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The flight into La Paz, Bolivia was an incredibly scenic one. Our commercial airliner was soaring through snow-capped Andean peaks. Though it wasn’t by any means that the pilot was flying low, rather that these mountains stood at dizzying heights. And the same can be said about the city of La Paz.

Few cities in the world boast as spectacular a setting as La Paz, and your first glimpse of the city will quite literally take your breath away. Set in an outrageously steep valley at around 3,660m high (12,000 feet), the city’s buildings cling to the sides of the canyon and spill spectacularly downwards quite haphazardly. Everything from Medieval-looking buildings, clusters of church spires, ramshackle homes and office blocks ascend the slopes of La Paz, dwarfed by the imposing snowy peak of Mount Illimani looming at 6,402m (21,000 feet) in the background. How to acclimatize quickly. 

Compelled to experience the city’s unique cultural energy and street life, we set out on mission to explore on our first day. Though it only took 10 minutes of a leisurely stroll before we turned away. While relatively fit and quite used to hiking and climbing throughout many climates and conditions, a casual city stroll had left our lungs gasping for oxygen we couldn’t have.

We found ourselves dizzy and exhausted, and we were unable to wander the frenetic markets, museums, crafts stalls and winding alleys of this sky high city at anything faster than a snail’s pace.

If there is one thing we learnt from our time in La Paz, it was that any destination at this altitude is to be savored over time, as it’s important to properly to acclimatize. When you’re traveling this high, your lungs need time to adjust to reduced oxygen and breathing thinner air. Otherwise altitude sickness kicks in. How to avoid altitude sickness.

Travelers to the Himalayas, Tibet, Nepal, the Andes, Mount Kilimanjaro and Mount Kenya, the Rocky Mountains, or those taking on famous treks like Everst Base Camp and the Inca Trail should be aware of this. Other high altitude destinations also include Cochabamba in Bolivia, Bogota in Colombia, Quito in Ecuador, and Cuzco in Peru. Which countries have high altitude?

Travelers trekking the Inca Trail should be aware of altitude sickness.

What is Altitude Sickness?

As you travel to high altitudes, the amount of oxygen in the air you are breathing declines. Altitude sickness is our body’s response to the low air pressure and reduced oxygen; less oxygen reaches the muscles and the brain, and the heart and lungs must work harder to compensate. This is a potentially serious disease, though is preventable with proper acclimatization.

Typically, altitude sickness occurs at altitudes over 2,500 metres (8,000 ft), though most people can ascend to 2,500 metres with little or no effect. At over 3,000 metres (10,000 feet) 75% of people will develop mild symptoms.

Symptoms start 12 to 24 hours after arrival and begin to decrease in severity around the third day. You may develop a headache, lassitude, insomnia, loss of appetite, nausea and vomiting. These symptoms are collectively referred to as acute mountain sickness (AMS) and perfectly imitate the feeling of a bad hangover. What does altitude sickness feel like?

Serious symptoms do not usually occur until over 3,600 meters (12,000 ft), an altitude which is considered extremely high. In rare cases, fluid can build up either on the lungs, brain or both which could cause a bubbling sound in the chest, worsening breathlessness, coughing up pink, frothy liquid, clumsiness and difficulty walking and/or confusion leading to loss of consciousness.

Peru Mountain Scenery

These are advanced forms of AMS referred to as High Altitude Cerebral Oedema (HACE) and High Altitude Pulmonary Edema (HAPE) and should be treated as a medical emergency. In this case the best form of treatment is to immediately descend to a lower altitude and seek medical help.

If you know that you are going to be traveling to high altitudes, follow a few simple steps to prevent altitude sickness.

How to Prevent Altitude Sickness

The best way to avoid getting sick is to ascend gradually, but if you have to ascend quickly, medicines are available to prevent altitude sickness.

Anyone can suffer from altitude sickness – it does not discriminate between age, gender, level of fitness or training. For instance AMS is actually more likely to affect fit young men who attempt a rapid ascent by racing up the mountain like some indestructible super hero! Even at the most extreme heights, it’s not necessarily the height that is important, rather the speed in which you ascended to that altitude. Will I get sick from altitude?

For this reason, travelers who drive, ride or fly to high altitude sites in the Andes and the Himalayas are more at risk than those who walk in.

Acclimatization

The main cause of altitude sickness is going too high too quickly. Given enough time, your body will adapt to the decrease in oxygen at a specific altitude. This is known as acclimatization. How to acclimatize to high altitudes?

The only way to avoid or cure for altitude sickness is either acclimatization or descent. Ascending slowly will give your body time to learn to cope with decreased oxygen. It usually takes a few days for the body to get used to this change, so those who fly into high altitude must be prepared to spend time acclimatizing on arrival.

Don’t exercise, don’t smoke, and plan for plenty of rest until you feel better. High carbohydrate diets often work well for alleviating acute altitude sickness symptoms as well as improving mood and performance, so be sure to eat appropriately. Will I get altitude sickness in Peru?

Also, drink plenty of fluids, though avoid alcohol or caffeinated products such as energy drinks or sodas as these can dehydrate your muscles. The body’s water losses increase during an active day in the dry cold air at high altitude, therefore, keeping hydrated is important (you may need as much as 4-7 litres per day). How long does it take to acclimatize?

It’s a good idea to tell people you’re travelling with how you feel, even if your symptoms are mild. This will help them be more aware of signs of severe sickness, such as irrational behaviour, if you develop them. If altitude sickness becomes worse, you must immediately descend to a lower altitude.

It is highly advisable not go over 9,000 feet in altitude in 1 day. Instead, spend a few days at 8,000–9,000 feet before proceeding to a higher altitude to give your body time to adjust to the low oxygen levels. Do not sleep 1,000 to 2,000 feet above the altitude you slept at the previous night. You should always spend an extra day acclimating for every 3,300 ft.

Pro Tip: As an alternative, consider taking a day trip to a higher altitude. It’s less risky to take a day trip to a higher altitude and then return to a lower altitude to sleep.

It is important to listen to your body when traveling to high-altitude locations, since altitude sickness can be serious. If you suspect that you are experiencing altitude sickness, don’t go any higher until your symptoms improve and move to lower ground if your symptoms get worse.

Medications

It is important to note that there is no substitute for proper acclimatization. Medicines are available to shorten the time it takes to get used to high altitude, however, people with altitude sickness should not continue to ascend until they have gotten used to the altitude. Altitude sickness medicines.

Critically, a person whose symptoms are getting worse while resting at the same altitude must descend or risk serious illness or death. Drugs to prevent AMS often only hide the warning symptoms as opposed to curing the problem, so in general it is much safer to rely on good planning and gradual ascent rather than medication. Which medicine is best for altitude sickness?

That being said many high-altitude destinations are remote and lack access to medical care, so preventing altitude illness is better than getting sick and needing emergency treatment. Available medications include the following:

Painkillers, such as paracetamol or ibuprofen, can be used to treat mild headaches caused by altitude sickness. Should I use painkillers to help altitude sickness?

If you’re experiencing nausea or vomiting, a type of medication called an anti-emetic may be useful. Promethazine is an anti-emetic medicine often used by people with altitude sickness.

This is the most tested drug for altitude sickness prevention and treatment. Unlike dexamethasone (below) this drug does not mask the symptoms but actually treats the problem.

Diamox makes your blood more acidic correcting the chemical imbalance brought on by altitude sickness. Acidifying the blood drives the ventilation, which is the cornerstone of acclimatisation. You are able to breathe faster so that you metabolise more oxygen.

Minor side effects include numbness or tingling of the face, fingers or toes. Some people find these quite distressing, so doctors often suggest trying it at home for two days before travelling if you’re likely to use it at altitude.

Nifedipine is often used to treat high blood pressure (hypertension), but it can also be useful in treating high altitude pulmonary oedema.

This medication decreases the narrowing of the artery that supplies blood to the lungs, helping to reduce chest tightness and ease breathing. It’s usually taken as a tablet at six- to eight-hour intervals.

Nifedipine can cause a sudden drop in blood pressure, so it’s important not to get up too quickly from a lying or sitting position if you take it.

This is a steroid which decreases brain and other swelling which can be a life saver if you have HACP or HACE. The dose is typically 4 mg twice a day for a few days starting with the ascent.

This prevents most of the symptoms of altitude illness from developing and essentially “buys time” especially at night when it may be problematic to descent.

WARNING: “Dexamethasone is a powerful drug and should be used cautiously and only on the advice of a physician. It is unwise to ascend while taking dexamethasone: unlike diamox this drug only masks the symptoms.”

If you are traveling to high altitudes in Central or South America, you could purchase coca leaves while you are there.

Coca is a stimulant that induces biochemical changes that enhance physical performance at high altitude, and locals throughout Central and South America chew on it or make tea to prevent altitude sickness.

Do however be aware that this is a substance which is illegal in the US. Even one cup of tea can result in a positive cocaine drug test.

Other Considerations

High altitudes put you at higher risk of exposure to the sun, of hypothermia, thrombophebitis (dangerous blood clots in leg veins) and retinopathy (eye damage).

Take full precautions to prevent sunburn and sunstroke, in particular, make sure you have appropriate eye protection – specialist sunglasses, snow goggles or equivalent. Snowblindness can occur even if it’s hazy.

If traveling to a high altitude destination it is absolutely essential to have taken out comprehensive travel medical insurance. Insurance which covers helicopter evacuation may save you a $100,000 bill.

Pro Tip: We go through Tim Jennings at Individual Health for insurance with #GeoBlue – they have a network of elite doctors in over 180 countries and a hugely helpful mobile app for quick and easy access to quality care for anything from emergency needs, to filling a simple prescription, to translating your symptoms, to finding the right doctor at home or abroad.

Contact Tim Jennings at sales@individualhealth.com or click for a free quote.

Summary of Advice

As well as acclimatising properly and taking prescription medication, you should also follow the advice outlined below.

  • If you start to develop mild symptoms of altitude sickness, stay at your current altitude until your symptoms improve.
  • If your symptoms get worse, immediately descend from your current altitude.
  • Make sure everyone you’re travelling with has fully acclimatised before going any higher. Let someone know that you are beginning to feel unwell.

  • Gradual ascent is the most important preventive measure. If possible chose a trip with time for gradual acclimatisation built in. Ideally avoid flying directly to areas of high altitude. Consider using medication to aid acclimatisation if gradual ascent is not possible.
  • Get lots of rest. When ascending above 3,000m, try to have a rest day every three days. Gentle exercise only for the first 24 hrs.
  • Keep well hydrated by drinking plenty of fluids and maintain a high-calorie diet while at altitude.
  • Don’t smoke, drink alcohol or use medication such as tranquillisers and sleeping pills while you’re at altitude, as they could make any symptoms of altitude sickness worse. Speak to your GP if you’re unsure.

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Megan is an Australian Journalist who has been travelling and blogging since 2007, with the main aim of inspiring others to embark on their own worldwide adventure. Her husband Mike is an American travel photographer, and together they have made the world their home.

Committed to bringing you the best in adventure travel from all around the globe, there is no mountain too high, and no fete too extreme! They haven’t been everywhere, but it’s on their list.

Follow their journey on Facebook, TwitterYouTube, Pinterest and Instagram.

Brought to you by IndividualHealth.com

    44 Comments

  1. Alternatively, you van use the time-honoured method of chewing on coca leaves or drink coca tea. Lovals in Perú, Nolivia and Northern Argentina have been doing it for centuries. It’s legal and you don”t get addicted to cocaine.
    Altitute sickness is.known as soroche in these parts.

    • Absolutely – we were recommended Coca leaves and tea by the locals while traveling through Bolivia. The only thing which stopped us was our direct flight back into the US – it’s legal throughout South America but illegal in the US and we didn’t want to risk any traces which could result in a positive cocaine drug test.

      Safer than sorry! But I have heard that they’re a fantastic way to alleviate the symptoms of altitude :)

  2. Thanks for sharing this. As I suffered from altitude sickness when I was in Quito, I am a bit afraid of traveling to Peru even though I really want to go there. To make it better I drank coca leaves tea and took paracetamols. It was a bit better but I still spent a whole day in bed. I don’t know if I had adapted myself as I had a flight to Mexico before I could acclimatize myself.That’s why I’m afraid of Peru, but I’ll guess I just have to give it some time and cross my fingers it won’t be too bad.

    • Sorry to hear you got stuck with altitude sickness in Quito Stef – when we hit up Ecuador we had just been through La Paz, so I guess had already acclimatized and didn’t have any problems.

      Though I personally didn’t find any issue with Peru actually – we flew into Lima after having been through Central America, spent a few days in Lima before hitting up Paracas and then doing the train to Machu Picchu. Take some medicine with you just in case, but I think Peru is fairly good when it comes to altitude. I would give yourself an extra day to acclimatize though if you’re worried, then that way you don’t lose out on anything you have planned and you can spend the time resting up :)

      Happy travels!

  3. I was surprised when we went to 3,800metres at Zermatt, that except for a little bit of a dizzy feeling for a couple of minutes, I was fine. I fully expected, that I might have felt dodgy, but guess I was lucky. There were signs everywhere about taking it easy. I did drink loads of water beforehand, so maybe that helped or I am just lucky. I did see other people not so well off.

    • It honestly comes down to each individual in the end, which is why it’s so important not to underestimate the effects of altitude. Because it doesn’t discriminate, and surprisingly smokers were actually seeming to do better with the altitude in LaPaz than we were when we consider ourselves to be pretty physically fit!

      Apparently their lungs are more used to less oxygen or something like that!!

  4. I like how you compare the symptoms to a bad hangover. That is exactly how I imagine altitude sickness would be! Great tips you got here, Megan!

    • It’s seriously what it feels like lol. So god I couldn’t even imagine what you would feel like if you went out on a bender and combined a hangover with altitude sickness!! Bad idea :S!

      Glad you found the tips helpful Erica – travel safe! X

  5. Great tips! I was surprised that, when I was in Italy for the first time I stayed in a village at an altitude of about 1500m asl, for the first few days I felt really horrible.. It’s really something that I think many people don’t think about.

    • Thanks Ashlee! And it’s absolutely not something people think about until it hits them. So hopefully we can spread some awareness for those who do travel to decent heights :)

  6. My sister has this problem, share it with her, thanks! :)

    • Feel free to pass on our contact info too if she has any further questions :)

  7. This is all a bit scary, the frothy pink thing and that… I’ve never been to high altitude destinations, but I’ve heard of a few fellow cyclists who had this trouble along the Pamir Highway… I can imagine that cycling in high altitude doubles the trouble… I’ll make sure to refer to this! :)

    • That bit is definitely rare, but I thought it was important to include it because people do need to know the emergency signs of severe altitude sickness so they can get lower straight away. Who knows, could maybe save a life one day!

      Cycling in high altitudes would definitely double the trouble, because you’re exercising when you need to be resting. We did mountain biking a fair bit in Bolivia, though we gave ourselves a few days before we went out and biked.

      Glad you found the tips to help :)

  8. Thanks for the tips Meg. I was eyeing to go to Kota Kinabalu and I was worried for the same thing, altitude sickness. I was training for it but apparently it’s not dependent on that. I hope I make it and I hope I don’t get it but incase it happens, good to know ways on how to deal with it.

    • You’re welcome Karla – hope you have a good time on Kota Kinabalu. Training will help you conquer the physical requirements of the mountain obviously, but yes, when it comes to altitude sickness, really the only thing you can do is allow yourself the time to acclimatize.

      Do visit your doctor before hand though to grab some meds if you’re still worried, and make sure you travel with a decent travel health insurance policy. Just to cover any and all possible scenarios.

      But I’m certain you’ll have a fabulous time! Happy travels!

  9. I really found this so interesting – I had no idea how quickly one could be affected if not acclimatised properly. It sounds an amazing place to visit, but obviously cautions have to be taken. I’d love to go one day!

    • I’m so glad Sarah. Altitude Sickness really can hit hard when you’re not expecting it, so always good to be prepared with the proper info just in case.

      La Paz is truly an amazing destination, and we really loved our time in Bolivia. Would highly recommend it, but yes, just practice precautions when it comes to traveling that high :)

      Happy travels!

  10. I just left the Andes of Peru where I was living/hiking for 3 months and have to say this info is much needed! During the time I was there, I heard of lots of people getting altitude sickness and one guy even died while trekking because of it. Of course this is an extreme case but people need to realize that the risks and understand how to properly acclimate themselves. Great tip on doing shorter day trips, this will help your body adjust gradually.

    • :( So sorry to hear about the guy who died while trekking Amanda – that’s such a tragic situation. Obviously it’s an extreme case, though I did hear of a similar story re an Australin backpacker in La Paz who also passed away due to altitude sickness just shortly after Mike and I were there.

      It’s really something we do need to start spreading awareness about because people need to know how to prevent a tragic situation and properly acclimatize themselves.

      Travel safe X

  11. Thanks for such an in-depth post. My husband had some altitude sickness in Zermatt, while I did not. You never know if you’ll get sick so it’s important to acclimate and be mindful of what you’re feeling.

    • Absolutely Jackie – it really doesn’t discriminate on who it hits, it’s just more about how well your body can handle less oxygen in the air.

      Glad you found the post helpful :)

  12. I wonder how high you’d have to be before altitude sickness kicks in. Looking at your beautiful pictures you look pretty high but I’ve only ever heard of altitude sickness when clinging mountains like Everest.

    • It really does depend on the individual – typically, altitude sickness occurs at altitudes over 2,500 metres (8,000 ft), though most people can ascend to 2,500 metres with little or no effect. At over 3,000 metres (10,000 feet) 75% of people will develop mild symptoms.

      So it’s important to check the altitude of a city if you think you’re traveling fairly high. Definitely something people think only applies to Everest, though it can hit you in many other places around the world too even when you’re not attempting a climb :)

  13. What amazing scenery! OMG! It must have been a thrill to hike some of those mountains. I suffer from migraines and stay away from high altitudes but I’m giving a visit a second thought!

    • It was absolutely one of the most stunning cities we visited in terms of scenery and landscapes – Bolivia really surprised us by it’s natural beauty.

      Definitely consider a visit, I’m sure you would absolutely love the country, though if you suffer from migranes already do consult your doctor first about what you can do to properly acclimatize and minimize any altitude sickness :) X

  14. Really fantastic advice. I just did the Inca trail and I know I could never have done it if I hadn’t spent a week at higher altitudes preparing for it. The first day I could barely climb a flight of stairs.

    • Thanks Jen – the Inca trail is definitely one to watch out for, it’s an incredibly popular trek but people don’t realize the altitude dangers can be right up there with Everest or Kilimanjaro just depending on how your body handles less air.

      And I feel your pain! We seriously couldn’t even walk up a steep hill the first two days in La Paz!!

  15. Great post we have never been at an altitude that high. The highest we got was in Otavalo, Ecuador I think it was around 8500 feet, I found even at the altitude we had less energy and tired out quicker, and of course we rented an apartment at the top of a 4 story walk up!
    We had plans to go to Bolivia and still will make it there maybe next year, I will keep your tips in mind.

    • I hope you do have the chance to get to Bolivia soon Rob – we didn’t think about it at the time, though it turned out to be amazing luck that we ended up with a ground floor room while staying in La Paz :D Maybe that’s something you can request next time so you can skip those annoying flights of stairs!!!

      Travel safe :)

  16. This article is very informative, thank you for sharing it with us! I’ve never been to extreme altitudes, but I’ll keep your advice in mind if I ever travel in the regions you mentioned.

    • Thanks Kathrin – I’m happy to help :) Definitely bookmark to refer back here if you do find yourself considering high altitude destinations in the future :) And we are always happy to help if you have any questions too.

  17. Great tips on dealing with the effects of altitude sickness! I’m planning a trip to Cuzco among others and this has definitely been a lingering concern. Will put this information to good use when I get there :)

    • Thanks James. Cuzco we found that we were fine, though as I mentioned in the post, it really does come down to each individual as to how their body is equip to handle less air.

      Definitely feel free to refer back here for any tips as you go – glad we could help you out before your trip.

      Travel safe!

  18. Love this informative post introduced through La Paz. What a gorgeous city! Very interesting that it’s located at such a high altitude. I’ve never experienced altitude sickness, but it sounds like it’s not to be taken lightly. Thanks for the great information!

    • Thanks Jen – La Paz truly is a wonderful city and the scenery is unlike anywhere else in the world. Highly recommend a trip to Bolivia to experience it for yourself … La Paz that is, not altitude sickness!! Make sure you properly acclimatize and you’ll be fine :)

      Happy travels!

  19. Very helpful post! I got my first altitude sickness upon arriving in jackson Hole, Wyoming, but it was over in about 24 hours; luckily. Bolivia looks so gorgeous and I hope to make it there in 2016. Thanks for the great advice!

    • Thanks Melody! So sorry to hear you’ve dealt with altitude sickness too. Glad to hear that it was over pretty quickly though.

      Hope you do manage a trip in 2016 – spectacular country! Travel safe :)

  20. Great tips for dealing with altitude sickness. I’ve never had it, thankfully, but I have noticed being out of breath at higher altitudes–it can be such a frustrating thing to deal with! Thanks for sharing these tips!

    • Thanks Jenna – I’m glad to hear you’ve never had it before. One of those things which people don’t think about until it happens!

      Safe travels X

  21. I remember an infamous trip to Atacama straight from a super jet lagged trip and feeling like I was floating the entire trip. I wish I had done a few of the things above because I have no memories of that trip, as if it was al just a dream

    • Hopefully you can get back for another trip then to experience it when you’re a bit more grounded :D

  22. It looks like there can be very severe and painful AMS symptoms, so acclimatizing properly is clearly very important to high altitude travel. Good tip about not sleeping 1,000-2,000 ft above where you slept the previous night.

    • Absolutely Mary – severe AMS is not something you want to be dealing with at all, so if it gets worse, it’s so important to descend immediately. Glad you found the tips helpful :)

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