Fighting Altitude Sickness – South American Edition

The view at ten thousand feet of Quito rooftops
Fighting altitude sickness in South America means preparing for the symptoms

Mural in Ibarra, Ecuador

Altitude sickness hit me in Cusco’s Plaza Grande. My head felt oddly heavy and stepping up a short flight of stairs turned into an endurance test. I live at sea level and should’ve expected the repercussions of jumping from Lima to over 11 thousand feet. Although I’d taken an herbal altitude sickness concoction, even though I chewed Coca leaves, and drank the tea, for over ten days I was plagued with symptoms. They weren’t unusual – a fluctuating pain in my head, a weakness in my legs, every step a grasp for breath, trouble sleeping, and even vomiting a few times! Fighting altitude sickness is not fun.
Determined to avoid all that the next time I ventured over six thousand feet, I took a prescription altitude sickness pill before a conference in the mountains outside of Denver. Landing was easy. Getting out of the airport and onto a shuttle went smoothly (one of my favorites for the cool architecture that mimics snow-covered mountains.) The Diamox prescription worked, however, out of a range of possible side effects, my fingers started tingling and that didn’t stop for the three days I was at the conference. My fingers stopped tingling quickly after I returned to downtown Denver and stopped taking the medication.
On my latest trip, I flew into Quito, Ecuador, with an altitude of over nine thousand feet. Again, landing went smoothly enough but once out of the terminal I needed water. The shuttle driver directed me to a Fybeca Pharmacy, outside the terminal, saying, “It will be much cheaper there.” I trust local advice and followed him across to the shop. Two large bottles of water and $1.60 later, we were gliding along the freeway into downtown Quito.
Visit the Angel in Quito at a height of nearly ten thousand feet

The Angel in Quito

Extra water daily can help to fight altitude sickness

I had been told by many that chugging water, as much as I am able, would ease altitude sickness. However, the Institute for Altitude Medicine suggests that an additional liter and a half of water is safest. Otherwise, they suggest that reducing normal sodium levels may cause weakness, etc. I wonder if you eat salted foods – hard to avoid when traveling – if your sodium levels would be at real risk.
My altitude sickness test began in earnest over the next three days as I explored the Quito. Chugging soda wasn’t an option for me. Likewise with juice or sweet tea. They contain too much sugar and I discovered that only water seemed to relieve the headaches and weakness.
Quito is a city built on hills between a mountain and a deep river gorge. It’s spread out long and thin due to the geography – about four miles wide East to West and thirty miles long. I was staying in Old Town with its rolling hills and narrow streets. While the headaches lessened over my days, the weakness came and went. I kept drinking water whenever I thought about it and took a few Ibuprofen tablets to help with minor aches. It worked. By the second day, I was comfortable and able to keep up with companions.
Cruce - Crosswalk sign in Quito, Ecuador

Cruce – Crosswalk sign in Quito, Ecuador

Downsides to drinking much more water:

Drinking a lot of water, or any diuretic means finding bathrooms often. Luckily, in Quito that was not a problem. Stop in for a coffee? “Donde es banos?” Where is the bathroom? I slipped into a hotel lobby more than once. Every church visit or meal meant I asked about the toilet. It wasn’t a problem. All were free and very clean. That area of the city is ancient so toilet paper goes into receptacles in each stall. Actually, it’s a trend across Ecuador and throughout Mexico. Quito takes pains to collect garbage out of public areas and I encountered the smell of bleach more than once.
Recycling bins are all over Ecuador

Recycling bins are all over Ecuador

About drinking water in South America

Don’t drink the tap water in Quito. Ask if water is filtered when you eat at restaurants. The same follows for Mexico. Plastic bottles are an unfortunate necessity but throughout Ecuador, there are recycling bins. If I were to return, I’d travel with a refillable bottle and a purifying system. There are several on the market. Fortunately, Quito is serious about recycling and most trash receptacles are split into sections to make plastic disposal easy.
I hope my experiences will help you manage altitude sickness wherever you may encounter it. Here are two earlier posts about dealing with it: Asthma medicines and Altitude Sickness and more about my Peru experiences.
Don’t let altitude sickness affect your adventures or keep you from seeing the beautiful, high places on the planet!
Perhaps you’ve experienced this? I’d love to hear your recommendations and stories. Tell me in the comments below about how you managed altitude sickness.

More Altitude Sickness tips:

  • Altitude sickness can be related to a number of physical challenges. Generally, there’s a higher rate of water vapor lost from the lungs at higher altitudes.
  • The Institute for Altitude Medicine suggests that avoiding caffeine might provoke headaches. Those of us addicted to our morning coffee could experience headaches if we stop drinking it quickly. There may be a likelihood of dehydration due to the diuretic effects.
  • Get emergency treatment if you have life-threatening symptoms!


  • Uh oh. Guess where we’ll be flying to in January? Quito. When we visited Cusco on our honeymoon in 1982, we both felt the altitude. The only good thing about that was that we actually had to go on our honeymoon the month before we were married and I lost my appetite from the altitude, so I had no problem losing the few pounds many imminent brides seem to want to lose.

    I am terrible at drinking enough fluid—so I’m often dehydrated, even at sea level. I’m come to tell Mr. Excitement that he is free to remind me to drink as often as possible when we’re on the Altiplano.

  • I also suffer from altitude sickness. I avoid high altitudes, but when I do venture up I start Diamox in advance and it takes care of my problems. In Cuzco I also chewed coca leaves and drank the local tea, which I’m sure helped, too–probably just the additional water assisted but I was told by a ex-pat there that it definitely helped and all the locals chew and drink, too.

  • Hasn’t hit me yet but I appreciate all the information. Hope you are fully recovered by now and that it didn’t hamper your travels too much!

  • Loved this post. I just returned from a two weeks in Peru, a lot of that time in Cusco, Sacred Valley and Machu Picchu. I took Diamox and it worked well, but my Rx was written to be taken only until “3 days after reaching highest elevation. Everything was fine until we returned BACK to Cusco to fly out the next day, and I hadn’t taken the altitude meds for several days. Like you, I got sick, including vomiting. Up until that, I had done fabulously. I did have that tingling in my fingers and toes, too. A couple of things that I also did that helped was bring drops of blueberry-flavored electrolyte drops to add to my water, and always had a bag of salted almonds and trail mix.

  • I’ve never traveled to really high places, or at least not as high as Quito. Did you stop taking the prescription medication because of the tingly fingers? And how would you compare the two strategies — prescription medication vs. extra water? Which worked best?

  • Thanks for the useful tips. I have never experienced altitude sickness, but my wife did during a visit to Pikes Peak in Colorado.

  • This is something I only imagined if you were mountain climbing not just visiting a city. Thanks for the interesting insight I am wondering now about times I felt this way when we travelled whether it was from this.

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