How to Deal With High Altitude in Peru and Bolivia and Avoid Altitude Sickness

Nicoletta Dasara
Oct 13
4 min read

If you’re planning a trip through Peru or Bolivia, you’ve probably already heard about one of the biggest challenges: high altitude. Many of the countries’ most famous attractions sit far above sea level, and if you don’t prepare or manage it properly, altitude sickness (soroche, as locals call it) can easily sneak up on you and ruin your plans.

The Andes run like a backbone down the length of both Peru and Bolivia, with much of the land sitting at 3,000 meters or higher. Just to give you an idea: Cusco (the gateway to Machu Picchu) sits at 3,400 m, and La Paz is the world’s highest capital at 3,800 m. Even crazier, the airport in El Alto is at 4,000 m — which means if you fly straight in from sea level, your body is going to feel it.

Locals in the Andes have adapted over centuries to life at high elevation. Physiologically, their bodies developed a larger lung capacity, more efficient oxygen use, and higher red blood cell counts. But for travelers like us, it takes time.

When Reid and I were traveling through the region, we quickly learned that taking altitude seriously was key to actually enjoying the trip. Here’s what we discovered:

Why does altitude sickness happen?

Altitude sickness happens because at high elevations, the air contains less oxygen. Your body has to work harder to get the oxygen it needs, which can lead to headaches, dizziness, fatigue, nausea, and shortness of breath. Not fun when you’ve just landed in Cusco and are eager to run around exploring.

The symptoms vary a lot between people — some get hit hard, while others barely feel a thing. We saw some people thrive (even going on a run at 3800 m!) and other people really suffer it. The tricky part is, you can’t predict how you’ll react until you’re there.

Reid and I dealt quite well with it, but we started at 2600 m in San Pedro de Atacama, and gradually started going to 4000 m while exploring the region. So when we went to Uyuni Salt Flats, we quickly acclimatized and managed without big issues, only a headache here and there.

uyuni salt flats high altitude sickness — *Uyuni Salt Flats sit at high up at 3,800 meters*

Tips on how to deal with high altitude in Peru and Bolivia

Here’s what worked for us and what I’d recommend to deal with high altitude in Peru and Bolivia:

1. Acclimatize slowly

If you can, plan your route so you gradually increase altitude. For example, start in Arequipa (2,300 m) before heading to Cusco (3,400 m). Jumping straight from sea level to 3,500 m or more is tough on your body.

2. Take it easy the first few days

Don’t plan a long hike or jam-packed sightseeing right away. Walk slowly, avoid rushing, and give your body time to adjust. Drink plenty of water — dehydration makes symptoms worse.

3. Consider altitude pills

You can get medication like acetazolamide (Diamox) from a doctor before your trip. You can also find it anywhere in both countries, at local pharmacies. I tried some, but honestly, the side effects weren’t great (tingling in my hands and feet, plus feeling tired). I only used them for two days, but they probably helped me adjust a bit. Everyone reacts differently, so see how your body feels.

Another thing you’ll notice is that oxygen bottles are sold everywhere — in pharmacies, little convenience shops, and even airports. They’re basically small canisters of oxygen that you can use for a quick boost if you’re feeling short of breath. They’re not a substitute for acclimatization, but they can give quick relief if you need extra help adjusting.

4. Try coca products

Many of the locals chew coca leaves, drink coca tea, or use coca candies to help ease the effects. Yes, coca is the same plant used to make cocaine, but drinking coca tea is not even remotely the same thing — it’s a mild herbal tea with a slightly earthy taste.

Coca tea, candies, or chewing the leaves — they’re all widely available and commonly used. They won’t solve everything, but they can take the edge off symptoms.

coca candies high altitude sickness — *Weird magical funny tasting candies*

Reid and I drank coca tea almost daily while we were in Peru and Bolivia. On our Uyuni Salt Flats tour, when we climbed up to over 5,000 m, I remember having a pounding headache. After a few sips of coca tea, it magically disappeared! I’m not saying it’s a cure-all, but locals swear by it, and I can see why.

5. Listen to your body

If you feel really bad — like severe headaches, trouble breathing, or confusion — don’t ignore it. Altitude sickness can become dangerous if you push too hard. In that case, the best cure is simply descending to a lower altitude.

lake titicaca cusco high altitude sickness — *Lake Titicaca sits at 3,800 meters, which makes it the highest navigable lake in the world!*

My two cents

Traveling through Peru and Bolivia means spending a lot of time at high elevations. It’s part of the adventure, and honestly, it makes these countries so unique and breathtaking (literally and figuratively!).

Altitude sickness isn’t something to panic about — thousands of travelers are exploring Cusco, Uyuni, and the Andes every day without problems. But respecting it, going slow, and knowing how to manage it will make your trip much smoother.

So take it easy, sip that coca tea, and let your body adjust. The mountains aren’t going anywhere — and once you’re acclimatized, you’ll be able to enjoy them much more.