Machu Picchu Altitude Sickness

All treks to Machu Picchu involve going to ‘high altitude‘, and therefore come with obvious altitude sickness risks.

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It is important that you understand these risks so that you can take the best preventative actions, as well as be well-informed on how to deal with altitude sickness symptoms, and it’s severe variants – High Altitude Cerebral Edema (HACE) and High Altitude Pulmonary Edema (HAPE) – both are very rare conditions on Machu Picchu treks.


Altitude Sickness, often known as Acute Mountain Sickness (AMS) is particularly an important consideration while trekking in Nepal. Altitude Sickness means the effect of altitude on those who ascend too rapidly to elevations 3000m. The initial symptoms of AMS are as follows:

Nausea, vomiting
Loss of appetite
Insomnia / sleeplessness
Persistent headache
Dizziness, light headache, confusion
Disorientation, drunken gait
Weakness, fatigue, lassitude, heavy legs
Slight swelling of hands and face
Breathlessness and breathing irregularly
Reduced urine output
These symptoms are to be taken very seriously. In case of appearance of any of the above symptoms any further ascend should be reconsidered; otherwise more serious problems may occur which can even cause death sometimes within a few hours. The only cure for the Altitude Sickness is to descend to a lower elevation immediately. Acclimatization by ascending to no more than 300 to 500 meters per day above 3000 meters and the proper amount of rest are the best methods for preventions of AMS.


Less Oxygen
Low pressure ie: Barometric Pressure
Rapid Ascent
Possible Dehydration

AMS : Acute Mountain Sickness
HAPE: High Altitude Pulmonary Edema
HACE: High Altitude Cerebral Edema



Mild symptoms feels like a hangover / not feeling well:
Fatigue / Tiredness
Shortness of Breath
Loss of Appetite
Disturbance in Sleep


Water in Lungs.
Increasing shortness of breath even at rest
Severe cough – Dry / productive
Very tired unusual fatigue while walking
High pulse rate, ie: 110
Blueness of face, lip, fingernails – that means the inability of transporting oxygen into the blood.


Water in the head :
Severe headache
Walking like an intoxicated (ataxia)
Mental confusion / altered mental status
Irritable – does not want to be bothered by other people
Unconsciousness or coma
Test: tandem walking test, heel to toe step. Fall off from the line.


Acclimatization – after a 1000m ascent, stay one more night for acclimatization.
Do not make a rapid ascend, don’t go too fast too high.
No alcohol, sleeping pills and smoking.
Drink more fluid 3-4 liters a day – clean water, boiled and filtered, or treated tea/coffee/soup/juice etc.
Do not carry heavy packs, 10-12 kgs ok.
Climb higher, always sleep lower.
Over 3000m, 300m ascent a day.
Never travel alone.

How does this apply to treks to Machu Picchu?

Well, as we mentioned above, Cusco is already at high altitude and generally above most people’s acclimatisation line. Hence symptoms of mild altitude sickness (see below for details) are common. For trekkers, the best solution in our opinion, is to stay in Cusco for at least two days to starve off mild altitude sickness symptoms and acclimatise (most tour operators include a two day acclimatisation period in Cusco as part of their tour package). All trails to Machu Picchu involve going over high passes (over 4,500m), so acclimatising early, albeit at a relatively high altitude, is worthwhile.

Alternatively, if you are just visiting Machu Picchu (2,430m) by train, it is possible to fly into Cusco (3,400m) and then descend immediately into the Sacred Valley (1-2 hour bus/car ride) to the towns of Urabamaba (2,800m) or Ollantaytambo (2,792m) where it is easier to start the acclimatisation process. Resting here for a day or two before proceeding to Machu Picchu by train, which departs from Ollantaytambo, can help lower the probability of experiencing altitude sickness. That being said you will still need to return to Cusco after Machu Picchu which could result in the onset of altitude sickness symptoms.

The absolute ideal scenario would be to fly into Cusco and then immediately drive to the Sacred Valley to rest for a couple of days. Then return to Cusco to rest for a few days, and then begin your trek. Most people don’t have the time or inclination to do this.


Coca is a plant that grows naturally in Peru and features prominently in Andean culture for it’s medicinal and superstitious qualities. A pharmacologically active ingredient in the coca plant, called the coca alkaloid accounts for about 0.8% of the fresh leaf and in it’s refined form makes cocaine. Drinking coca tea or chewing the leaves do not however produce the same effects as cocaine.

When chewed, coca can act as a mild stimulant and has been shown to repress hunger, fatigue, thirst and pain. Traditionally, various Andean cultures use the coca leaf for a number of medicinal, nutritional and religious purposes.

One traditional use is in the prevention of altitude sickness. Locals either chew the leaves or drink coca tea, and encourage tourists to do the same as a preventative measure.

There is however no conclusive evidence that coca leaves help prevent the onset of altitude sickness, or indeed help treat the symptoms.