Considering altitude is an essential factor for planning a trip to Peru. This is the one thing I rarely saw mentioned as we planned for our Peru travels. Altitude and what it does to a traveler if you aren’t prepared can be very serious. In all my years of trip planning, I have never even thought of altitude as a factor in trip planning. When altitudes are over 10,000 feet you really need to take this into consideration.
When we found our cheap tickets to Peru and started planning the trip, we knew we wanted to go to Machu Picchu and that was pretty much it. We discovered that Peru has one of the best 10 train rides in the world and decided it was worth the slight splurge to take the 10+ hour journey on the Luxury Train. The train goes between Puno where Lake Titicaca is, and Cusco the big city closest to Machu Picchu. No brainer. Fly from Lima, the capital, to Puno and then get the train to Cusco. I had flights paid for, Airbnb’s picked when about a month before the trip, my husband asked me what the elevation of Puno is. When I looked it up, I discovered it was 12,500 feet. So what does that even mean? As someone who lives at 800 feet this was going to cause some problems. With research we found:
“The pressure of the air that surrounds you is called barometric or atmospheric pressure. When you go to higher altitudes, this pressure drops and there is less oxygen available. If you live in a place that’s located at a moderately high altitude, you get used to the air pressure. But if you travel to a place at a higher altitude than you’re used to, your body will need time to adjust to the change in pressure. Any time you go above 8,000 feet, you can be at risk for altitude sickness.”
https://www.webmd.com/a-to-z-guides/altitude-sickness
The link above goes into detail on the three types of sickness ranging from severity of a headache and nausea to coma. There are some medications that can possibly help, but the best option is to slowly acclimatize. In other words, don’t go from sea level to 12,500 with an hour flight like we were planning to do.
Pivot time. We looked at the map of Peru and noticed Arequipa as a larger city between Lima and Puno. At only 7,550 feet this would be a good stopping place before we reached Puno. At first I was very disappointed. Adding this stop would mean one less full day in Lima and hardly any time in Puno to explore Lake Titicaca. We also would be eating one flight (only about $150 total) and one night of an Airbnb (and I hate losing money!). It also meant that really the only way to get from Arequipa to Puno would be a bus (you can fly but it’s a flight back to Lima and than to a city an hour away from Puno and it might have undone the benefit we would have gotten from staying in Arequipa). Needs must though so I booked the new flight, found an Airbnb, and finally got bus tickets (I kept hoping another option would suddenly appear which it didn’t).
It turned out that two days in Lima was plenty and Arequipa was one of our favorite cities. Our Airbnb had a stunning view of fields and a volcano, it was relatively untouristy, and it is the place to buy Peruvian goods. The bus trip was not my favorite. At only $28 total for both of us, we actually got luxury reclining seats but opted to seats on the 2nd level next to each other so we could see the view. We saw lots of llamas and alpacas but in high desert there were hardly any trees or even people. I wish we had taken the reclining seats and just slept most of the time. By the time we got to Puno, I was not feeling great either due to altitude adjustments or a six hour winding bus ride. We certainly walked slower and I had a slight headache but none of the extreme symptoms and it didn’t affect our enjoyment the next day of our luxury train trip. We met multiple people on the train who had not been able to enjoy any of their time in Puno due to feeling very ill.
To save you the same headache (figuratively and literally!), learn from my mistake and fly from Lima to Arequipa, luxury bus to Puno and then absolutely take the Luxury Train Trip to Cusco. If you have time, spend a full day in Puno to explore the reed islands of Lake Titicaca.