Lots of great advice already on the thread including REI's advice in response #1 but I thought I could add a few salient points. Do: - Bring IBUprofin or Diamox. Research diamox as it has some downsides for some people. - Be in great fitness shape before you leave. Note, there is no correlation between fitness level and your associated risk of altitude sickness. That said, being very fit will mitigate one additional controllable risk. - Try to get acclimated in advance. It's important to do this as close to your trip as possible. (Going up to 10K feet 3 months in advanced won't help). The week before and the week of is very helpful. Cusco is at just over 11K feet - the Inca trail climbs to 13,828. The good news? You don't need to "work out" to get acclimitized- if you can go on a mountain get away the week before at 8K feet, sleep, rest, and relax it will be helpful. I hiked Mt Whitney this past Monday at 14,500 and did 2 back to back trips to Flagstaff at 12,700 and got to Lone Pine (Mt Whitney base) and day in advance to explore- zero problems but I live at about 2700 feet. - Don't know about coco leaves- but can't help trying! I've also heard stories of taking Chlorophyll drops beforehand but have never tried it. It supposedly increases red blood cell counts. Also Ginko Biloba 24 hours beforehand 80mg. Again, haven't tried this, but some research is out there on efficacy of it. - Extra hydration should be done before and while you're there. - If you start to experience AMS (headaches usually start first) and then begin to lose balance- go down and DO NOT push through it. Balance is a critical symptom which indicates more progressive symptoms. - If you really want to go crazy and buy a Garmin Fenix 5X plus, it has a pulse ox meter built in. You can track your o2 levels as you hike. Best of luck!!!!
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