Altitude sickness (called soroche or sorojchi in Bolivia) is something travelers often underestimate, especially at high altitude extremes, such as in La Paz and other popular tourist attractions on the Altiplano (Lake Titicaca, Oruro, Uyuni, Tiahuanaco, Copacabana, Potosi). Below you'll learn about altitude sickness symptoms, how to prevent altitude sickness, remedies, and medicines some people use. These are some things you can do to ensure altitude sickness doesn't spoil your trip.

1. People say dehydration is one of the main causes for altitude sickness. Although I do find that drinking lots of water helps, others don't. Some climbers actually suggest against it. One of the effects of the altitude is that you digest more slowly. I find drinking lots of water helps me digest. But you can counteract this with other foods that contain a lot of fiber instead. One of the reasons so many people emphasize hydration to offset altitude sickness actually has nothing to do with the altitude. It's because so many travelers get diarrhea (in addition to all the altitude effects) that hydrating is important. If you've got it you DO need to hydrate.

2. Don't drink any alcoholic beverages. Remember that alcohol dehydrates you and it takes alcohol at least 24 hours to leave your system.

3. About 3 days prior to traveling try eating 6 light meals a day instead of three heavy ones. If you're not suffering from diarrhea, you may find the opposite is true: one of the other effects of altitude changes is constipation because digestion is slower. Eating lots of vegetables and fruit prior to arriving in places like La Paz, and eating lightly several times a day will help you digest better. Try eating oatmeal or semolina for breakfast for a few days prior to your trip. Broccoli and strawberries also have lots of fiber. In general, take the advice doctors give pregnant women during their last two trimesters. Avoid foods that are acidic (including white bread). Avoid unclean foods and water so you can avoid diarrhea on top of altitude sickness.

4. If you don't exercise, begin taking 1/2 hour walks about 2 weeks before you travel. Get your lung capacity up before you go to the altitude. If you exercise regularly you'll be in better shape than others. At high altitudes you'll take longer to produce red blood cells. Red blood cells carry oxygen through your body. This is the key to fighting off the effects of altitude sickness. The problem is that most tourists don't have the time it takes to build up blood cells (about 7-10 days) so just do the best you can with the time you have, including building them up for as long as you can BEFORE your trip.

5. Having said that, don't smoke. Duh.

6. During your flight do hydrate (your skin will love you too). Ask for light meals and order extra fruit or drink fruit juice. Canned and boxed fruit juices have a lot of sugar but sometimes sugar helps you feel better (temporarily). Don't drink cranberry juice - it's a diuretic. Gatorade is good. It has electrolytes and is a good choice if you get diarrhea - you can purchase it at grocery stores in Bolivia. You can also go to a pharmacy and ask for a "suero". A suero is a hydration pack for people with diarrhea. It comes in a powder or liquid. In powder form it is called "sales rehidratantes" (rehydrating salts). You drink it. Precaution: a suero is also an intravenous drip, so be specific - you don't want to drink the wrong thing.

7. If your health allows, you can ask your doctor to prescribe you some high altitude pills. Ask your doctor how often you should take them and how many days prior to your trip you should begin taking them. In La Paz you can get them easily. Almost all the local pharmacies keep them on hand for tourists - they're called "sorochi pills". But ask your doctor if you should take them regardless of where you purchase them and be sure to follow the regimen he or she gives you to the letter! If you're on any regular medications it is especially important to ask your doctor first. Avoid altitude pills that act as diuretics, especially if you'll be traveling by land. In Bolivia they are called Sorojchi Pills. They contain: Acetylsalicylic acid 325 mg, Salophene 160 mg, and Caffeine 15 mg. They prevent headaches, dizziness, fatigue, nausea and drowsiness.

8. One of the best ways to ward off altitude sickness is to drink a nice hot cup of coca leaf tea when you arrive. People in the highlands have been using it for eons, although they usually chew the leaves. So effective is this, that many taxi drivers that drive the airport route keep a thermos in their car. They'll offer you a tiny cup of coca tea on the way down to the city from the airport. If they don't, ask for one when you arrive at your hotel. Remember, coca tea is not a drug. It's just a couple of coca leaves boiled in water. This is an herbal tea and will also calm your stomach. If you have any illnesses or take any medications, ask your doctor if you can drink coca tea - some people cannot drink any herbal teas (if you're one of them, avoid coca tea too). You don't want to fight altitude sickness only to get ill from something else!

9. If you're feeling lightheaded or queasy or are having a hard time breathing on the plane (this happens to some people when the airplane doors open and the plane depressurizes) ask the flight attendant for oxygen. They carry tiny individual oxygen tanks that you can hold up to your mouth and breathe in. It really helps! Flight attendants who fly Bolivia routes are well-trained in helping people with altitude sickness.

10. Likewise, most hotels have oxygen tanks on hand for their guests (can't say hostels and cheap hotels do) but most larger hotels do. It's a common enough problem that they've invested in them.

11. Once you arrive in La Paz continue to drink and eat lightly. Sip throughout the day - don't chug. During your first two days or so, continue to eat light meals and avoid fried foods and alcohol.

12. Give your body the time and rest it needs to build up your red blood cell count.

13. During your first couple of days rest as much as you need to and when you go out walk slowly and don't overexert yourself. Every few breaths, take one really deep one. If you feel queasy, find a place to sit down and put your head between your knees for about 30 seconds. Then slowly raise your head and sit up straight - slowly, breathing slowly and deeply as you sit back up. Sleep with your feet slightly elevated to ensure bloodflow to your head.

14. If you have to throw up, do it. It will relieve your stomach and your head. But after you do, drink water to counter the acidity and avoid citrus juices that are acidic (including maracuya juice). If your head hurts a lot, drink coffee, Coca Cola or eat some chocolate. Caffeine often helps get rid of headaches.

15. Most people make the mistake of planning too much into their first few days. I know there is a lot to see, but NOT giving yourself a good full day to acclimate could end up spoiling your trip, resulting in lost time anyways.

16. If you're planning a long trip through several regions consider beginning your trip at the lower altitudes and moving slowly up into higher elevations. One way to do this is to travel overland rather than flying directly from sea level to the highlands.

17. Are you anemic? Follow your doctor's orders and don't skip your iron tablets.

18. The nice thing about La Paz is the large change in altitude between downtown and areas like Obrajes and Calacoto - there's a difference of 2800 feet. If you're worried about altitude sickness, choose a hotel in the lower end of the city (called the Zona Sur or southern zone). Some doctors advise you sleep at a lower altitude than when you are awake. So spend the day sightseeing the city, then go to Calacoto in the southern zone for the night.

19. One of the side effects of high altitude is that you might not sleep well. Because your breathing may be more shallow while you sleep, you may not get enough oxygen. Many people find they wake up frequently. I had this problem when I was pregnant and huge! My doctor suggested I sleep on my left side and it helped a LOT. For some reason, I found it works for me in the altitude too.

20. One of the effects of lack of oxygen and altitude sickness is that you might hyperventilate. Consider carrying a paper bag with you. (You can't find them easily in Bolivia). If you begin to hyperventilate, take out your paper bag, hold it over your mouth and breathe into and out of the paper bag, inflating and deflating it until you stop hyperventilating. This is just something that works for me personally. Ask your doctor for advice about hyperventilation before you travel.

21. If you're asthmatic and use an inhaler, do NOT forget it. You can get them in Bolivia (usually, and only in big cities) but they are very expensive! Also ask your doctor about how your inhaler might affect you at high altitudes. You should actually ask this about any medication you take. For example, at very high altitudes, surgeons and dentists often reduce the amount of anesthetics they use.

22. If you think altitude sickness might affect your strongly, you'd be wise to purchase travel insurance. Although medications and doctor's visits cost less in Bolivia than in many places, it's still an extra cost that could take a chunk out of your travel budget.