Altitude sickness in Bolivia: symptoms and acclimatization plan

El Alto airport sits at about 4,060 m, and at that height even a small effort leaves anyone arriving from sea level out of breath. The cause is physical: at 4,000 m air pressure is around 60% of that at sea level, and at 5,000 m there is about half the oxygen. A good share of the country’s attractions lie between 2,800 and 5,000 m, so it makes sense to treat soroche as part of the route.

Below you will find what soroche is, how to recognize it, a concrete prevention plan for La Paz, Uyuni and Sucre, which remedies help and when you must descend. It does not replace a medical consultation.

What altitude sickness is

Soroche is the local name for acute mountain sickness. The body receives less oxygen and takes hours or days to compensate: it breathes faster, the heart rate rises and, over time, it makes more red blood cells. While it adapts, symptoms appear. The most common form is mild and passing. There are two severe, uncommon forms: high-altitude pulmonary edema and high-altitude cerebral edema.

The key, clinical guidelines say, is the altitude where you sleep, more than the height you reach during the day. You can go up to 5,400 m one morning and come back to sleep at 3,600 m with far less risk than someone who sleeps at 4,300 m without acclimatizing.

Altitudes you will cross in Bolivia

The Sud Lípez sleeps between 4,200 and 4,300 m and its highest point is around 5,000 m. La Paz stretches from about 3,000 m in its lower districts to about 4,100 m on the high slopes.

Symptoms: how to recognize it

Mild form (acute mountain sickness)

A headache plus at least one of these: nausea or vomiting, fatigue, dizziness or poor sleep. It usually appears in the first hours after reaching a higher altitude, and night is the classic time. Most people improve in a day or two if they rest and go no higher.

Warning signs

These signs point to a severe form and require you to descend at once and get medical attention:

• Pulmonary edema: shortness of breath even at rest, a persistent cough, a feeling of tightness in the chest, frothy or pink sputum, disproportionate tiredness.
• Cerebral edema: confusion, difficulty walking in a straight line, intense drowsiness, changes in behavior, a headache that will not ease.

Prevention: what does work

1. Climb gradually. From 2,500 to 3,000 m upward, limit the gain in sleeping altitude to about 500 m per day and add a rest night for every 1,000 m gained.
2. Sleep low if you can. Going up by day and sleeping down protects you more than the reverse.
3. Pause on the first day. Rest, eat lightly, walk slowly and do not rush to see the city.
4. Drink water regularly, without forcing extreme amounts.
5. Avoid alcohol on the first day and limit tobacco.
6. Do not trust your fitness. Running marathons does not protect you from soroche.
7. Look after your sleep: sleep with your head slightly raised.
8. Sun protection: at high altitude ultraviolet radiation increases a lot, and so does dehydration.

Acclimatization plan by arrival route

You arrive in La Paz from sea level

El Alto airport is at about 4,060 m and the center of La Paz at 3,640 m. If you can, arrive overland from Peru first, or stop at an intermediate altitude such as Cusco or Sucre beforehand. If not, go through these three days anyway:

You arrive via Sucre, Potosí or Uyuni

Sucre (2,790 m) is the best acclimatization stop: temperate climate, moderate altitude and little fatigue. From there, Potosí (4,070 m) and Uyuni (3,660 m) are a more gradual step up. Many travelers follow the order Sucre, Potosí and Uyuni before the Sud Lípez.

You arrive from Chile via San Pedro de Atacama

San Pedro is at about 2,400 m. Spend at least one quiet night in Uyuni (3,660 m) before climbing to the Sud Lípez. A Uyuni and Sud Lípez circuit in 4 days recommends 24 to 48 hours of prior acclimatization.

1. Sucre2,790 mgentle acclimatization, 2 to 3 days
2. La Paz3,640 m2 to 3 days
3. Uyuni3,660 m1 night before climbing
4. Sud Lípez4,200 to 5,000 mnights at 4,200 to 4,300 m

What can ease mild symptoms

For minor discomfort, these are the usual measures. None guarantees anything: if symptoms get worse, see the next section.

• Rest, water and light meals. Rest the first few hours, drink regularly and eat little and light. Avoid alcohol and heavy meals.
• Paracetamol for the headache.
• Coca tea and coca leaf. In Bolivia coca tea and chewing the leaf (akulliku) are legal and part of daily life. Coca tea is easy to find in La Paz hotels and restaurants. Tradition uses them to ease mild symptoms; the scientific evidence is limited. You cannot take leaves, tea bags or coca products abroad: coca remains controlled internationally and is illegal in many countries.
• Oxygen. According to travel guides, some hotels and clinics in La Paz offer it and portable bottles or cans are on sale; prices and availability are not guaranteed, and in 2026 blockades left a shortage of medical oxygen in hospitals in La Paz and El Alto. It relieves symptoms for a while but does not cure: if there are warning signs, you must descend.
• Agua de Florida. Some people sniff this traditional cologne out of custom to feel better. There is no scientific evidence that it eases soroche.
• Sleeping lower and climbing slowly. This protects you most: sleep lower than the height you reach by day and walk at a slow pace.

In La Paz you will find in the pharmacies what you need to ease altitude discomfort, and pharmacists are used to helping travelers with soroche: ask them without hesitation. If in any doubt, see a doctor.

When to descend

Descend if:

• The headache gets worse despite rest and paracetamol.
• The vomiting does not stop.
• Shortness of breath at rest, a cough with pink sputum or tightness in the chest appears.
• There is confusion, clumsiness in walking or unusual drowsiness.

According to the Wilderness Medical Society guidelines, for moderate or severe acute mountain sickness and cerebral edema a descent of 300 to 1,000 m is often enough; for pulmonary edema, descending at least 1,000 m with the least possible effort is recommended, with oxygen if available. Do not keep climbing with symptoms and do not stay to sleep higher until they have completely gone.

In the Sud Lípez, logistics are a separate matter: if someone in the group gets worse, the driver and guide decide on the descent, and it may mean several hours on the road. Report any symptom from the very first moment.

Who needs to take extra care

• People with heart or lung disease, poorly controlled high blood pressure or anemia: see a doctor beforehand.
• Pregnancy: it should be assessed with a doctor; some tours expressly advise against it, such as the Sud Lípez circuit.
• Young children: they cannot describe their symptoms. Some circuits do not accept children under seven, and Chacaltaya does not accept those under 10.
• People who have had soroche before: history predicts risk, so repeat the plan that worked.
• Older people: they are not at higher risk in themselves, but they more often have pre-existing conditions.

Common myths

• “If I’m fit it won’t get me.” False: soroche does not depend on fitness.
• “Coca tea is enough.” It helps as support, but it does not replace the pace of ascent.
• “You have to drink liters and liters.” Staying hydrated, yes; forcing extreme volumes, no.
• “It will pass by tomorrow.” Sometimes, yes, but if it gets worse, descending is the only solution.

Recommended tour : Tiwanaku and Puma Punku tour from La Paz