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Being physically fit doesn't protect you from altitude sickness — that's the part almost nobody expects. Marathon runners get hit hard in Cusco while less fit travelers feel fine, because it comes down to genetics and how fast you ascend, not your fitness level. Destinations like Cusco and Machu Picchu, Bogotá, Mexico City, and Kilimanjaro all sit high enough that real symptoms are common, while most of the world is a total non-issue. A quick check before you go tells you whether to plan an easy first day.
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