Altitude Sickness (Soroche)

The altitude sickness (Spanish: Soroche) is the number one topic for travelers to Peru. Cusco is at 3,400 m, Lake Titicaca at 3,812 m, and many mountain passes exceed 4,000 m. At these altitudes, the air contains only 60–65% of the oxygen you breathe at sea level.

Symptoms

Mild symptoms (very common, occur in 30–70% of travelers):

• Headaches (the most common symptom)
• Shortness of breath with exertion
• Insomnia
• Nausea, loss of appetite
• Dizziness, fatigue
• Slight swelling of face or hands

Severe symptoms (rare, but serious!):

• Severe headaches that do not respond to painkillers
• Vomiting
• Shortness of breath at rest
• Confusion, coordination problems
• Blue lips

Prevention

• Ascend slowly! Do not fly directly from Lima (0 m) to Cusco (3,400 m) and start an excursion on the same day. Plan the first day as a rest day.
• Drink plenty: 3–4 liters per day, no alcohol on the first day
• Eat lightly: Prefer carbohydrates, avoid heavy meals
• Coca tea (Mate de Coca): The traditional home remedy of Peru! Offered free in every hotel in the highlands. Proven to help with mild symptoms. Coca leaves are legal in Peru and have nothing to do with cocaine.
• Acetazolamide (Diamox): Prescription medication that accelerates acclimatization. Discuss with your travel doctor! Start 1–2 days before ascent.
• Smart route planning: If possible, go to the Sacred Valley (2,800 m) first and then to Cusco (3,400 m) — this way you acclimatize gradually.

If it hits you

• Rest, drink plenty, coca tea
• Ibuprofen or paracetamol for headaches
• Hotels in Cusco and Puno often have oxygen bottles at the reception
• For severe symptoms: Descend immediately! Even 500–1,000 meters less altitude brings dramatic improvement