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Here in Cusco we´re high - as in 3,399 meters (11.152 feet) above sea level; other destinations in the Peruvian Andes not quite so much: for example, Machu Picchu 2,430m (7,972 ft.), Pisac 2,980m (9,776 ft.), and Urubamba 2,870m (9,416 ft.). And one issue that some (by no means all) visitors from lower-lying places can face is what we call soroche or mal de altura - altitude or mountain sickness provoked by the lower air pressure and oxygen levels up here. It can kick in at heights starting at 2,400-2,500m when for example they arrive suddenly by plane instead of getting more gradually acclimated by coming up here more slowly by road or train.

We locals are used to living so high up, but those who aren´t may experience symptoms including fatigue, shortness of breath, insomnia, persistent headache, elevated heart rate, dry cough, nosebleeds, nausea, and lack of appetite - and even being physically fit won't make you immune. The good news is that these symptoms usually disappear after one to three days (although it´s also true that in very rare, extreme cases dangerous cerebral or pulmonary edemas can occur). Fortunately, there are ways to lessen the likelihood of suffering soroche, or if it does hit you, to lessen its unpleasant effects. 

(By the way, it should go without saying that altitude sickness is a condition which can occur at high altitudes in mountains anywhere in Latin America, North America, Europe, Africa, and Asia.)

Prevention and Treatment

First of all, if you can´t travel here in a way that gets your body gradually used to increasing heights, at least before arrival try to eat sparingly, concentrating on foods rich in carbohydrates and natural sugars.

Then once you´re here, strategies start with taking things easy and breathing as deeply as possible to get the oxygen you need. Also stay well hydrated, as soroche leaves sufferers with a good deal of thirst and a parched throat; drinking water also helps breathing and relieve  the sensation of lack of oxygen. Also limit alcohol consumption and do not overeat. 

You also have several medicinal options:

Coca tea - The millenary and sacred coca leaf was used in Inca times as a remedy for various ailments, and nowadays it is recommended to drink mate de coca, an infusion of coca leaf to combat the symptoms of altitude sickness (it´s sometimes even served at the airport to arriving passengers).

Sorojchi pills - Also known simply as soroche pills or altitude pills, these can help ease symptoms and can be found in any pharmacy in Cusco and other Andean towns without a prescription. Ibuprofen can also help with headaches.

Chlorophyll drops - These increases the amount of red blood cells in the blood, giving it more chance for oxygen to be absorbed by it. Bring your own or pick them up in health food stores in Cusco and elsewhere.

Supplemental oxygen - In more severe cases, local clinics and even some hotels can administer tank oxygen to help alleviate symptoms.

Keep all this in mind and don´t let a little soroche ruin your experience of a wonderful destination - we look forward to seeing you here soon!