High Altitude Hiking

I am going to Peru and May and am going to hike the Inca Trail to Machu Picchu. I’ve done some hiking before, but am far from an expert. And I’ve never been in high altitude (except in an airplane!). What is the best way to prepare?

-Bob, New York

ANSWER: Machu Picchu
Your trip will be amazing! I haven’t been to Peru yet, however, a close friend hiked the Inca Trail 2 years ago and loved it. The best thing to do is start preparing early, so I’m glad you asked the question.

Physical Preparation:

The best way to prepare for a long-distance, high altitude hike is to practice exactly that – high altitude, distance hikes. ๐Ÿ™‚

In the New York area you are a bit limited because most mountains in the tri-state area are only 2,000 to 4,000 feet high, compared to 8,000 feet at Machu Picchu. What you can do easily is practice long-distance hiking up shorter hills. Perhaps section hiking the Appalachian Trail (check out Bill Bryson’s book for more info on that)?

If you can’t get outside, prepare by using the stairmaster or an elliptical machine. It is very different to hike uphill for hours vs. walking on flat areas (stairmaster vs. treadmill). Also, even if you’re using the gym, wear a backpack filled with water and some gear. Even though you likely will have porters carrying most of your gear, you’ll definitely be carrying a daypack, so start strengthening your back and shoulders by wearing a pack.

High Altitude Tricks:

As far as the altitude, the best way to prepare is to spend time in high altitude before you do strenuous physical exertion. If you can get there a day or 2 early, do moderate physical activity to get your body ready. I also take supplements starting a week before a trip (like my summer hike of Mount Whitney, CA):

  • Chlorophyll. Liquid ChlorophyllFirst, I take liquid Chlorophyll supplements starting a week before the hike. Since the bottle is glass I don’t take it with me when I’m concerned about the weight of my backpack, but I diligently take it everyday for at least 1 week prior to the hike. You can also find Chlorophyll online or at Whole Foods. Chlorophyll helps you increase your red blood cell count, so along with Ginkgo, is invaluable in helping you acclimatize. Remember that your body will be deprived of oxygen in the high altitude. If you’re very concerned about high altitude health issues, ask your doctor about Diamox, which is a prescription drug that is used to hasten acclimatization). I have some friends that have taken it along with them as an emergency kit addition.
  • Ginkgo Biloba.Ginkgo for altitude sickness I take Ginkgo Biloba supplements starting about a week before a trip, and continue to take it throughout the trip. You can pick up Ginkgo supplements online or at a local Whole Foods store. Ginkgo Biloba increases the blood flood to your extremities, which is important in oxygen deprived, high altitude environments like Machu Picchu.

Finally, be sure to drink tons of water and eat enough food. You likely won’t feel hungry when in high altitude. You have to force yourself to eat.

Putting Chlorophyll drops in my water 3 days before hike
Putting Chlorophyll drops in my water 3 days before hike

I’m so excited for you! It will be an amazing trip! I did the same preparation when I hiked Mt. Whitney this summer and I was problem free in the high altitude.

Happy trails!
Hiking Lady

Do you have a question for the Hiking Lady?


  1. Mark says:

    Also “high altitude ” begins at 2700 meters not 5k feet. Until then the oxygen in the air is plentiful enough that your lungs don’t work any harder to breathe.

  2. Mark says:

    Your body does NOT burn any additional calories at high altitude. Lack of oxygen in your lungs in no way affect the caloric exertion . It’s like saying a smoker burns more calories in same treadmill excercise bec be is short of breath. It’s not true. Lastly Machu pichu needs no acclimatization since whether to do the Inca or salkantay trail for example Machu pichu is actually THOUSANDS of feet LOWER than the higher points of those trails

  3. Summer says:

    Just hiked Peru and Machu Pichuu in October. Thank you for your high altitude tips regarding the Chlorophyll and Ginko Biloba–I was surprised how well it worked! Followed the directions on the both bottles and did it 10 days prior to landing in Cusco. Did not want to do the Diamox because there are no washrooms in Machu Pichuu– only at the entrance. My husband asked, complained about making him drink grass! We are in our 60s, average fitness, and I’m prone to bronchial/pneumonia problems– I was worried about the altitude. Brought my meds, inhaler etc. just in case, and never needed it, thank God. Worked out 2 months advance and made sure that included a lot of stair climbing. We were fine. There was guy in his 30s who passed out who was on Diamox. We thought it was bc of no sunblock and no SPF hat–you really need one. Many of the guides wear gloves. I was wearing SPF 70 and my hands got sunburned. Also wear hiking books. Many unprepared people hiking Machu Pichuu with no SPF hats, no sunblock and got really sun burned, no insect repellant, some people wore
    sandals, flip flops and were having problems.

  4. E says:

    Those of you taking about Peru, coca leaves will decrease the effects of altitude. That is how Peruvians handle the altitude. The leaves are chewed and are a mild stimulant. Just don’t try to take any home as they are the very same plant that cocaine is made from!

  5. Ann. Fleck says:

    We will be spending 35 days in Peru leaving April 27th . Besides the 2 day Inca trail hike, we are doing a 5 day Ausangate lodge to lodge trek with Andean lodges…..Highest pass 17,ooo. We would like to go on a long weekend getaway early April to do some higher elevation hiking. Where can you suggest we go in the USA? We live in Alberta, so Rocky Mountains are still snow covered so no hiking there before we go:(
    Thanks in advance!

  6. Hiking Lady says:

    Hi Karla,

    Great question. I would consult with physician about the potential interaction with high blood pressure medications. Good luck on your trip, drink lots of water, and if you experience any signs of altitude sickness, make sure you get to a lower elevation.

    Happy trails!

  7. Karla Haney says:

    Hi, I wanted to ask if Chlorophyll and Ginko Biloba interact with any meds like high blood pressure meds, and any other natural supplements. I also wanted to find out if a healthy, active 81 year-old can take both these supplements and be fine at high altitudes. I am very worried about AMS since we are flying from sea level to 2000 ft. Then 3 days later, we are flying to 8000 ft, and the day after that we are going on a bus excursion to 10500 ft high where we spend 4-6 hrs walking about, and the day after that, we go on a bus excursion 14,500 ft high and staying there for 6 hours. I will surely take the supplements 1 week before leaving, but do you have anymore tips? Really don’t want to take Diamox, especially at my age.

  8. Hiking Lady says:

    Hi Jessica,

    Great questions. Whomever told you that hiking down to a lower altitude to sleep is partially incorrect. It depends what they mean by “lower altitude”. You should indeed be sleeping at a lower altitude than where you climbed during the day for acclimatization to work, however, that doesn’t mean you go all the way down to the bottom of the mountain.

    You need to “climb high” during the day, and “sleep low”. If you’re hiking up a mountain, you’d hike up a few hundred meters during the day, and sleep at base camp. The next day you’d climb a bit higher, and in many cases set up camp higher than where it was the first night, but lower than where you hiked during day 2. So you steadily make progress up a mountain, while letting your body slowly adjust to the elevation differences (“acclimatization”). By definition, acclimatizing means letting your body adjust to gradual change.

    There is no hard and fast rule as to how many meters of elevation gain your body can handle in a day. All of us are different. Plus, a major factor is the starting elevation of the mountain you’re climbing. (i.e., if you start from sea level, it is very doable for a lot of average hikers to gain 6,000 feet/1,828 meters of elevation in a day. If you are climbing Mt. Everest, the total gain from base camp to the summit is 11,560 feet/3,523 meters. It takes most of the world’s best climbers several weeks to acclimatize, and many still end up using supplemental oxygen).

    Good luck!

  9. As a native of the UK I thought we had some superb camping and hiking trails until I skipped through some of you pictures! Wow! There are some amazing places to try! Great Blog

  10. Jessica says:

    Also, I’ve been taking wheatgrass every morning to get ready. I also practice coherence breathing. There are usefull videos which help you breath at the right moment

  11. Jessica says:

    Question, I will be hiking in Lapaz, Bolovia and was wondering what’s the maximum amount of meters in altitude I should be doing per day. I was told that hikers should follow the following amount of meters:
    day 1: 300m day2: 300m day3: 1000m day 4:300m day 5: 300 day 6: 1000m. So basiacaly it’s 300, 300, 1000, 300,300,1000 and so on. I was told that going higher than these altitudes could cause sickness and even death.
    Also, I was also told that hiking down to a lower altitude to sleep doesnt help since your body went to a higher altitude during the day.

  12. Priya Anand says:

    Hi, I am in my late 40s, average fitness and have done two treks in Himalayas going up to 13500 feet. Now am planning a high altitude trek to Ladakh with a group of women. Am worried about high altitude sckness though we plan to acclimitize in Leh for 3 days. Thanx for the chlorophyll tip. Any other tips that would help?



  13. Jacqueline says:

    Hi Mountain Lady! Thanks so much for the tip about chlorophyll. Two weeks ago I hiked the Grossglockner – the highest mountain in Austria (3,798 m) and was a bit nervous beforehand about the altitude. I’m originally from Florida, but have been actively hiking since my move to Austria, so about five years, but this was my highest challenge yet! So in looking up tips, I found yours and decided to follow it. Long story short, there were four of us in the group, and I was the only one who didn’t get altitude sickness, and I think it was the chlorophyll!

    Thanks so much for the help!! ๐Ÿ™‚

    Happy Hiking!

  14. Hiking Lady says:

    Hi Mel,
    If you can find stairs to climb, that would be helpful too! Also put on a backpack when you’re on the treadmill or doing the stair climb. Good luck with the training and enjoy your Machu Picchu adventure! ๐Ÿ™‚

  15. mel says:

    I’m doing the Salkantay trail to Machu Pichu in October, I live in the UK at sea level or just below, there are no hills or mountains anywhere for miles. I’m doing lots of walking and use the treadmill on incline. Have you any advice please, I’m 46, sort of fit.
    Just found your site and enjoying reading.

  16. delgardo says:

    hi i live in the uk close to manchester and in about 2 months im visiting colorado to meet family and thay like hiking up the mountains there and thay want me to go with them so any tips about how i can train for it?

  17. Hiking Lady says:

    Hi Sowmya, yes that works, but it is a bit tricky. In order to retain the chlorophyll in the food, it is best to eat it raw or just barely cook it/steam it. The liquid chlorophyll is highly concentrated, so you can get a lot fast, without eating a lot of food. Happy trails!

  18. Sowmya says:

    Hi, was wondering if eating a lot of greens and iron rich foods prior to a high altitude hike would work the same way as Gingko and liquid chlorophyll??


  19. Mark Whitman says:

    Hi Jeanne, if you have controlled asthma you should have no problem, however if you have severe persistent asthma you might have trouble at altitude.
    In general the body is highly adept at acclimatising to high altitude if you give it enough time. Treks like the Inca Trail and Kilimanjaro are challenging because they are completed in a short period of time. Kili in particular is a challenge as it is significantly higher than the Inca Trail and indeed EBC, but most people take routes that only provide 4 or 5 days before summitting.
    If you are trekking Kili I highly recommend taking Diamox, which is a prophylactic (i.e. used as a preventative medicine not a cure). It will make you pee a lot and it might give you a few other symptoms like tingling in your fingers, however it will increase your probability of not being affected by AMS. For Kili climbers here is a detailed article on acclimatisation (http://www.climbkilimanjaroguide.com/acclimatization-kilimanjaro/) and this article on Diamox (http://www.climbkilimanjaroguide.com/using-diamox-on-kilimanjaro/) should help as well. Best of luck, Mark

  20. Jeanne Kizer says:

    These are great suggestions. I am going on a whitewater rafting,camping, hiking week with our boyscout troop to the Colorado Rockies in June. I am 55 yrs old and in moderatee shape. I plan on upping my aeobic & cardio activity to prepare for the trip. I also have asthma so I am very leary of going, but this is a once in a life time trip. Any suggestions as far as the asthma in the higher altitude?

  21. Hiking Lady says:

    Great question Suzanne. I put 24-36 drops into an 8 oz glass of water once per day for 5-7 days prior to the trip. With the brand I buy, 36 drops is equal to 100mg. Happy trails!

  22. Suzanne Rogers says:

    Thanks for your tips on altitude sickness prevention. Could you tell me the dosage, ie strength of the chlorophyll drops and how many to take and how often?
    Thank you,

  23. Ty says:

    These are great tips. I have always had issues with high altitude hiking… to the point where I’ve avoided it the last few years. Even when I do what I can to prepare myself for it, I still seem to get very light headed and feel ill. The chlorophyll and the raw garlic are excellent ideas and I am excited to give this a shot.

  24. Miss Chaos says:

    Another tip, albeit not the most pleasant, is to chew on a clove of raw garlic as you hike in a high altitude setting. Raw garlic heats and thins your blood, making the circulation of the limited oxygen supply much easier up there, aiding in the acclimatization process.

  25. Sherry says:

    Hello there! I just discovered yr site! Very interesting and helpful. Am heading to Kilimanjaro end this month and checking out info on altitude. I come from Malaysia so no mountains that high. Local alternative med has also recommended Rhodiola, a herb in Chinese called hong jing tian. Think I will try that and yr recommendation. Thanks!

  26. Hiking Lady says:

    Hi Carol – great question. I generally start a week before the hike. As far as dosage, the respective containers will have the daily recommendation. I believe that the Chlorophyll I purchased says to put 18 drops in an 8oz glass of water, and Ginkgo is 1 per day. I’d follow the guidelines on the package. Have fun on your 14er hike! You’ll have a great time ๐Ÿ™‚

  27. Carol says:

    Wondering… is there a recommended dose for the Chlorophyl and Ginkgo… also how soon before the planned activity should a person start. I plan to do a 14er this summer and currently live below 2k. thanks

  28. Patrick says:

    We are heading to in Kilimanjaro in a few months and I have been wondering if there was anything we could find to help with the altitude and i can across your site while I was looking. We will give both the Chlorophyl and Ginkgo a try and hopefully avoid some of the problems to, thanks for the info.

  29. Hiking Lady says:

    Hi Valerie!
    That will be so much fun! ๐Ÿ™‚ Because of the wide temperature differences, be sure to dress in layers, and have warm clothes with you in your backpack (I’m talking gloves and a hat). A good friend did this hike and he said the temperate variance was so extreme…and he wasn’t prepared…so was extremely cold at the top and almost got frostbite since he was wearing shorts. I know you won’t make that mistake since you read HikingLady.com ๐Ÿ™‚
    Happy trails and safe travels!

  30. Valerie says:

    We’re planning on climbing Mt. Fuji (12,000 ft) in July. It’ll be WARM at the start and then very cold at the top. I love your great tips on backpacking. Do you have any more recommendations for our 1st climb? We will be on a boat 12 days prior so we could use all of your helpful hints.

    Thanks for sharing your experience and wisdom on hiking!

  31. Hiking Lady says:

    Have fun in Peru, and best of luck with the high elevation! I hope to read more about your adventures on your website. That’s a good tip about the best nail polish colors for hiding dirt! ๐Ÿ™‚

  32. Morgan says:

    I’m heading to Cuzco, Peru in July to hike Macchu Piccu as well as the Lares Trek. I never heard about taking Chlorophyl or Ginkgo so I’ll be sure to check those out, thanks! I’m from the Canadian rocky mountains so have a lot of experience with high elevation hikes but none as high as in Peru! Fingers crossed altitude sickness is avoided!

  33. Hiking Lady says:

    Hi Mary! Since it doesn’t sound like you’re going to have any time to hike at elevation in advance of your trip, my best advice is to drink plenty of water now, drink lots on your airplane ride, and as soon as you get there. That is the best thing you can do for jet lag. Also try to eat nutritious food so that your body can be best equipped to deal with battling the jet lag and handling the high altitude hikes. Have a wonderful trip!

  34. mary conway says:

    I’m going to Nepal India in a little over 2 week. Needless to say I didn’t get a whole lot of warning on this trip but I’m looking forward to it just the same. The tour guide told my friend that a 60 year old woman in good health should be ok. i don’t trust the guide so I’ve started to go to the gym every day to build up a little more muscle mass and work on my diet to drop a few lbs before I get there. Its a two day plane ride, we’re flying from DC. We’re off the first day we get there which should help. Any recomendation for the jet lag we are going to get nailed with. We are not climbing Mtn Everst which is fine with me ;-)!

  35. Hi Hiking Lady! I just discovered your site and love it! I hiked quite a bit in Bolivia and Peru at altitudes over 15k and it is no joke! I love your advice and agree completely. I think time to acclimate is the most important. Local guides often have home remedies (including coca tea or chewing coca leaves) that may also be helpful. Local pharmacies in Andean countries may sell medication to prevent or ease altitude sickness, but these are met with varying opinions.

  36. Belinda says:

    I take ginko and found it to help. At least I haven’t had altitude sickness yet. I hike a lot in the colorado Rockies.

  37. Hiking Lady says:

    Great question, Liz! You’re going to have fun up there again! I’m jealous!!

    I think part of the reason your legs and ankles were swollen and crampy was the long bus ride. If you can, try to stretch your legs as much as possible and drink lots of water during your journey.
    If you can get there earlier this year and have more time to acclimatize that would be helpful. Do short walks/hikes each day, going higher up in elevation and then coming back down at night. Be sure to get plenty of rest and drink lots of water.

    I also would try taking Ginkgo as mentioned above… do it at home a few weeks before your trip just in case you are allergic (take it with food), then start it up again a week before you go. That helps with circulation, which may help prevent the swollen ankles you experienced last year.

    Also, get the in best physical shape you can prior to going to Yellowstone… that way it will be physically easier for you to hike and climb stairs. Shortness of breath is typical for those of us who journey from low elevations to high ones, but getting in the best shape possible will help a bit.

    Have fun, and happy trails!

  38. Emily says:

    Dear Hiking Lady,

    Last year I went to work and live in Yellowstone National Park. I took a two day bus trip from Austin, TX. When I arrived in Bozeman, MT (one day before I was to start work in the park) my legs and ankles were swollen and crampy. It was painful to walk. This continued for the next week. Breathing was also really hard for the first two weeks and eventually became easier but I still became winded while hiking or climbing stairs. I am heading back for another 3 months at the end of April. Any tips on how to make the physical transition easier this time around? Should I just arrive earlier with more time to get used to the elevation? Thanks!

  39. Liz says:

    Great tips! I have heard about using Ginkgo, but not Chlorophyll. I’m definitely going to try that too! Thanks!!!

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