Visiting Machu Picchu one of the seven wonders of the world is a dream for many — a mystical journey into the heart of Incan civilization nestled high in the Andes of Peru. But while the stone citadel inspires wonder, it also sits at nearly 8,000 feet (2,430 meters) above sea level. For many travelers, that means one thing: the risk of altitude sickness. So how to prevent altitude sickness when traveling to Machu Picchu?
Preparation is key — not just for your itinerary, but for your body and mind. In this guide, we’ll walk through what altitude sickness is, how to recognize symptoms, and most importantly, how to prevent it. Whether you’re hiking the Inca Trail or taking the train to Aguas Calientes, this post will help you stay safe, comfortable, and fully present to experience the magic of Machu Picchu.
🏔 What Is Altitude Sickness at Machu Picchu?
Altitude sickness — also known as acute mountain sickness (AMS) — happens when your body struggles to adjust to lower oxygen levels at high elevations. You don’t have to be climbing Everest to feel it; symptoms can start as low as 8,000 feet (~2440m) — right around the elevation of Machu Picchu.
Many travelers reach Machu Picchu by flying from Lima (528 ft / 161 m) to Cusco (11,152 ft / 3,400 m) — a sharp and sudden jump in elevation that gives the body little time to acclimate. This rapid ascent significantly increases the risk of AMS.
Common symptoms include:
- Headache (intense, throbbing)
- Nausea or vomiting
- Dizziness or lightheadedness
- Shortness of breath
- Fatigue
- Poor sleep or insomnia (frequent waking, irregular breathing)
- Loss of appetite
Symptoms typically appear within 6 to 24 hours of arriving at high altitude. Most cases are mild and manageable — but if ignored, they can develop into more severe conditions like high altitude pulmonary edema (HAPE) or high altitude cerebral edema (HACE), both of which require urgent medical care and immediate descent.
⚠️ Risk Factors for Travelers
Certain people may be more susceptible to altitude sickness, including:
- Individuals who ascend rapidly without time to acclimatize
- Those with a history of AMS or related conditions
- People with heart or lung conditions (consult your doctor before traveling)
- Surprisingly, people over 50 may have a slightly lower risk of developing AMS, possibly due to slower physical exertion or different breathing patterns. However, this is not a guarantee and precautions are still necessary.
🌿 How to Prevent Altitude Sickness Before Machu Picchu
1. Plan a Gradual Ascent
This is the most effective way to prevent altitude sickness (AMS). Flying directly from sea level to Cusco (11,152 ft / 3,400 m) can shock your system. If your schedule allows:
- Spend 2–3 nights in the Sacred Valley (around 9,000 ft / 2,750 m), which is lower than Cusco, before continuing on to Machu Picchu. Towns like Ollantaytambo, Pisac, and Urubamba are great options for acclimatization, offering a slower pace and beautiful surroundings.
- Ollantaytambo (9,160 ft / 2,792 m) is famous for its impressive ruins and Incan terraces, making it a perfect starting point for your high-altitude journey.
- Pisac (9,700 ft / 2,950 m) offers a mix of archaeological sites, including the Pisac ruins, and a lively market for local handicrafts.
- Urubamba (9,300 ft / 2,835 m) is the heart of the Sacred Valley, surrounded by mountains and rivers, and serves as a great base for exploring nearby attractions.
If you feel comfortable after a few days at a lower altitude, you can consider visiting Chinchero (12,350 ft / 3,765 m) and Maras (11,200 ft / 3,414 m), which are higher in elevation. Chinchero is known for its well-preserved Incan terraces and vibrant textile traditions, while Maras is home to the unique salt mines that have been in operation since Incan times. However, these towns should only be visited after you’ve spent adequate time adjusting to the altitude.
Avoid strenuous activities during your first 24–48 hours at elevation, and listen to your body as it adjusts.
2. Talk to Your Doctor About Acetazolamide (Diamox)(1)
Acetazolamide (brand name Diamox) is a prescription medication commonly used to help the body adjust to high altitudes more quickly. It works by speeding up the process of acclimatization. Specifically, Diamox helps to increase the amount of oxygen in the blood, which allows your body to adjust to the lower oxygen levels at high elevation.
How it works:
- Acetazolamide helps the body breathe faster and more efficiently, stimulating the kidneys to remove excess bicarbonate and allowing the blood to become more acidic. This helps to stimulate the production of red blood cells, which improves oxygen delivery to tissues at higher elevations.
- It is typically taken 1–2 days before ascending to higher altitudes and continued for a few days after reaching elevation.
If you’ve had altitude sickness before or are concerned about the rapid ascent to Cusco or Machu Picchu, consult with your doctor to see if Diamox is right for you. Your doctor will advise on the correct dosage based on your individual health needs.
Side effects: while Diamox is generally safe for most people, it can cause side effects, which may include:
- Tingling in the hands or feet (a common and harmless side effect)
- Frequent urination
- Dizziness or lightheadedness
- Nausea or upset stomach
- Fatigue
- Changes in taste (a metallic taste is common)
If you experience any severe or concerning side effects, discontinue use and consult with your doctor immediately.
💊 Ibuprofen (600 mg every 8 hours), as recommended by the CDC, can also help prevent altitude sickness symptoms, though it’s less effective than Diamox(1). However, do not take ibuprofen if you are allergic to it or have conditions such as heart disease, stomach ulcers, or kidney problems. Always consult your doctor before taking any medication.
3. Pack Wisely for High Altitude
In addition to your usual travel items, pack:
- A reusable water bottle
- Oral rehydration salts
- Electrolyte tablets or powder
- Over-the-counter nausea (ex. Gravol) or headache medication (ex. Tylenol)
- Warm layers (it gets cold at night, even in warmer seasons)
💧 On-the-Ground Tips to Prevent Altitude Sickness in Machu Picchu
1. Hydrate Like It’s Your Job
Drink 3–4 liters of water daily. Higher altitudes increase fluid loss through respiration and sweat, even if you don’t feel it.
2. Avoid Alcohol and Smoking
Both alcohol and smoking reduce oxygen delivery to your body. Skip both for at least the first 48 hours at altitude.
3. Eat Light, Carb-Rich Meals
Your body digests carbohydrates more efficiently at altitude. Choose small, carb-rich meals and avoid heavy or greasy foods during your first few days.
4. Try Coca Tea (Mate de Coca) — Respectfully
This traditional Andean tea is widely used to ease symptoms of altitude sickness. It’s usually served at hotels and cafes. While generally safe for short-term use, check your country’s laws before trying to bring any coca products home — some places consider it illegal due to its relation to the coca plant.
🧘♀️ Mindful Tips to Prevent Altitude Sickness at High Altitude
- Rest Often: Move slowly. Enjoy the journey instead of rushing from site to site.
- Sleep Well: Get quality rest — sleep helps your body recover and adjust.
- Listen to Your Body: Don’t ignore symptoms. If you feel dizzy, nauseous, or unusually tired, take a break.
- Consider Supplemental Oxygen: Some hotels in Cusco offer oxygen tanks, and portable oxygen cans are available in pharmacies.
🗺 2025 Machu Picchu Visitor Circuits: Best for Altitude Adjustment
🗺 Once you’ve given your body time to adjust, the next step is choosing how you’ll experience Machu Picchu. Since 2024, Peru has updated the routes into designated circuits — and knowing the differences can help you pick the best one based on your energy level and acclimatization status.
This new circuit system is to better protect the site and manage visitor flow. There are now 3 main circuits with 10 sub-routes, each offering a unique experience of the ancient city.
If you’re adjusting to high altitude, it’s worth choosing a route that matches your energy levels and physical condition.
Here’s a quick overview:
- Circuit 1 (Panoramic): Includes Huayna Picchu and Machu Picchu Mountain — stunning views, but physically demanding with steep climbs.
- Circuit 2 (Classic): Takes you through the heart of the citadel with iconic photo spots like the Main Temple and Sacred Plaza. Moderate walking with some stairs.
- Circuit 3 (Lower Circuit): A gentler path that explores the lower agricultural and urban areas — ideal for travelers who are still acclimating or prefer an easier walk.
⏰ Entry is by timed ticket, and each route has limited spots.
🎟️ You can check availability and book through the official site: tuboleto.cultura.pe
🧘♀️ Tip: If you’re still adjusting to altitude, Circuit 3 or the lower terrace routes are a great option to soak in the magic without overexerting your body.
🚨 When to Seek Medical Help
If you notice any of the following signs, seek medical attention immediately and descend if possible:
- Severe, persistent headache
- Confusion or difficulty walking
- Shortness of breath while resting
- Tightness in the chest or continuous coughing
- Blue lips or fingertips
🎒 Bonus: Travel Health Packing List for Peru
Here’s a checklist of handy items for high-altitude travel:
✅ Acetazolamide (if prescribed)
✅ Ibuprofen or acetaminophen (if safe for you)
✅ Nausea relief (e.g., Gravol or motion sickness tabs)
✅ Electrolyte powder or rehydration salts
✅ Coca tea (for local use only) or altitude herbal blends
✅ Sunscreen and lip balm (UV exposure is stronger)
✅ Moisturizer or hand cream (air is dry)
✅ Comfortable, supportive walking shoes
✅ Rain jacket or layers (weather is unpredictable)
✅ Reusable water bottle
✨ Final Thoughts: Let the Journey Ground You
Machu Picchu is more than a postcard-perfect destination — it’s a space to reconnect with the earth, with ancient wisdom, and with yourself. Preparing for altitude is about more than medicine or gear. It’s about tuning in to your body’s needs, slowing down, and approaching your journey with intention and respect. When you travel mindfully, you not only feel better — you experience more deeply.
With the right preparation, you can prevent altitude sickness when traveling to Machu Picchu and be fully present for the sacred wonder of the Andes. Don’t forget to consider travel vaccines and travel insurance!
❓ FAQ: Altitude Sickness & Machu Picchu
Yes. Machu Picchu sits at ~2,430m (7,970 ft), enough to trigger mild altitude sickness in some people, especially if coming from Cusco (3,400m).
Spend 2–3 days in the Sacred Valley first. Stay hydrated, eat carbs, and ask your doctor about Diamox.
Yes. It helps you acclimate faster by increasing blood acidity and respiration. It’s widely recommended by the CDC and travel clinics.
Circuit 3 is gentler with fewer stairs — ideal for travelers adjusting to altitude.
Have you experienced altitude sickness before? What helped you recover or stay well? Share your story in the comments — your tips could help another traveler stay healthy at high altitude.
Disclaimer:
The information provided in this post is for general informational purposes only and should not be considered medical advice. While I’ve provided tips and recommendations based on research and personal experiences, it’s essential to consult with a healthcare professional before traveling to high altitudes, especially if you have pre-existing health conditions or concerns. Always prioritize your safety and well-being during your travels, and follow expert medical advice regarding altitude sickness prevention.
The tips and products mentioned, including medication like acetazolamide, are based on general recommendations. Please check with your doctor before using any medication or supplements. This post contains affiliate links, which may earn me a small commission at no additional cost to you. All affiliate recommendations are based on my belief that they offer value to my readers.
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