Top Tips to Avoid Altitude Sickness in Machu Picchu

Soak up the local culture and some extra oxygen at these high-elevation locales.

Steeped in orchids, ancient ruins, and Pisco sours, Peru (and its Incan citadel in the Andes, Machu Picchu) is a destination for the most adventurous traveler. Accordingly, the trip over will take a little more planning than a weekend in the Catskills. There’s so much to explore (Lima, the Sacred Valley, Cusco) and so many means by which to do it (by plane, by train, or by foot), that it can make your head spin. Or maybe that’s just the altitude sickness.

The farther you travel from sea level, the less oxygen you get into your bloodstream, which can make you feel you’ve been served one too many Pisco sours — think headaches, nausea, dizziness, fatigue, and shortness of breath.

With elevations of more than 6,000 feet, the journey to and from Machu Picchu requires some mindfulness to avoid the hangover from hell. Generally speaking, you need to watch out for destinations above 8,000 feet, which is where most symptoms will begin within six to 24 hours. At 7,970 feet, Machu Picchu is just below the danger zone; however, residing within the mountainous region of the Peruvian Andes, the extremely steep, uneven terrain can bring about symptoms of altitude sickness (a risk that increases with age and poor health). There are also various steps to ascend and peaks to climb within Machu Picchu which can tip the site over that 8,000-foot line. Plus, traveling too quickly between the vastly different altitudes of Machu Picchu, the Sacred Valley, Lima, and beyond can wreak havoc on the body.

A few good rules of thumb are to drink plenty of water, avoid flying directly to areas of high altitude, and take two or three days to acclimate to high altitudes before going above 8,000 feet. Since you’ll probably be spending a few nights in various Peruvian locales while you adjust, you’ll want to know where to go and what to see around Machu Picchu (and how to acclimate to keep from falling off it).

Lima

The country’s capital is where most travelers first land in Peru. Since Lima is just above sea level, it requires no acclimation. Spend a couple of days here to settle in and prepare yourself for your Machu Picchu journey. Lima is one of the world’s best food cities, so take advantage of the numerous great restaurants while you’re here.

Rest up for the journey ahead at the Westin Lima, where you can experience an introduction to Peruvian gastronomy at Maras, the hotel’s fine dining restaurant with modern Peruvian dishes and cocktails. The hotel also has an incredible spa, complete with an indoor pool, a thermal circuit, and a fitness center for those wanting to relax before heading towards Machu Picchu.

Sacred Valley

From Lima, fly into Cusco, the closest airport to Machu Picchu. Since Cusco (just above 11,000 feet) sits at a higher altitude than Machu Picchu (nearly 8,000 feet), it’s recommended to travel down into the Sacred Valley (around 9,000 feet) after landing to acclimate at a less daunting altitude.

Take a leisurely bike ride through the Andean highlands to see the beauty of the Valley, or grab a drink at Sacred Valley Brewing — just don’t have too many or you risk altitude sickness. For a taste of something special, look for a chicheria — an establishment that sells chicha — a fermented beer made from maize. Usually served in an oversized glass, the sour, cider-like chicha also comes in a strawberry flavor. If you don’t see signs advertising chicheria, look for places that have a red bag hanging off of a pole out front, which is the typical signage for a chicheria.

Consider checking into the Tambo del Inka, a Luxury Collection Resort and Spa, which sits right along the Urubamba River and is the only hotel in town with a private train station to Machu Picchu. The tracks are a five-minute walk through the hotel property, where the luxurious, 1920s-style train from PeruRail awaits, complete with an observation car that provides sweeping Andes views and gourmet meals. The train will also deliver you back to Tambo del Inka, where you can hit the spa and ease sore muscles after a day of trekking Machu Picchu.

Cusco

At 11,200 feet, Cusco is one of the highest points in Peru and is the destination that will probably give you the most trouble. You may want to visit last after acclimating to the intermediate altitude of the Sacred Valley (and, ideally, you may want to only explore the city after taking a couple rest days somewhere in town first). But don’t let the risk of altitude sickness scare you off entirely. Once the capital of the Inca Empire, Cusco is full of ancient history, vibrant colors, and excellent markets.

In the heart of Cusco is the Palacio del Inka, a Luxury Collection Hotel, a 500-year-old mansion complete with original Inca walls and 195 pieces of art from the pre-Inca, Inca, Colonial, and Republican periods on display. Take it easy with a Pisco sour lesson, or enjoy a delicious meal at the hotel restaurant, Inti Raymi, which serves epicurean cuisine and wines curated by the master sommelier. Don’t forget to check out the markets of Cusco, where you’ll find some of the most authentic Peruvian wares to bring back home.

And if you do decide to risk it by traveling directly from Cusco to Machu Picchu, you can do so aboard the Belmond Hiram Bingham train for a truly unique experience. Sample Peruvian cuisine and dance to live music in the Bar Car on the luxury train after a day of exploring the Incan citadel.