If you have a headache, feel dizzy, or do not want to eat on the Inca Trail, do not keep it to yourself. Tell your guide. At high altitude, “it will pass” is the phrase that causes the most problems.
This page does not replace a doctor. It explains what to do on the trail while the team makes a decision. How to train and whether the classic route is right for you are covered in other guides.
What is soroche on this route?
Altitude sickness (soroche) occurs when your body does not adapt to thinner air. On the classic route, it usually hits on the second day, near Warmiwañusca, or when reaching the highest campsite.
Mild symptoms are not unusual. Severe symptoms are something else. The mountain rule is simple: if you feel unwell at altitude, treat it as altitude sickness until proven otherwise. Do not go higher. If it gets worse, go down.
How to tell when it is mild
It usually appears within hours of going higher, sometimes the next day:
- headache
- nausea or loss of appetite
- dizziness
- fatigue that does not match how far you have walked
- a poor night’s sleep, broken sleep
Do not keep climbing to see whether it passes. Stop, rest, drink water, and tell your guide. Water does not cure soroche, but dehydration can look exactly the same.
What to do if it is mild
- Tell your guide. Do not hide it.
- Do not go any higher until it eases.
- Stop. Sit down. Keep warm.
- Eat light if you can. Do not force yourself to eat a heavy meal.
- No alcohol. Do not overdo coffee on your first day at altitude either.
- If the guide has oxygen, they decide when to use it.
Altitude medication (acetazolamide and others) should be prescribed by a doctor before your trip. Do not take it just because a tent mate brought some. It does not replace descending if symptoms worsen.
When you need to descend
If symptoms do not ease or get worse, descend. Going down is what works best. In the mountains, dropping a few hundred meters is often enough, but the guide and team arrange that; do not decide on your own or take a shortcut at night.
Do not descend alone. Do not carry your large backpack if you are being evacuated. The extra effort can worsen some lung conditions.
When it is an emergency
Headache. Alert your guide immediately and evacuate:
- shortness of breath while sitting, without climbing
- a worsening cough, pink or foamy phlegm
- blue lips or fingernails
- being unable to walk straight, as if you were drunk
- confusion, not knowing where you are, drowsiness you cannot shake off
- vomiting that does not stop
- a headache that gets worse and does not go away
This may be pulmonary or cerebral edema. Do not wait until morning. Descend and seek help. Oxygen and whatever the team carries can buy time. They do not replace descending.
What not to do
- Do not keep climbing to see if it passes.
- Do not drink alcohol with dinner to help you sleep.
- Do not take pills from another trekker.
- Do not leave the group to clear your head.
- Do not wait until sunrise if you are getting worse.
Frequently asked questions
What should I do if I get a headache on the trail?
Tell your guide, stop, do not go any higher, and rest. If it eases, reassess. If it gets worse, descend.
Is coca tea enough?
It may help you feel a little better. It does not treat a severe condition or replace stopping or descending.
Should I take altitude medication on my own?
No. A doctor should prescribe it before your trip, based on your medical history. Do not take anything another person in your tent offers you.