Getting High In Peru: How to prepare for the Inca Trail and high altitude hiking in the Andes.

Hiking the Inca Trail is one of those bucket list items most people dream of. It has the perfect combination of spectacular archaeological sites and beautiful scenery that make it a can’t miss experience.  One of the only things that prevents most people from enjoying their time on the Inca trail and hiking throughout most of Peru is the altitude. A typical walk in the park can turn into an epic feat of endurance when you are high up. I live in a spot that is pretty close to sea level, so I didn’t know how altitude would affect me. I had heard horror stories of people getting really bad altitude sickness in Cuzco and it was making me nervous for my time in Peru. 

What is altitude sickness?

Altitude sickness occurs when you cannot get enough oxygen from the air at high altitudes. As you go up in elevation, the pressure decreases, making the air ‘thinner’.  Even though the percentage of oxeygen is the same, the air is less dense so every time you breath, your body is taking in less oxygen. It happens most often when people who are not used to high altitudes go quickly from lower altitudes to 8000 ft (2438 m) or higher. Altitude sickness can affect your lungs and brain. Symptoms tend to be worse at night and when your respiration is slower. Mild altitude sickness does not interfere with normal activity and symptoms generally subside within two to four days as the body acclimatizes. At over 3,000 metres (10,000 feet) 75% of people will have mild symptoms. Altitude sickness can happen to anyone, no matter how fit or healthy they might be.  


What are the symptoms?

  • Headache
  • Nausea & Dizziness
  • Loss of appetite
  • Fatigue
  • Shortness of breath
  • Disturbed sleep
  • General feeling of malaise

The symptoms usually start 12 to 24 hours after arrival at altitude and begin to decrease in severity around the third day. 

How did the altitude affect me?

When I first landed in Cusco, my feet and body felt heavy. I also felt like my head was a little foggy, similar to a hangover or not getting enough sleep. As the day progressed I developed a headache. I took some ibuprofen and drank a lot of coca tea to stay hydrated. The heavy feeling and fogginess went away on the second day but the headaches got worse. By the third day my headaches were almost completely gone. I didn’t suffer anymore effects of altitude until we took a bus to Puno and Lake Titicaca. Along this road they let us out at  a viewpoint and I felt really out of breath again. 


What can we do to avoid altitude sickness? 


1.Get in shape 

We are all guilty of letting our exercise regimes slack a little, but now is the time to kick it into high gear. Start slowly increasing your cardio routine about 2-3 months out from your departure time. ( Make sure to consult your doctor before starting any fitness routine.) I highly recommend interval training because it will prepare your heart for high bursts of anaerobic activity. A spin class or HIIT routine is perfect for this.

Walking on a treadmill with the incline as high as you can tolerate will also prepare your calves, butt, and hamstrings for the steady ascents you will face on the trail and the infamous “stairs of death” at dead woman’s pass. Keep in mind, even Olympic athletes can get altitude sickness. Being in shape does not exclude you from getting altitude sickness. Training just prepares your body for the coming activity and will make the hike more enjoyable because your muscles won’t be as sore.

2. Slowly acclimate

If you are headed to Peru for 1-2 weeks, plan your itinerary to gradually increase elevation as you go. Most people fly into Lima and then head straight to Cusco which is a gain of over 5720 ft. If you add in a few days at another site beforehand, you can give your body some time to build up red blood cells. I recommend heading to Arequipa for a few days before heading on to Cusco. It has some beautiful architecture, awesome food and lots of outdoor activities to enjoy.

 If you can’t add in a few days before hand, head to the sacred valley when you touch down in Cusco. Pisac and Ollantaytambo are two cities in the Sacred Valley and they are almost 2000 ft lower than Cusco. There is lots to see and do in this area.                                                                                                                                    

 Here is a list of some of the major sites in Peru and their corresponding elevations. 

City Altitude (ft/m)
Lima 5080 / 1550
Arequipa 7740 / 2380
Machu Picchu 8040  /2450
Ollantaytambo 9150 / 2790
Cusco 10800 / 3300
Puno 12420  /3860
Lake Titicaca 12420 / 3860

3. Hike high, sleep low

This is the strategy by which you sleep at a lower elevation to which you have ascended during the day. A perfect way to do this in Cusco is to hike up to Saksaywaman during your stay in Cusco. This amazing archeological site sits at 12,142 ft. and has lots to see. Spend half the day exploring the area and then head back down to Cusco (elevation 10,800 ft) to sleep at night. 


4. Stay Hydrated 

When you are at altitude you tend to loose your lust for food and drink . Keep on drinking plenty of water and avoid alcohol and caffeine. You will find coca tea everywhere in and around Peru and this stuff seems to work like magic. Maybe it is the placebo effect, or maybe it was from drinking lots of this liquid, but my headaches seemed to get better and I felt less dizzy after having a few cups of this wonderful elixir.

Don’t worry, even though the coca leaf is the raw material in cocaine, its effects when made into tea are quite different.  Coca is a mild stimulant that combats thirst, hunger, pain and fatigue, without the euphoria and psychoactive effects of cocaine. 

5. Take it easy 

During your first day or two in Cusco, just take your time doing some nice walks around the city. It is full of beautiful places to see. You can spend a whole day visiting the Plaza de Armas, the Iglesia de la Compañía de Jesús, the Cathedral of Santo Domingo, and the many museums clustered around the city center.

 Listen to your body, if you feel like you can take on more, head into the San Blas area of Cusco. This beautiful and atmospheric neighborhood is located in an increasingly steep area, a short walk up from the Plaza de Armas. It is full of artsy shops, galleries, and some of the best bars and restaurants in Cusco. 

6. Go slowly 

It’s not a race. On any hike, take your time to really enjoy the scenery. Stop and take photos and drink some water. This will give you time to catch your breath and recover. I am an avid photographer so I am constantly stopping to snap a pic. This helps me catch my breath and get my heart rate back down. 

7. Hire a porter 

Don’t feel guilty about handing your heaviest gear off to a porter. You will thank me when you are hiking up dead womans pass and your tiny day pack feels like an elephant on your back. In addition to easing your burden, hiring a porter injects money into the local economy and gives these people a good income relative to others locals working in the area.

8. Bring poles 

Hiking poles are a life saver. They distribute the burden off of your legs and onto your arms to help propel you up the mountain or slow your descent down the hill. Poles reduce the impact on your legs, knees, ankles, and feet. This is especially true when going downhill. A 1999 study in The Journal of Sports Medicine found that trekking poles can reduce compressive force on the knees by up to 25 percent.

The extra two points of contact significantly increase your traction on slippery surfaces like mud, snow, and loose rock, this is imperative when you are hiking anywhere in Peru. Lots of the trails in and around Machu Picchu are made up of giant irregularly sized rocks. It’s easy to trip or loose your footing on the rocks especially if it is raining. I use REI Traverse Power Lock hiking poles. They are great value for the money. 

9. Take Diamox (Acetazolamide) 

If you are really feeling the effects of altitude sickness, get yourself some Diamox. This medication is the most tried and tested drug for altitude sickness prevention and treatment. It works by increasing the amount of alkali (bicarbonate) excreted in the urine, making the blood more acidic. Acidifying the blood drives the ventilation process, which is the cornerstone of acclimatization.

Side effects of acetazolamide include: an uncomfortable tingling of the fingers, toes and face; carbonated drinks tasting flat; excessive urination; and very rarely, blurring of vision, so consult a doctor before taking this medicine. Take this medication before you head to Peru to see how it affects you first. If the side effects are worse than the benefits it would be best to acclimate naturally by gradual accent instead.

10. Be Prepared 

Being prepared for your hiking adventures before you get to Peru, will ensure your time on the trail goes well. Here are a few important tips to get prepared:


Wear sunscreen and/or sun protective clothing – 

The suns rays at high elevation can cook you in an instant. The last thing you want to do is to spend all day hiking in the sun and end up with a painful sunburn that will make the rest of your trek miserable.  You can still get fried even though it can be deceptively cool or overcast.  A wide brimmed hat, sunscreen, sunglasses, light long sleeved shirts and pants are best for avoiding the high altitude sun.

Break in your hiking shoes before you arrive in Peru –

So many people get new shoes right before they leave for a major hiking trip and end up with painful blisters during their treks. It would be a shame to have bleeding blisters end your time on the trail. 

Make sure your backpack is sized appropriately for your body –

Having the weight of your pack on your hips rather than your shoulders will make the load feel lighter. Buy your pack from a reputable place and they can help size you and pick out the right pack for your body.

Bring clothing for every weather condition- 

The weather can change in an instant up in the mountains. Make sure you pack warm and waterproof clothes. Having the right gear can mean the difference between a happy hiker and a miserable hiker. 

I hope my tips help you have an awesome time during your hiking adventures in Peru. Don’t let the high altitudes scare you away! This view is totally worth it! 

Machu Picchu


*Important Note:

I am not a doctor. Before heading out on any international trip, you should always consult with your physician first. Ask them about the different options that will be the most appropriate for you. 



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