Bolivia Altitude sickness: symptoms, prevention & treatment [2026 Guide]

Bolivia is one of the highest countries in the world. La Paz, the capital, lies at 3,640 meters - higher than the Zugspitze. El Alto airport sits at 4,061 meters, and many sights (Lake Titicaca, Uyuni, Potosí) are between 3,600 and 4,200 meters. This means that almost every traveler to Bolivia is confronted with altitude sickness.

As a German-speaking guide who has lived in La Paz for years and looked after hundreds of travelers, I have first-hand knowledge of altitude sickness. I have seen how tourists had to go straight from the airport to hospital - and I have seen how well-prepared travelers got through Bolivia without any problems.

In this comprehensive guide, you'll learn all about altitude sickness in Bolivia: symptoms, prevention, treatment, and the most common mistakes. I'll show you how to acclimatize properly, which medications help and when you need to see a doctor. With the right preparation, altitude sickness is not a problem - just a minor challenge on your Bolivian adventure.

Quick overview: Altitude sickness in Bolivia

What is altitude sickness? The body's reaction to low oxygen levels at high altitude
At what altitude? Possible from 2,500m, often from 3,000m
Main symptoms: Headache, nausea, fatigue, dizziness
Dangerous forms: HAPE (high altitude pulmonary edema), HACE (high altitude cerebral edema)
Best prevention: Slow acclimatization, drink plenty of fluids, coca tea
Medication: Diamox (acetazolamide), ibuprofen, Sorojchi pills
When to see a doctor: In case of severe shortness of breath, confusion, coughing with blood
Most important rule: In case of worsening, get off immediately!

---

What is altitude sickness? The science behind it

Altitude sickness (also known as "acute mountain sickness" or "soroche" in Spanish) is your body's reaction to the lower oxygen levels at high altitude.

Why does altitude sickness occur?

At sea level: Air pressure 1,013 hPa, oxygen content 21%
At 3,640m (La Paz): Air pressure 640 hPa, oxygen content still 21% - BUT: 37% less oxygen per breath!
At 5,000m: Only 50% of oxygen still available

Your body needs time to adapt:

• Produce more red blood cells (transport oxygen)
• Increase breathing rate
• Accelerate heart rate
• Dilate blood vessels

If you ascend too quickly, your body can't keep up - and you get altitude sickness.

The three forms of altitude sickness

1. Acute mountain sickness (AMS)

Frequency: 50-80% of travelers in Bolivia
Severity: Mild to moderate
Danger: Low (if treated)

Symptoms:

• Headache (most common symptom!)
• Nausea, vomiting
• Loss of appetite
• Tiredness, weakness
• dizziness
• Sleep disorders

Typical course: Symptoms begin 6-12 hours after arrival at altitude, peak after 24-48 hours, and disappear after 2-3 days (as you acclimatize).

2. High Altitude Pulmonary Edema (HAPE)

Frequency: 1-2% of travelers above 4,000m
Severity: Severe, life-threatening!
Danger: High - can be fatal

Symptoms:

• Severe shortness of breath (even at rest!)
• Cough (initially dry, later with bloody sputum)
• Rattling breathing noises
• Blue lips and fingernails
• Extreme weakness
• Confusion

**Immediately descend (at least 500-1,000m) and seek medical attention!

3. High altitude cerebral edema (HACE)

Frequency: <1% of travelers
Severity: Very severe, life-threatening!
Danger: Extremely high - can be fatal

Symptoms:

• Severe headache (does not respond to painkillers)
• Confusion, irrational behavior
• Coordination problems (can no longer walk straight)
• Hallucinations
• Loss of consciousness

**Immediately dismount and call an ambulance!

---

Altitude in Bolivia: Where is it the worst?

Bolivia is extremely high - almost all tourist destinations are above 3,000m.

The highest places in Bolivia:

El Alto (4,061m):

• La Paz airport
• This is where you land!
• Highest city in the world

Potosí (4,090m):

• Historic mining town
• Highest city with over 100,000 inhabitants

Uyuni (3,656m):

• Starting point for Salar de Uyuni
• Tours go up to 4,900m!

La Paz (3,640m):

• Capital city
• Center is at 3,640m, residential areas up to 4,100m

Lake Titicaca (3,812m):

• Copacabana, Isla del Sol

Huayna Potosí (6,088m):

• Popular trekking mountain
• Base camp at 4,700m

Sajama (6,542m):

• Highest mountain in Bolivia

Comparison with Europe:

• Zugspitze (Germany): 2,962m
• Mont Blanc (France/Italy):** 4,808m
• La Paz:** 3,640m (higher than the Zugspitze!)

Important: In Bolivia you live at the altitude at which Europeans go mountaineering!

---

Symptoms: How do you recognize altitude sickness?

Mild altitude sickness (AMS)

Main symptom: Headache + at least one of the following:

• Nausea or vomiting
• Fatigue, weakness
• dizziness
• Loss of appetite
• insomnia

Typical course:

• Hours 0-6: No symptoms yet (the "honeymoon phase")
• Hours 6-12: First headaches, slight nausea
• Hours 12-24: Symptoms worsen
• Day 2-3: Peak of symptoms
• Day 3-5: Symptoms disappear (as you acclimatize)

My tip: Almost everyone has mild symptoms in the first 24-48 hours. This is normal! A headache does not mean you have to descend immediately. Observe whether it gets better or worse.

Moderate altitude sickness

Symptoms:

• Severe headache (hardly responds to painkillers)
• Frequent vomiting
• Severe fatigue (can hardly stand up)
• Significant dizziness
• Shortness of breath with light exertion

Warning signal: If the symptoms do not improve or worsen after 24 hours!

What to do?

• Do not ascend any further!
• Rest, drink plenty of fluids
• Take Diamox (if not already prophylactically)
• Descend 200-300m if necessary

Severe altitude sickness (HAPE/HACE) - EMERGENCY!

HAPE symptoms:

• Severe shortness of breath (even at rest)
• Cough with bloody sputum
• Rattling breathing noises
• Blue lips
• Extreme weakness

HACE symptoms:

• Confusion, irrational behavior
• Coordination problems (walking test: can no longer walk straight)
• Hallucinations
• Loss of consciousness

EMERGENCY! Descend immediately (at least 500-1,000m) and seek medical attention! HAPE and HACE can be fatal within hours!

---

Prevention: How to avoid altitude sickness

The best treatment is prevention! With the right preparation, you can reduce the risk by 50-70%.

1. slow acclimatization (MOST IMPORTANT RULE!)

"Climb high, sleep low " - The golden rule of high-altitude mountaineering.

Ideal acclimatization plan for Bolivia:

If you fly directly to La Paz:

• Day 1: Arrival in La Paz (3,640m), rest! Only light activities (walk, café)
• Day 2:** City tour, walk slowly, drink a lot
• Day 3:** Acclimatization hike to 4,000-4,500m (e.g. Valle de la Luna), sleep back to La Paz
• Day 4:** Rest day or light activity
• Day 5:** Ready for higher destinations (Lake Titicaca, Uyuni, trekking)

If you are coming from Peru (via Puno/Lake Titicaca):

• Better! Puno is at 3,827m, Lake Titicaca at 3,812m
• You acclimatize slowly while traveling
• Nevertheless: 2-3 days in Puno/Copacabana before higher destinations

If you are coming from Argentina/Chile:

• Worse! You come from sea level directly to 3,600m+
• Plan 3-4 days of acclimatization in La Paz/Uyuni

My tip: Don't rush! I keep seeing travelers who drive directly from the airport to Uyuni (3,656m) and then drive up to 4,900m on the Salar tour. The result: altitude sickness, abandonment of the tour, wasted money. Take your time!

2. drink a lot (4-5 liters per day!)

Dehydration makes altitude sickness much worse!

Why?

• You breathe faster at altitude → more fluid loss
• Dry air → more evaporation
• You don't feel thirsty (altitude suppresses the feeling of thirst)

How much to drink?

• Minimum: 3 liters per day
• Optimal: 4-5 liters per day
• Control: Your urine should be light yellow (not dark!)

What to drink?

• Water (best)
• Coca tea (really helps!)
• Herbal tea
• Electrolyte drinks

What NOT to drink:

• Alcohol (makes symptoms worse!)
• Coffee (dehydrating, but 1-2 cups okay)

My tip: Buy a 1.5 liter bottle and drink it empty 3 times a day. That way you have clear control.

3. coca tea (mate de coca) - the miracle cure from the Andes

Coca tea is the traditional remedy for altitude sickness in Bolivia. And it works!

**Why does coca tea help?

• Expands blood vessels → more oxygen to the brain
• Suppresses nausea
• Gives energy
• Has a mild analgesic effect

**How to drink?

• 3-4 cups per day
• Start on the plane (if available)
• Especially in the morning and at the first symptoms

Where to buy?

• In any supermarket, market, café in Bolivia
• Tea bags or loose leaves
• Very cheap (10-20 BOB / ~1.50-3 USD per pack)

**Is coca tea legal?
Yes, coca tea is legal and widely available in Bolivia and Peru. It only contains traces of cocaine (0.001%) - far too little for any effect. You will NOT get high!

**Coca leaves and coca tea are illegal in Europe and the USA! Do not bring them home.

My tip: Drink coca tea from the moment you land in La Paz. Every hotel offers it. It tastes like green tea, slightly bitter but pleasant.

4. walk slowly (Pole Pole!)

At altitude, speed is your enemy.

Why walk slowly?

• Your body needs more oxygen for every movement
• Fast walking → overexertion → altitude sickness
• Slow walking → Body adapts

How slow?

• 50% slower than normal
• Breathe deeply and evenly
• Take a break every 20-30 minutes

My tip: "Pole pole" is Swahili for "slowly slowly" - a mantra for high altitude climbers. Repeat it in your head: Pole pole, pole pole...

5. eat lightly

Heavy meals put a strain on your body at altitude.

What to eat?

• Carbohydrates (rice, pasta, bread, quinoa)
• soups
• fruit
• vegetables

What to avoid?

• Heavy meat (beef, pork)
• Fried food
• Very fatty foods

My tip: In the first 2-3 days in La Paz: soups, rice, quinoa. After that you can eat normally again.

6. Diamox (acetazolamide) - The medication

Diamox is the only scientifically proven medication to prevent altitude sickness.

**How does Diamox work?

• Accelerates acclimatization
• Reduces symptoms by 50-75%
• Prevents AND treats

Dosage (prophylactic):

• 125mg, 2x daily (morning + evening)
• Start 1 day before the ascent
• Take it for 2-3 days at altitude

Side effects:

• Tingling in hands/feet (harmless)
• Frequent urination
• Changed taste perception (beer tastes stale)

Where to buy?

• In Bolivia: Any pharmacy, without prescription
• In Germany: prescription only (ask your doctor)

Important: Diamox is NOT a substitute for acclimatization! It helps, but you still have to ascend slowly.

My tip: I recommend Diamox for:

• Travelers flying directly to La Paz
• Travelers with little time (no 3-4 days acclimatization)
• Travelers who have had altitude sickness before

7. sorojchi pills (Bolivian miracle cure)

Sorojchi pills are very popular in Bolivia - a mixture of aspirin, caffeine and a painkiller.

Ingredients:

• Acetylsalicylic acid (aspirin) 325mg
• Salophene 160mg
• Caffeine 15mg

Effect:

• Relieves headaches
• Gives energy
• Reduces dizziness

Dosage:

• 1 tablet every 8 hours
• Start 1 hour before the ascent

Where to buy?

• Any pharmacy in Bolivia
• Very cheap (10-15 BOB / ~1.50-2 USD per pack)

My tip: Sorojchi pills are good for mild symptoms (headaches, fatigue). But they are not a substitute for Diamox! For moderate symptoms: take Diamox.

---

Treatment: What to do if you have altitude sickness?

For mild symptoms (headache, mild nausea):

1. take a break

• Do not ascend any further!
• Take a rest
• Observe whether it gets better or worse

2. drink a lot

• 4-5 liters of water per day
• Coca tea

3. drink coca tea

• 3-4 cups throughout the day

4. painkillers

• Ibuprofen 400-600mg (for headaches)
• Paracetamol (alternative)

5. eat lightly

• Soups, rice, bread

6. breathe deeply

• Consciously breathe in and out deeply
• Helps to absorb more oxygen

My tip: Give your body 24-48 hours. Most mild symptoms will disappear on their own.

For moderate symptoms (severe headaches, frequent vomiting):

**1. Do not ascend any further!

• Stay at the current altitude
• Or descend 200-300m

2. take Diamox

• 250mg immediately
• Then 125mg, 2x daily

3. drink a lot

• Even if you vomit, try to drink

4. rest

• Lie down, sleep if possible

5. observe

• Is it getting better or worse?
• If no improvement after 6-12 hours: Get off!

My tip: Moderately severe symptoms are a warning sign! Do not ignore them. If it doesn't get better, get off.

In case of severe symptoms (HAPE/HACE) - EMERGENCY!

**1. dismount immediately!

• At least 500-1,000m
• Even at night, even in bad weather
• Someone must accompany you!

2. call an ambulance

• In La Paz: 118 (ambulance)
• In remote areas: Organize evacuation

3. oxygen (if available)

• Many hotels in La Paz have oxygen bottles

4. dexamethasone (if available)

• 8mg immediately (for HACE)
• Then 4mg every 6 hours

Important: HAPE and HACE are life-threatening! Don't wait until it gets better - get off immediately!

---

The most common mistakes (and how to avoid them)

Mistake 1: Climbing too fast

Problem: Directly from the airport to Uyuni, then Salar tour at 4,900m
Consequence: Severe altitude sickness, abandonment of the tour
Solution: 2-3 days acclimatization in La Paz before higher destinations

Mistake 2: Drinking too little

Problem: Only 1-2 liters of water per day
Consequence: Dehydration worsens altitude sickness
Solution: Drink 4-5 liters per day, urine control

Mistake 3: Drinking alcohol

Problem: Beer or pisco sour in the first few days
Consequence: Dehydration, worsened symptoms
Solution: No alcohol in the first 2-3 days!

Mistake 4: Ignore symptoms

Problem: "Oh, I'll be fine" - continue to climb despite symptoms
Consequence: Moderate altitude sickness becomes severe, HAPE/HACE
Solution: Take symptoms seriously, take a break, descend if necessary

Mistake 5: Going too fast

Problem: Normal pace as at home
Consequence: Overexertion, altitude sickness
Solution: Walk 50% slower, take breaks

---

When to see a doctor?

Go to the doctor when:

• Symptoms do not improve after 48 hours
• Symptoms worsen despite rest and treatment
• Severe shortness of breath (even at rest)
• Cough with bloody sputum
• Confusion, coordination problems
• Loss of consciousness

Where can you find doctors in Bolivia?

La Paz:

• Clínica del Sur (private, good, English-speaking)
• Hospital de Clínicas (public, cheap)
• Many hotels have oxygen and can call a doctor

Uyuni:

• Hospital Uyuni (public)
• Many hotels have oxygen

Copacabana:

• Centro de Salud Copacabana (public)

Emergency number: 118 (ambulance)

---

Special situations

Pregnant women

Recommendation: Do not travel above 3,000m!
Risk: Altitude sickness, lack of oxygen for the baby
If you do: Consult a doctor, acclimatize slowly, take oxygen with you

Children

Risk: Children cannot communicate symptoms well
Recommendation: Particularly slow acclimatization, observe a lot
Symptoms: Whining, loss of appetite, tiredness

Pre-existing conditions

Cardiovascular diseases: Consult a doctor before the trip!
Pulmonary diseases (asthma, COPD): Consult a doctor, take oxygen with you
Hypertension: Can worsen at altitude

---

Conclusion: altitude sickness is avoidable

Altitude sickness is the biggest challenge in Bolivia - but it is avoidable!

As a German-speaking guide who has lived in La Paz for years, I can tell you: with the right preparation, altitude sickness is not a problem. I have looked after hundreds of travellers, and those who take their time, acclimatize slowly and drink a lot almost never have problems.

The most important rules again:

1. ascend slowly (2-3 days acclimatization in La Paz)
2. drink a lot (4-5 liters per day)
3. drink coca tea (3-4 cups per day)
4. walk slowly (50% slower than normal)
5. take symptoms seriously (do not ignore them!)
6. if the condition worsens: get off!

Bolivia is one of the most spectacular countries in the world - don't let the altitude put you off! With the right preparation, you will master the thin air and enjoy the Andes to the full.

**Ready for Bolivia? The altitude is waiting for you - but you are now prepared!