Feeling Unwell at Cusco? Let’s Talk About It

During the first days in Cusco, it is common for travelers to notice small changes in how their body feels. The symptom most people mention during consultations is headache, although others may experience nausea, occasional vomiting, fatigue, dizziness, loss of appetite, or difficulty sleeping during the first nights.

Many patients begin the consultation with a familiar sentence:

(“Doctor… I think it might be the altitude.”)

Sometimes that is correct — but not always.

When arriving in a new country, the body is adapting to many changes at the same time. Travelers are adjusting not only to altitude, but also to long flights, travel fatigue, new foods, changes in sleep patterns, different hygiene conditions, and sometimes dehydration after long travel days.

Because of this, symptoms during the first days in Cusco do not always have a single explanation. Sometimes they are related to normal altitude adaptation, sometimes to gastrointestinal illness, dehydration, food-related infections, or simple travel fatigue, and occasionally more than one factor may be present at the same time.

Evaluating these situations is something I do every day in clinical practice here in Cusco, caring for visitors who are unsure whether what they are feeling is normal adjustment or something that deserves medical attention.

From what I observe in daily practice, the great majority of travelers adapt to altitude without significant problems. Only a smaller portion develop symptoms of altitude illness, and serious complications are fortunately very uncommon.

Another situation I frequently see in consultation involves portable oxygen monitors. Many travelers arrive with small pulse oximeters or smartwatches that display oxygen saturation levels. These devices can be useful, but they can also cause unnecessary concern.

It is quite common for patients to tell me something like:

(“Doctor, my oxygen is only 88%… am I in danger?”)

At this altitude, a moderate decrease in oxygen saturation is expected and does not automatically mean something is wrong. Oxygen values at high altitude are naturally lower than those seen at sea level.

Sometimes the situation becomes more complicated when anxiety appears. A traveler may see a number on their device that seems alarming, begin to worry, start breathing faster, and suddenly feel palpitations, dizziness, or tingling in the hands and feet.

Then the conclusion becomes:

(“Doctor… I think I’m having altitude sickness… or maybe a heart attack.”)

In reality, anxiety, dehydration, cold temperatures, fatigue, and hyperventilation can also influence oxygen readings and symptoms.

Another common scenario occurs when travelers take medications without proper guidance. Occasionally patients arrive after taking higher doses of acetazolamide (Diamox) than recommended, sometimes combined with coffee during the day and alcohol in the evening.

(Your body generally appreciates a little more kindness than that.)

These situations can produce symptoms such as tingling in the fingers or toes, dizziness, or unusual sensations, which are actually common side effects of the medication rather than signs of severe altitude illness.

For these reasons, it is always better not to draw conclusions based only on a device reading or internet advice. A simple medical evaluation usually clarifies the situation quickly and helps determine whether symptoms represent normal altitude adjustment, mild altitude illness, medication effects, or another travel-related condition.

In most cases, the solution is surprisingly simple: rest, hydration, light meals, and giving the body time to adapt.

The goal is not to alarm travelers.

The goal is to help you feel safe, understand what your body is experiencing, and continue enjoying Cusco and the Andes with confidence.