Breathing Easy Before Machu Picchu

The first thing most people picture when they think about Machu Picchu is the ruins themselves, the postcard view, stone walls surrounded by green mountains. What doesn’t cross their mind right away is that to even get there you’ve got to deal with altitude. Cusco sits at something like 3400 meters, over 11,000 feet, and that’s where almost every trip starts.

If you’ve never been that high before, it’s a shock. Some folks arrive and feel fine, others feel like they’ve been hit with the worst hangover, with symptoms like:

• Pounding headache
• No appetite
• Shortness of breath

It hits people in such random ways, and being fit or strong doesn’t really protect you from it.

Why Altitude is a Big Deal

The science is pretty simple, even if it feels strange when you’re going through it. At higher altitude, the air has less oxygen. Every breath you take gives you less than what your body is used to, so the blood has to adapt. It needs more red blood cells, but that doesn’t happen in one day. That’s why the first couple of days feel rough. After a few nights your body starts catching up and things get easier.

Practical Tips for Acclimatization

Take it Slow (Seriously)

First tip is the simplest but most ignored: take it slow.

I’ve seen travelers land in Cusco in the morning and spend the afternoon rushing up and down steep streets, trying to see every church and ruin at once. By evening, they’re lying down with headaches and no energy. Better to spend the first day wandering slowly, drinking water, maybe a gentle walk, and resting. Even better, some people skip Cusco at first and head straight to the Sacred Valley, to towns like Pisac or Ollantaytambo. They’re lower than Cusco, so your body has an easier time adjusting there before climbing higher again.

Hydration is Key (and Coca Tea Helps)

Water really matters. The air is dry, and you don’t realize how fast you dehydrate. Sip all day, even if you’re not thirsty. And then there’s coca tea. In Cusco every hotel, every café, offers it. Locals drink it and travelers swear by it. Scientists argue about whether it really helps, but it warms you, it’s mild, and it’s part of the local culture, so why not. Chewing the leaves is another tradition, but the tea is what you’ll probably get first.

Eat Smart, Drink Later

Food makes a difference too. Heavy meals slow you down when your stomach is already confused by altitude. Light soups, vegetables, bread, easier to digest carbs—those go down better in the first days. Alcohol, not a great idea at the start. It dehydrates you more and hits harder at altitude, so that pisco sour you’ve been dreaming of is better saved for later in the week.

A Word on Medication

Some people turn to medication. Diamox, or acetazolamide, is the one doctors prescribe most often. You start it before climbing to altitude and it makes your body adjust quicker, though it can cause tingling in fingers and more bathroom trips. For sensitive travelers it can be a lifesaver. In Cusco, pharmacies also sell herbal pills or remedies aimed at altitude sickness. Some work better than others, but the main cure is always time.

Pace Your Adventures

Time and pacing are everything. If you’re planning to hike Huayna Picchu or climb around the ruins right after you land, rethink it. Your body needs a couple of days. Trekking routes like Salkantay or Ausangate are even higher, with passes over 4000 or 5000 meters. Trying those without acclimatizing first is just asking for misery. Better to use the first three or four days in Cusco or the Valley to do short hikes, let your lungs and blood catch up, then go big.

Don’t Stress About Sleep

Sleep is another thing travelers don’t expect. At altitude, some people wake up suddenly in the night gasping for air, or they sleep lighter, tossing and turning. It’s not dangerous, it’s just the body reacting to less oxygen. Naps during the day help, warm blankets help, patience helps too. After a few nights it gets better.

Know the Danger Signs

It’s important to know the difference between mild and serious symptoms. A little dizziness, headache, feeling tired, that’s normal. But if the headache is crushing, if there’s nausea, vomiting, confusion—that’s not normal anymore. That’s altitude sickness in a stronger form, and the only cure is to go down. Not medicine, not tea, just descent. Most people don’t get that far if they take precautions, but it’s worth keeping in mind.