Summary
NASM-certified trainers Wendy Batts and Ken Miller break down the science and practical considerations of altitude training. They explain how hypoxia triggers erythropoietin (EPO) production, which increases hemoglobin and red blood cells to carry more oxygen. Key findings include that performance benefits require at least 15-18 days of altitude exposure, the worst performance days are 3-6 days after arrival, and full adaptation takes about three weeks. They discuss how training at altitude increases metabolic rate and caloric burn, with elevated EPOC lasting 12-15 hours post-workout. They cover the three stages of acclimatization (preparation, ascent, descent), the three types of altitude sickness (AMS, HAPE, HACE), and practical tips including aggressive hydration with electrolytes, gradual ascent of 1,600 feet at a time, and monitoring urine color. Real-world examples include NFL teams traveling early to Denver and NBA teams going straight to altitude for playoff advantage.
Key Points
- Hypoxia triggers erythropoietin (EPO) production, increasing hemoglobin and red blood cells over time
- Performance benefits require at least 15-18 days of altitude exposure; benefits last about two weeks after return
- Days 3-6 after arrival are the worst for performance as the body struggles to acclimate
- Full adaptation takes approximately three weeks at altitude
- Training at altitude increases metabolic rate and caloric burn, with EPOC lasting 12-15 hours post-workout
- Above 10,000 feet, altitude affects 40-50% of the population; above 8,000 feet, about 25%
- Three types of altitude sickness: AMS (headaches, nausea), HAPE (fluid in lungs, most common cause of death), HACE (brain swelling, life-threatening)
- Stay aggressively hydrated with water and electrolytes; monitor urine color
- Gradual ascent of 1,600 feet at a time is supported by research
- Resting heart rate can reach 100 BPM just sitting at 11,000 feet if unacclimatized
Key Moments
Altitude training boosts red blood cells and endurance performance
Altitude training increases aerobic capacity, lactic acid tolerance, and oxygen flow to muscles. Benefits require at least 15-18 days of exposure and last about two weeks after returning to sea level. Distance runners and endurance athletes seek out locations like Colorado and Flagstaff for this advantage.
"you're going to end up increasing your aerobic capacity. your lactic acid tolerance, your oxygen flow to your muscles. And, you know, these are super, super beneficial for anyone because if you've got exposure for anywhere to 18 days, I think you're going to be able to show performance when you come back down."
Worst performance days are 3-6 after arrival at altitude
Days 3-6 after arriving at altitude are when performance is worst as the body struggles to acclimate. Sports teams arrive a week or more early to mitigate this. Miami Heat flew straight to Denver after clinching their series to get extra acclimatization time for the NBA Finals.
"anywhere from three to six days after you get there, those are your worst performance days, because your body's not acclimated. It's trying to figure out what's going on. You don't feel great. You start to feel nauseous."
EPO and hemoglobin adaptation is a hormonal process
Erythropoietin (EPO) is the hormone that drives adaptation at altitude by stimulating hemoglobin production, which helps red blood cells bind and carry more oxygen. This hormonal adaptation takes time and explains why you cannot rush acclimatization.
"it was erythropoietin, which is there to help you create more hemoglobin, right? Which is what helps bind more oxygen to the red blood cell. So that hasn't happened yet within those first couple of weeks, but things progressively do get easier as you produce more of that hormone"
Resting heart rate hits 100 BPM at 11,000 feet when unacclimatized
Ken describes sitting at dinner at 11,000 feet at Keystone Resort and measuring a resting heart rate of 100 BPM just cutting food. He could only dance for one song before needing to sit down. Even at 9,000 feet, he operated at 50-75% of his normal capacity.
"I measured my heart rate. I can't remember how I measured my heart rate. I don't think I had a heart rate monitor on me, but I'm sitting at dinner, just cutting my food up. And I was already at like a hundred beats per minute, just sitting there."
