very helpful in being preventative against altitude sickness.
• Pillows – Sleep with pillows under your legs the first night you’re in Cusco, as it’ll reduce any puffiness from the altitude and take away any leg pressure.
• Oxygen – Every hotel in Cusco has oxygen tanks available in their reception for guests to use. They don’t usually even charge for it. If you’re feeling bad, don’t be shy about it tell someone. The hotel can easily give you five minutes or so breathing in the oxygen, and you will feel much better. On my trip, three people in my group felt quite ill, but after just five minutes of oxygen, they felt fully recovered.
• Go slow – Walk slowly while at this elevation, especially when you just get there. It really does take the wind out of you. Walking for two blocks feels like you’ve just ran for a couple of miles. The best thing to help is go slowly. Your body is taking in less oxygen than at a lower elevation, so it will tire easier.

Giving your body a little extra care, using trusted local advice on things to consume and avoid and above all, taking a little more time will help you get through the altitude without ill feeling spoiling your time there. Try not to stress too much about altitude sickness as if you worry a lot about it, you’re more likely to actually get sick. So follow this advice and get excited about the incredible trip you’re taking, and enjoy it.

Here are more articles on Machu Picchu and Peru:

Machu Picchu – What should I pack for a three-day overland trip with a cruise ship?

Don’t be coy, try a cuy – Eating guinea pig in Peru

Cusco Suenos