If you’re all caught up on our adventures through Peru and Bolivia during summer 2016, you know that living life at 12,000 feet above sea level didn’t really agree with Adam and me. Combined with the fact neither of us are doctors, it might come as a surprise that we do indeed have tips to share on how to avoid altitude sickness.
After effectively field-testing a number of different strategies during our week in the Andes, here are our thoughts on what worked, what didn’t, and what you can do to keep altitude sickness at bay.
Altitude Sickness Tip #1:
► KNOW WHAT ALTITUDE SICKNESS LOOKS LIKE—AND KNOW IT’S OUT OF YOUR CONTROL
Altitude sickness occurs at high elevations when the body isn’t receiving enough oxygen. The air gets thinner the higher up you go, which means oxygen levels drop and are much lower in places like Cusco and La Paz than at sea level. For some people, this isn’t a problem; some bodies quickly adapt and learn to operate efficiently within a matter of hours with few or no side effects. For other people, symptoms like nausea, fatigue, and headache can set in quickly or over the course of a day.
How can you tell if you will be among the lucky ones who aren’t impacted by high altitude? In short, there’s nothing you can do. You won’t know how your body will react to altitude until you are at a high elevation. Once you’re on the ground, though, there are a few telltale signs that often appear in short order:
- Headaches (Adam and I both had splitting headaches during our first night, and mine recurred quite often for the first few days)
- Lightheadedness or dizziness
- Higher than normal heart rate or heart palpitations
- Difficulty sleeping (I had a lot of trouble staying asleep most nights)
Altitude sickness is no joke. It can be life threatening. Some people experience more severe symptoms like trouble breathing even while not actively moving around, confusion or trouble processing information, and difficulty standing up. These symptoms can be indicative of a much more serious issue with altitude which can necessitate an emergency trip back to sea level. While most people don’t experience such issues, it’s important to know what they are so you can recognize them in yourself or others and get the help you need if you get very sick.
Altitude Sickness Tip #2:
► GET YOUR REST
Travel can really take its toll on the human body. When Adam and I visited Cusco, we did everything wrong. Our flight from Washington, DC to Lima was a redeye that left at 11:30 PM and landed at 6 AM, and neither one of us slept. We rushed through the airport to catch our connection and were still wide-awake when we landed in Cusco. As soon as we were off the plane we were sprinting toward baggage claim, and once we were checked into our hotel we immediately headed back outside to walk toward Plaza de Armas. After a lengthy trek and a long lunch we finally went back to our hotel—and by then we had both been awake for close to 36 hours. Those were bad decisions all around.
Treat your body well, and take rest seriously. If you, like us, end up on a redeye that leaves you with little or no sleep between departure and arrival, skip sightseeing on your first day and relax in the hotel. Catch up on your sleep if you can, or spend some time relaxing so your body can conserve some energy and acclimate. An exhausted body isn’t going to acclimate quickly or even feel good, so save the walking and touring for a day or two after you arrive.
Altitude Sickness Tip #3:
► EAT LIGHT
Another mistake Adam and I made was to start our visit to Peru with a big, heavy lunch. We had been traveling for 15 hours and were really hungry when we landed, so we inhaled a delicious three-course lunch to refuel and to celebrate our arrival in South America. That was a terrible choice; our bodies don’t process food the same way at altitude as they do at sea level, and we both felt full and sluggish as soon as we left the restaurant.
Spend the first day or two eating light and nourishing your body. Try complex carbs like whole grains or starchy foods like potatoes, all of which require less oxygen to process and convert into fuel. Many people experience decreased appetites at high elevations, so don’t force yourself to eat the same quantities you might at home if you aren’t hungry. Our first lunch was delicious, but the best meal I had in Cusco was a simple slice of French bread pizza from a little bakery near our hotel. The carbs and tomato sauce gave me plenty of energy and were filling and satisfying. Listen to your body and eat what it needs to feel good.
Altitude Sickness Tip #4:
► SKIP THE DRINK WITH DINNER…
What’s a trip to Peru without a pisco sour? We weren’t about to find out—but we also paid the price. Adam’s pisco sour during our first lunch was great, and I loved the glass of Peruvian wine I ordered, but it wasn’t long before a single alcoholic beverage turned into a full hangover, complete with throbbing headaches and nausea. Neither one of us were prepared for those effects. After all, we have taken elaborate wine tours in several countries now; a glass of anything rarely impacts us.
Altitude changes everything, and you shouldn’t be overly confident that your body will tolerate alcohol the way it does anywhere else. By all means, enjoy a drink if you would like one, but wait a day or two to acclimate before you order one, and consider skipping a second round. As good as that glass of wine was, I wasn’t happy to spend my first night tossing and turning in bed hoping the pounding in my head would die down.
Altitude Sickness Tip #5:
► ….BUT DRINK A LOT OF WATER
If you’re going to drink anything, make it water. That’s one thing we did well, and I can’t say enough about the importance of hydration. This was particularly important when we visited Salar de Uyuni in Bolivia. Standing in the middle of the salt flats—by definition a very dry place—in the sun at 12,000 feet above sea level left my body in desperate need of much more water than I usually drink. I was glad to have a few extra bottles in my backpack. Dehydration feels just as awful as altitude sickness does!
Carry extra cash so you can pick up some water any time you start to run low, and pack a few bottles for any daytrips you take where water might not be plentiful or accessible. We also carried refillable water bottles with built-in filters that would purify tap water, and while we never had to worry about finding clean water, it was good to know we would be OK if we needed to fill up at a hotel or restaurant. If drinking local water of any kind sounds risky to you, buying extra bottles will be even more important.
Be careful to monitor your water intake: although it is important, consuming too much water can sometimes make you feel worse if you have altitude sickness because it dilutes the sodium in your body. Try to find a comfortable balance between too little and too much, but always drink when you’re thirsty.
Altitude Sickness Tip #6:
► ASCEND SLOWLY
We knew acclimating in Cusco would be harder than anywhere else, but given the logistics of our trip it was necessary to make the highest Peruvian city we visited our home base. If we were to do it all again, we would have acclimated at a lower elevation, like Ollantaytambo or Aguas Calientes. Both locations are thousands of feet closer to sea level than Cusco, which makes a huge difference on how the altitude can impact the body. I felt like a new person when I got to Aguas Calientes on the day we visited Machu Picchu, and it was a welcome break from the more oppressive elevation we experienced in Cusco.
If you can, pick a location at an elevation midway between sea level and the highest place you will visit. The acclimation process will be much easier on your body that way, and you may find the altitude’s effects are diminished or possible eliminated by taking it slow. If your itinerary is flexible enough to accommodate the stop—even if it’s just for a day—it’s worth the consideration.
Altitude Sickness Tip #7:
► CONSIDER NATURAL AND OVER-THE-COUNTER REMEDIES
There is a lot to think about when it comes to preventing or treating altitude sickness, and your preference for natural remedies or over-the-counter medication will guide which method you choose.
We looked into medication, but ultimately we decided against it. Adam’s physician in particular was open to prescribing some, but he cautioned that it wasn’t guaranteed to be effective. Talk with your doctor about what options are available to you. We saw a lot of advertising for altitude sickness medications in Peru and Bolivia, but be cautious when taking medicine you aren’t familiar with in a foreign country; you may have unexpected side effects.
Natural remedies are often abundant, especially in South America where coca tea reigns supreme. We both tried coca tea and muña tea, and both helped to alleviate the symptoms we experienced. We also picked up a bag of coca candies, which may have been mostly sugar but certainly made us feel better when we were lightheaded or queasy. A note of caution: coca tea is widely available and perfectly legal to consume in places like Peru, but do not try to export it. You’ll see it sold all over the place, but it is not a good idea to try to bring it back through customs, especially in the United States. Coca tea is only legal in the U.S. if it has been decocainized, which is not guaranteed. It’s not worth the risk.
Whichever remedy you choose, consider taking pain relievers like ibuprofen in your carry-on luggage. I suffered from frequent headaches while acclimating, and I was grateful to have something to take to keep them at bay. Pepto Bismol is also a helpful addition for nausea and stomachaches which can occur at altitude.
Altitude Sickness Tip #8:
► DON’T LEAVE HOME WITHOUT MEDICAL INSURANCE
Many people don’t realize that the health coverage you have at home won’t travel with you when you hit the road. It’s critical to purchase a plan that will cover any medical situations that may arise—especially if you don’t know how your body will react at high altitude. Be sure you have a plan that will cover everything from hospital stays to emergency evacuations in case you need to get back to sea level quickly. Many plans are comparatively inexpensive, so they won’t add much to your budget, but they will absolutely give you some needed peace of mind. Plus, many plans also include coverage for travel interruptions or lost baggage, so the benefits really add up.
Traveling at high altitude can be a huge challenge if you don’t take care of yourself. If you listen to your body, hydrate, fuel well, and rest, you’ll be feeling like yourself and ready to explore in no time!
*DISCLAIMER: As mentioned above, we are not doctors and are in no way qualified to provide medical advice. These tips are provided as the result of our own experiences. Your experience at high altitude may vary. Please be sure to check with a medical professional before you travel and if you have questions or concerns about health and safety at high elevations.