We are planning a trip to Peru including a visit to Machu Picchu. We will be in Cusco for two nights before the trip to Machu Picchu. Is altitude sickness just a given? I have looked at Sorojchi Pills (locally available in Cusco without a prescription) and Diamox (U.S. prescription). Due to medical restrictions I can’t take either one. Will I be OK with 48 hours of acclimation in Cusco and taking it slow, and being pretty physically fit? Or is it just too risky?
Edit: we’ll be in Sacred Valley a couple of nights befoer going to Cusco. I think Cusco is actually a higher elevation than Machu Picchu.
That’s a question for your doctor, not the internet.
Got any of these risk factors?
Various congenital and valvular heart diseases
Hypertension
Primary and secondary pulmonary hypertension
Symptomatic coronary artery disease
Poorly compensated heart failure
Chronic obstructive pulmonary disease
Sickle cell disease and trait
Sleep disordered breathing (including central sleep apnea)
Urinary retention from BPH
High-risk pregnancy
Radial keratotomy
Dexamethasone is an alternative preventative med for altitude sickness.
Cusco is over 11,000 feet (3400 meters), definitely riskier than Machu Picchu.
Macchu Picchu is only at 8000 feet (2400 meters), so that’s relatively low risk if you’re healthy. Recommendations for ascent to that level are as follows:
No prior history of altitude illness and planning ascent to <2800 m
Taking two days or more to arrive at 2500 to 3000 m from low altitude
Ascending no more than 500 m/day (sleeping altitude) once over 2500 m and taking one extra day to acclimatize for every additional 1000 m of ascent
I’ve been up over 14,000 feet driving to the top of Pike’s Peak and did ok. And stayed for 5 days at about 8800 feet at a resort, and while I felt somewhat short of breath with minimal exertion, and woke up several times at night with a sensation of shortness of breath, I did fine.
Even then, there’s almost no way to be sure. People react very differently to altitude so someone with the same medical history might have problems when you don’t. It also can change for you on different trips; you might have no problems on one trip to 12,000’ but have serious complications the next time. I’ve never taken Diamox but might consider it as I get older.
Have you been to altitude before? 8000’ has never been a problem for me, I regularly ski above that. I’ve hiked to 18,000 but we had a lot of acclimatization on the approach. You will feel out of breath and you’re likely to have a headache, but that’s pretty normal. Drink lots of water, avoid caffeine and alcohol, and listen to your body.
I have an appointment with my cardiologist this week and will get a medical assessment. I am asking more from the standpoint of the specific elevation and the general experience of altitude sickness. Cusco is 11K feet per the sources I’ve looked at. The sources always caution about it but I don’t know how many people actually experience it.
Good. ask if you might be a candidate for dexamethasone as a preventative. And remember, the best cure for significant altitude sickness is going down to a lower altitude. I bet you do fine though.
I went to about 11,000 feet once in Utah. The first day of my trip i went nearly that high, and i didn’t get sick, but walking up a very gentle incline exhausted me. Then I spent a few days in salt lake city (4,000 feet) and ate red meat and liver. At the end of the weekend, i returned to the mountains and i was astonished how much easier it was to hike uphill.
My friends who have been to the Andes have all been offered coca tea, and anecdotally, the people in their groups who drank it did better than those who didn’t. You might want to ask your doctor if that’s safe for you. (The tea is not very addictive, it’s not like snorting cocaine.)
For me personally, a couple days in the Sacred Valley plus a couple of days in Cuzco would be more than enough to let me do whatever climbing or walking would be required for Machu Picchu. The worst part for me would be Cuzco, because by the end of the first day at 8000 feet I always get a headache that doesn’t go away for a few days, and I would think that going to 11,000 after only a few days would just make it worse, plus above 9000 feet it causes me to tire out on even the mildest incline. The last time I was at altitude I managed to avoid headache and fatigue by sleeping at 5-7000 feet and taking day hikes higher than that for 7 days, and then was fine at 10,000 feet, but I rarely have the luxury of that type of acclimation, and like others have said, everyone is different.
I once went hiking on the Inca Trail and we acclimatized in Cuzco prior to the hike. I had no difficulties in Cuzco, indeed had been there before, but going much higher on the first day of hiking, I developed mild (but scary) pulmonary edema. Fortunately I had brought appropriate medicines and this settled down quickly, allowing me to finish the climb. I’ve never had it in other high places.
I would take medicines just in case, ask a doctor about what these are, when you should take them, your risk, as well as get local advice on other treatments and how to access them.
Not a bad idea at all, but oxygen may actually not be all that helpful in treating altitude sickness for many folks. Better than nothing, but it doesn’t address the underlying problem. The problem is lack of adequate atmospheric pressure to enable the lungs to do proper gas exchange.
A rule of thumb is that a moderately fit person needs a couple of days to adapt to an increase of 5000’ before anything approaching strenuous exercise is comfortable. But this does not address the issue of actual altitude sickness, such as HACE & HAPE - these notoriously affect people in ways that are hard to predict.
My guess is that you’ll be fine. But you should allow for the possibility that a prompt retreat to low altitude becomes necessary. As QtM notes, oxygen alone does not reliably resolve real altitude sickness.
AMS (Acute Mountain Sickness) has a number of warning signs (headache, out of breath, loss of appetite, dizziness) that can be treated. The main one is don’t go higher or go lower if possible, but also drinking water, resting, taking medicine for your headache. Avoiding alcohol, smoking and staying hydrated, and acclimatization are your best bets.
But things can progress to HAPE(High altitude pulmonary oedema) or HACE (High altitude cerebral oedema) which is when things start getting serious quickly. In those cases getting to a lower elevation is critical, followed by medical attention.
And just to reiterate:
Your age, sex or physical fitness do not affect your likelihood of getting altitude sickness.
Also, just because you may not have had it before, this does not mean you will not get it on another trip.
There’s also the much less serious HAFE (high altitude flatulence effect), which I have suffered from and been victimized by on multiple occasions on hikes and camping trips in the Sierra.
I hiked the Inca trail to Machu Picchu back in the nineties. And I did get some altitude sickness. Which was surprising to me because we’d been much higher and had no incident. But that’s how it works. When we were in Nepal we had come slowly up to the height, travelling by old slow buses.
We flew into Lima, then right Cuzco where we were meeting a friend. He’d been hanging around waiting on us, so we were quickly off to the trek. Both of us barely slept in Cuzco, first couple of days on the trail, I had no appetite. But the guide just kept bringing food and water forcing me to consume. It’s a tough trek, the highest pass, 13,800’, is on the second day, so not sleeping wasn’t really an issue any more.
They did give me coca tea, and it did ease my symptoms. By the fifth day when we reached the site, (at dawn, hours before any buses would arrive!), my symptoms had resolved.
Just in time to scamper all about, up, down, and around.
A fabulous time was had by all.
I hiked the Inca trail in 2018, moderate shape, spent 4 days in Cusco, which for me was the right thing to do, I needed all four days to acclimate. It wasn’t that I felt out of breath, I felt like I was breathing enough but there just wasn’t enough oxygen. It was not what I was expecting as this was my first time in > 10K feet altitude.
After the hike, which was gorgeous btw, we had the best weather, the best views, we spent a night in Aqua Caliente (sp?) by the time we got back to Cusco for the return flight, I had lost all the acclimation and I was back at square one with the feeling that I wasn’t getting enough oxygen.
At the end of the weekend, i returned to the mountains and i was astonished how much easier it was to hike uphill.