One big caution for travel in Peru and Bolivia is altitude sickness. Symptoms include dizziness, headache, nausea, shortness of breath, fatigue. In more serious cases, weakness, confusion and other extreme symptoms can happen and need to be treated medically. I worried over being impaired in both countries because of hypobaropathy more than mosquito bites or untreated water. I didn’t want to take medication, such as acetazolamide. So, I was left with oxygen therapy or, as the locals do, chewing coca leaves.
These are the very leaves from which cocaine is made. Do you need to get high to get high? No. The active alkaloid concentration is too small. The leaves of the coca plant have been chewed for millenia by Andeans as a remedy for many ailments, including altitude sickness, but consumed casually as a way to boost energy and mood, much like caffeine.
The first I saw the leaves were at Cusco Airport on debarkation. There were no instructions, simply a small basket filled with them. I took a few leaves and started chewing, since Cusco sits at 11,000 ft (3,400 m). Every hotel I stayed at had the dried leaves available, along with tea bags to make infusions. The general advice was to chew the leaves or make the tea up until mid-afternoon, after which coca may make it difficult to fall asleep.
My only symptom at high Peruvian towns was breathlessness, which I could easily overcome by hyperventilating. Almost always, bending down to tie my shoes was a bit laborious. It wasn’t until I got to 12,000 ft or more that I started getting headaches, which acetomenophen (paracetamol) cured.
I chewed and drank every day at breakfast. Did the coca leaves help? I can’t say for sure. Maybe they forestalled worse symptoms. I’m just glad that my body didn’t rebel against the altitudes and make me get low.