Health & Preventing Altitude Sickness

If there’s one thing that can derail your dream trip to Peru, it’s underestimating the altitude. From Lima at sea level to Cusco at over 11,000 feet, your body will go on its own journey as you travel. The best way to enjoy Peru without feeling miserable? Ascend gradually whenever your schedule allows.

Altitude by City

• Lima: Sea level

• Arequipa: 7,661 ft (2,335 m)

• Sacred Valley (Ollantaytambo, Urubamba): ~9,400 ft (2,850 m)

• Huaraz: 10,141 ft (3,091 m)

• Cusco: 11,152 ft (3,399 m)

• Puno (Lake Titicaca): 12,556 ft (3,830 m)

👉 Pro Tip: If you have time, build your itinerary to climb slowly. On our first trip, we went from Lima → Arequipa → Puno → Cusco, and by the time we arrived in Cusco, we felt great and barely noticed the altitude. Travelers who fly straight from Lima to Cusco often struggle their first few days.

How to Adjust to Altitude

• Climb Gradually: The single most effective way to avoid altitude sickness.

• Take It Easy on Arrival: Plan light activities on your first day at altitude.

• Stay Hydrated: Drink plenty of water, but limit alcohol and caffeine.

• Try Local Remedies: Coca tea or leaves can help with mild symptoms (though this is a stimulant like caffeine); muña tea (a local mint) is excellent for digestion and our local doctor claimed it was an even better alternative than coca.

• Medication: Consult your doctor about options like acetazolamide (Diamox) if you know altitude hits you hard. Our doctor recommended avoiding taking medication if possible (since it comes with its own side effects), but everyone is different.

• Know When to Descend: If you experience severe symptoms (confusion, intense headache, shortness of breath), go lower immediately.

Food & Water Safety

• Tap water isn’t safe to drink. Use bottled or filtered water for drinking, cooking, and even brushing your teeth. Avoid ice as well, so request your drinks "sin hielo, por favor."

• Be cautious with salads or raw foods washed in tap water. We avoided these entirely and only consumed cooked veggies.

• Research restaurants ahead of time. If you are going to sample street food, stick to busy food stalls for street eats. High turnover means fresh.
  

👉 Our experience: We avoided uncooked vegetables, as well as fruits that did not have a skin (like berries) and we were fine. We also always travel with Pepto Bismol if our stomachs are having a hard time adjusting.

Vaccines & Health Precautions

No vaccines are required for entry, but several are recommended:

• Routine: MMR, tetanus, hepatitis A, and typhoid.

• Yellow Fever: Recommended for jungle regions like Iquitos and Puerto Maldonado, or if you are hiking the Salkantay Trek. Ideally, get it 10+ days before exposure.

• Mosquitoes: Dengue and Zika are present in the Amazon, so bring repellent and wear long sleeves.

Fitness & Terrain

Peru is a hiker’s paradise, but even city walks can leave you breathless. Expect cobblestones, steep stairs, and no elevators in historic areas.

👉 Pro Tip: Break in your hiking shoes before your trip. Blisters and altitude would be a terrible combo.

✨ Bottom Line: Altitude doesn’t have to ruin your trip. If you ascend gradually, listen to your body, and take precautions, you’ll be free to enjoy Peru at its best.