Is There a Benefit to Altitude Training? – with Dr. Peter Hackett and Jon Jonis

Not everything that happens to us at altitude is positive, nor do we all respond the same way. We discuss the ins and outs of altitude camps, and how to make sure you benefit from them.

Tarcu, Romania: Road racer training at high altitude in the mountains.

Perhaps nothing in endurance sports carries the sort of mystique that altitude camps carry. It’s a marker of the seriousness with which we take our training when we go to altitude for a few weeks, build up that natural EPO, and return home to crush our friends and rivals.  

But is it really that simple? Do we see those mythical gains promised to us from time in the high mountains? The answer is a definitive no, followed by a maybe, followed by a clear yes if you do it right. The truth is that there are responders and non-responders to altitude. To take it a step further, many adaptations to altitude take time, take very high altitudes, and not all those adaptations are positive. Doing an altitude camp right takes careful planning and monitoring.  

Here to help us navigate through the many landmines of altitude training is one of the top experts on the subject, Dr. Peter Hackett. He is the director of the Institute for Altitude Medicine. Dr. Hackett has spent decades researching altitude in the Himalayas, Denali, South America, and Colorado. Joining him is Jon Jonis, the founder of Mountain Air Cardio, here in Boulder. Jonis built a company that tries to help athletes get the benefit of hypoxic exposure without having to deal with the negative consequences of training at high altitude.

Along with our two experts, we’ll hear from a host of coaches, athletes, and physiologists, including Dirk Friel, the founder of TrainingPeaks, and Tim Cusick, who develops the WKO+ training software. Jim Miller, the head of High Performance at USA Cycling, will talk about running altitude training camps. Payson McElveen, host of the popular Adventure Stache podcast, will talk about living at altitude as an athlete. Dr. Robert Kenefick, the senior Vice President of Research and Development at Entrinsic Health Solutions, will share his thoughts on supplemental oxygen. Finally, Dr. Andy Pruitt, Colby Pearce, and Todd Carver will discuss the downside of training at altitude.  

So, dial up your altitude tent to 11, and let’s make you fast! 


Brothers, M. D., Doan, B. K., Zupan, M. F., Wile, A. L., Wilber, R. L., & Byrnes, W. C. (2010). Hematological and Physiological Adaptations Following 46 Weeks of Moderate Altitude Residence. High Altitude Medicine & Biology, 11(3), 199–208. Retrieved from 

Burtscher, M., Gatterer, H., Faulhaber, M., Gerstgrasser, W., & Schenk, K. (2010). Effects of Intermittent Hypoxia on Running Economy. International Journal of Sports Medicine, 31(09), 644–650. Retrieved from 

Cerretelli, P., Marzorati, M., & Marconi, C. (2009). Muscle Bioenergetics and Metabolic Control at Altitude. High Altitude Medicine & Biology, 10(2), 165–174. Retrieved from 

Chapman, R. F., Laymon, A. S., & Levine, B. D. (2013). Timing of Arrival and Pre-acclimatization Strategies for the Endurance Athlete Competing at Moderate to High Altitudes. High Altitude Medicine & Biology, 14(4), 319–324. Retrieved from 

Flaherty, G., O’Connor, R., & Johnston, N. (2016). Altitude training for elite endurance athletes: A review for the travel medicine practitioner. Travel Medicine and Infectious Disease, 14(3), 200–211. Retrieved from 

Flueck, M. (2010). Myocellular limitations of human performance and their modification through genome‐dependent responses at altitude. Experimental Physiology, 95(3), 451–462. Retrieved from 

GORE, C. J., CLARK, S. A., & SAUNDERS, P. U. (2007). Nonhematological Mechanisms of Improved Sea-Level Performance after Hypoxic Exposure. Medicine & Science in Sports & Exercise, 39(9), 1600–1609. Retrieved from 

Green, H. J., Roy, B., Grant, S., Hughson, R., Burnett, M., Otto, C., … Johnson, M. (2000). Increases in submaximal cycling efficiency mediated by altitude acclimatization. Journal of Applied Physiology, 89(3), 1189–1197. Retrieved from 

Gunderson, S., Chapman, & Levine. (2001). Live High Train Low Altitude Training Improves Sea Level Performance in Male and Female Elite Runners. 

Hoppeler, H., Klossner, S., & Vogt, M. (2008). Training in hypoxia and its effects on skeletal muscle tissue. Scandinavian Journal of Medicine & Science in Sports, 18(s1), 38–49. Retrieved from 

Koivisto-Mørk, A. E., Paur, I., Paulsen, G., Garthe, I., Raastad, T., Bastani, N. E., … Bøhn, S. K. (2020). Dietary Adjustments to Altitude Training in Elite Endurance Athletes; Impact of a Randomized Clinical Trial With Antioxidant-Rich Foods. Frontiers in Sports and Active Living, 2, 106. Retrieved from 

Lundby, C., Calbet, J. A. L., Sander, M., Hall, G. V., Mazzeo, R. S., Stray‐Gundersen, J., … Levine, B. D. (2007). Exercise economy does not change after acclimatization to moderate to very high altitude. Scandinavian Journal of Medicine & Science in Sports, 17(3), 281–291. Retrieved from 

Michalczyk, M., Czuba, M., Zydek, G., Zając, A., & Langfort, J. (2016). Dietary Recommendations for Cyclists during Altitude Training. Nutrients, 8(6), 377. Retrieved from 

Millet, Grégoire P, Faiss, R., Brocherie, F., & Girard, O. (2013). Hypoxic training and team sports: a challenge to traditional methods? British Journal of Sports Medicine, 47(Suppl 1), i6. Retrieved from 

Millet, Gregoire P., Roels, B., Schmitt, L., Woorons, X., & Richalet, J. P. (2010). Combining Hypoxic Methods for Peak Performance. Sports Medicine, 40(1), 1–25. Retrieved from 

Mujika, I., Sharma, A. P., & Stellingwerff, T. (2019). Contemporary Periodization of Altitude Training for Elite Endurance Athletes: A Narrative Review. Sports Medicine, 49(11), 1651–1669. Retrieved from 

Neya, M., Enoki, T., Kumai, Y., Sugoh, T., & Kawahara, T. (2007). The effects of nightly normobaric hypoxia and high intensity training under intermittent normobaric hypoxia on running economy and hemoglobin mass. Journal of Applied Physiology, 103(3), 828–834. Retrieved from 

Płoszczyca, K., Langfort, J., & Czuba, M. (2018). The Effects of Altitude Training on Erythropoietic Response and Hematological Variables in Adult Athletes: A Narrative Review. Frontiers in Physiology, 9, 375. Retrieved from 

Ponsot, E., Dufour, S. P., Doutreleau, S., Lonsdorfer-Wolf, E., Lampert, E., Piquard, F., … Richard, R. (2010). Impairment of maximal aerobic power with moderate hypoxia in endurance athletes: do skeletal muscle mitochondria play a role? American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 298(3), R558–R566. Retrieved from 

Pottgiesser, T., Ahlgrim, C., Ruthardt, S., Dickhuth, H.-H., & Schumacher, Y. O. (2009). Hemoglobin mass after 21 days of conventional altitude training at 1816m. Journal of Science and Medicine in Sport, 12(6), 673–675. Retrieved from 

Roberts, A. C., Butterfield, G. E., Cymerman, A., Reeves, J. T., Wolfel, E. E., & Brooks, G. A. (1996). Acclimatization to 4,300-m altitude decreases reliance on fat as a substrate. Journal of Applied Physiology, 81(4), 1762–1771. Retrieved from 

Robertson, E. Y., Saunders, P. U., Pyne, D. B., Gore, C. J., & Anson, J. M. (2010). Effectiveness of intermittent training in hypoxia combined with live high/train low. European Journal of Applied Physiology, 110(2), 379–387. Retrieved from 

Saunders, Philo U, Pyne, D. B., & Gore, C. J. (2009). Endurance Training at Altitude. High Altitude Medicine & Biology, 10(2), 135–148. Retrieved from 

Saunders, P.U., Telford, R. D., Pyne, D. B., Hahn, A. G., & Gore, C. J. (2009). Improved running economy and increased hemoglobin mass in elite runners after extended moderate altitude exposure. Journal of Science and Medicine in Sport, 12(1), 67–72. Retrieved from 

Schmitt, L., Millet, G., Robach, P., Nicolet, G., Brugniaux, J. V., Fouillot, J.-P., & Richalet, J.-P. (2006). Influence of “living high–training low” on aerobic performance and economy of work in elite athletes. European Journal of Applied Physiology, 97(5), 627–636. Retrieved from 

Schmutz, S., Däpp, C., Wittwer, M., Durieux, A., Mueller, M., Weinstein, F., … Flück, M. (2010). A hypoxia complement differentiates the muscle response to endurance exercise. Experimental Physiology, 95(6), 723–735. Retrieved from 

Solien, J., Haynes, V., & Giulivi, C. (2005). Differential requirements of calcium for oxoglutarate dehydrogenase and mitochondrial nitric-oxide synthase under hypoxia: Impact on the regulation of mitochondrial oxygen consumption. Comparative Biochemistry and Physiology Part A: Molecular & Integrative Physiology, 142(2), 111–117. Retrieved from 

Episode Transcript

Rob Pickels  00:04

Hello and Welcome to Fast Talk, your source for the science of endurance performance. I’m your host Rob Pickels here with Trevor Connor.

Perhaps nothing in endurance sports carries the sort of mystique that altitude camps have. It’s a marker of the seriousness with which we take our training when we go to altitude for a few weeks, build up that naturally EPO, and return home to crush our friends and rivals.

But is it really that simple? Do we see those mythical gains promised to us from time in the high mountains? The answer is a definitive no, followed by a maybe, followed by a clear yes if you do it right. The truth is that there are responders and non-responders to altitude. To take it a step further, many adaptations to altitude take time, take very high altitudes, and not all those adaptations are positive. Doing an altitude camp right takes careful planning and monitoring.

Here to help us navigate through the many landmines of altitude training is one of the top experts on the subject, Dr. Peter Hackett. He is the director of the Institute for Altitude Medicine. Dr. Hackett has spent decades researching altitude in the Himalayas, Denali, South America, and Colorado. Joining him is Jon Jonis, the founder of Mountain Air Cardio, here in Boulder. Jonis built a company that is trying to help athletes get the benefit of hypoxic exposure without having to deal with the negative consequences of training at high altitude.

Along with our two experts, we’ll hear from a host of coaches, athletes, and physiologists including two top coaches, Dirk Friel, the founder of Training Peaks. The other being Tim Cusick, who develops the WKO+ training software. Jim Miller, the head of High Performance at USA Cycling, will talk about running altitude training camps. Payson McElveen, host of the popular Adventure Stache podcast will talk about living at altitude as an athlete. Dr. Robert Kenefick, the Senior Vice President of Research and Development at Entrinsic Health Solutions will share his thoughts on supplemental oxygen. Finally, Dr Andy Pruitt, Colby Pearce, and Todd Carver will discuss the downside of training at altitude. So, dial up your altitude tent to 11, and let’s make you fast!

For many of us in North America, the road racing season is winding down. You can test your end of season fitness with Fast Talk Labs. Just schedule an inside Advanced Test with us, your inside test results will reveal your VO2 Max, up to date training zones, anaerobic threshold, carb Max, fat Max, VLA Max, then it will suggest a path forward for better training and fitness. Learn more at

Trevor Connor  02:47

Well welcome everybody to the show. I’m actually really excited about this one. Because altitude was something that I was always interested in when I was actually studying Exercise Science at CSU. I took every opportunity I could to get involved in studies on it to write a paper on it, which means I probably know about a 100th of what the two of you know, but it’s an exciting subject. And I, we haven’t covered it yet in the show. So I’m really going to be interested in going into how does altitude affect you? Whether training at altitude has benefits or not? Because I think a lot of people involved in dirt sports think, Oh, I’m gonna go up to altitude, get a spike that EPO and I’m gonna come back and crush everybody. And my guess is as we go through this conversation, it’s not so black and white, it’s not so clear cut. So I think it’s going to be an interesting conversation. And I hope both of you are looking forward to this.

Jon Jonis  03:42

Yeah, Trevor, I’m really interested, you know, in we’re focusing today on how altitude affects training itself, right. And I think it’s really important that we are focusing on more of that narrow, you know, sort of track so that we can understand with a little bit more depth exactly what’s happening physiologically within the body. You know, I think everybody should listen, maybe we’ll follow this up at some point in the future with a how does it affect performance, right, which is a totally different topic, you know, the decrement in performance and VO to max in the acute sense when you say come up to Boulder to do an Ironman up here, you know, when you otherwise live at sea level.

Trevor Connor  04:18

So why don’t we start instead of going into right away the physiology of what happens when you go to altitude? I want to answer that big question. Is it always beneficial is it always a positive thing? Are you going to see gains if you go and sign up for that big altitude camp?

Dr. Peter Hackett  04:36

The answer to is it always positive is no next question.

Jon Jonis  04:42

So this is gonna be a really short so it’s a very simple topic, and and we’re done. That was another episode of fast talk.

Dr. Peter Hackett  04:51

The whole idea of altitude training is to strike a balance between the beneficial effects of a climatization and And the effects that aren’t so good. And you want to come up predominantly with the beneficial effects. So that requires some planning and some smarts, but it can’t be accomplished, you know, for a lot of people. But then there’s also this issue of some people just don’t respond in terms of performance. Now, when we say responders and non responders, you can talk about performance, which is what coaches and athletes want to know about, or you can talk about the change in hemoglobin mass as a responder or non responder. But there’s certainly related, but I think for cyclists and athletes, it’s about performance. So you know, there are some people that don’t get any benefit. And there are those that do get a benefit. And there’s quite a search going on right now to nail down what the mechanism is that differentiates the responders from the non responders. And it’s not solid yet, but clearly the HIFF pathway, the hypoxia inducible factor pathway, which is what is responsible for the EBO effect, the rise in April and rise in hemoglobin mass is the key factor. And there has to be genetic polymorphisms that explain why some people respond and others don’t. In other words, it’s most likely in your genes, although there can be external factors as well. But that search continues a paper by Ben Levine and where they looked at responders and non responders in a large population of subjects that studied over the years. But this was 10 years ago before, it was really advanced methodology in snip testing and whole genome sequencing, looking at these specific areas, and they did find a mutation that was associated with non responders, but it wasn’t very robust. In other words, it didn’t have any kind of predictive value. And it was in the HIF pathway. But I think that’s where the money is. And the science just isn’t quite there yet to figure out the genetic basis of responders versus non responders, whether you’re a

Trevor Connor  07:03

responder or non responders, just one of the factors you have to consider when going to altitude, here dirt free, I’ll describe several of the other factors that may go into altitude tricky.

Dirk Friel  07:14

It’s tricky to do it right. And to come out of it in a positive way, there’s many ways you can mess it up. And if you go in to altitude, and you push too hard, too many days, you just come out of it in a state that you can’t really come back from in the right amount of time. So I mean, to do it properly, you’re going in with blood work, you know, where’s your blood work, before we even get to altitude can you know, tracking hemoglobin, what mass I think is what it whatever was tracking that throughout your stay, and seeing how your body is adapting, and adjust and adjust from there. So certainly, it can help. There’s plenty of examples of where it’s done all the time. You know, there’s many more examples, probably where it didn’t help people just because they pushed it too hard. So it’s an area of caution. If you go to altitude, you know, I tend to think like, really, you need to hold back more than what you think you can do. And kind of just let altitude kind of take care of itself. But don’t expect to do really high quality training at altitude and don’t but then that can affect your mental state too much either. So, you know, yes, you can be of great benefit. But it’s tricky to manage.

Jon Jonis  08:34

Is there a way to know ahead of time if somebody was going to be a responder or a non responder before somebody goes through? Or do they just have to try the cam try altitude and see what happens?

Dr. Peter Hackett  08:46

Yeah, the answer is not yet. There is no way yet. If we can nail down the polymorphism that is responsible for this. Like if it’s EPS one for example, or EGL. And what you know, one of the genes that codes for the HIF pathway, I’m sure that’s what we’re going to find. But no, that’s eventually what it might take.

Jon Jonis  09:06

And soon enough, it’ll be on 23andme.

Trevor Connor  09:10

And I love those said, well, we’ll hit you with the physiology later. We’ll start with the big picture. And yeah, we can’t wait to see what we’re going to talk about later if we’re not in the physiology yet. But I’m glad you brought that up. Because someday we’re going to talk a lot about is this f1 alpha, the hypoxia inducible factor, which seems to be the master regulator. And as you pointed out, there’s different polymorphisms that seems to have different impacts on on different people. So before we start to really dive into that, something I wanted to bring up again, kind of that gross overview is it seems like the research is really mixed. Some studies show big benefits. Some studies showed no benefits and it’s hard to kind of chase us down into some of that because of this huge individual variability and who they get into their studies that they might just get responders, they might get more non responders and as a result, you’re gonna get different study results?

Dr. Peter Hackett  10:08

Well, certainly that’s a factor No, no question about it. But then there’s also the dose of hypoxia, or the dose of altitude and the duration. And don’t forget that there’s pretty good consensus that there’s no benefit of training at altitude for sea level performance, if you can’t include low altitude training, that is intense training as part of that program. But the ones that really show the benefit and remarkable benefit are the ones that combine living at high altitude, and then intensive training at low altitude at least three times a week during that training camp at altitude.

Jon Jonis  10:46

Yeah. And to clarify that point, right, there’s kind of three different scenarios that we can have, we can have people that live low and they train low, we can help people that live high and train high boulders kind of moderate, but I’ll throw us in that category. But then there’s also kind of what a lot of the positive research has been around, which is living high and training low. And oftentimes, you know, a way to do that is to say, to live in Park City, Utah, kind of at a high elevation in the mountains, and then drive back down to Salt Lake, which is I remember a kind of just underneath sort of the threshold to be considered low in really being purposeful about your living situation. Another way to do it right is to not necessarily move your physical location, but then you can also change your living quarters at home, right. And this is where things like altitude tents can come in, and then you can be sleeping sort of overnight in a hypoxic environment. So there’s sort of multiple ways for people to achieve this live high train low. But it definitely seems to be the clearest, you know, us people living at altitude all the time, maybe we’re not getting the benefits for CeeLo of a performance, or at least not all of them.

Dr. Peter Hackett  11:50

There’s a number of ways to do it. So if you agree that what seems to be the most effective paradigm is sleep high and train low, that is live high, and train low, then you as you pointed out, you do the classic studies of the Venus stray Gundersen Where’s Park City and Salt Lake. So you can do that you can do that between Mammoth and Bishop, for example, but it’s hard like in western Colorado, you can’t do that very well, because you can’t get down below 5000 feet very easily. To get any effect, you have to be between 2000 to 2500 meters, so that’s 60 608,000 feet to trigger the EBO response. However, at those altitudes, your VO two Max is impaired acutely, your sub Max endurance is impaired and you get a detraining effect that has to be counteracted with intensive training in a greater oxygen environment. So you can either move to a lower altitude to do that training, you know, during the week, or whatever. Or you can do like the US Olympic Training Center in Colorado Springs, and you can actually give oxygen, which is the same as going down to lower altitude and that’ll that’ll tremendously increase your training intensity while you’re living at high altitude. That’s another approach.

Trevor Connor  13:00

So that really brings us to what I was hoping to talk about next, because we’ll we’ll dive deeper into the different training methods later on. What is the minimum in terms of both the the altitude and the length of time you need to be at altitude in order to see an effect? And I think a lot of people can be surprised by this, because you just talked about I think you said 6800 feet. And for example, a lot of people come to Boulder go and longing to go and get all that altitude training Well, boulders only a 5400 feet.

Dr. Peter Hackett  13:30

Yeah, I think the data are pretty clear. 2000 meters, that’s 6600 feet would be the minimum and 2500 meters is considered kind of the maximum for being able to live at altitude comfortably without the some of the detrimental effects. And the duration. The classic studies show four weeks ideal four weeks is better than three weeks, three weeks is better than two weeks, and less than two weeks doesn’t do much at all. So I think people, you know, if you’re going to consider a two to three week camp, you want to go for the three week training camp rather than the two week. And you know, I’m not saying this is all to 100% consensus, but this is my take on the literature and talking to experts. So that’s duration. So what happens, why can’t you go to 5500 meters like 80,000 feet for a few days and get the same effect. You know, if it’s a dose, if it’s the altitude stimulus or hypoxic stimulus times time, you would think if you want a lot higher for a shorter time, it’d be just as good. The problem is that to get a beneficial effect, you have to have a sustained equal response. You cannot run up to 6000 meters, get a huge EBO response and come back down because as soon as you come back down, there is a very strong off response. And you have to have be able to main tain a high eco level cause Earlier this studies show one big difference between the responders and non responders. At two weeks into the altitude training camp, the responders all had 20 times the normal eco level at sea level. And the non responders had not it it turned off, or it was turning off and on, you know, they didn’t follow it every single day, but it was not sustained. So you need a sustained response of EBO? And how many hours a day does it take? Well, clearly, there’s been a lot of studies now looking at one hour a day, four hours a day, six hours a day, and none of them work. The what I call the classic studies showed you have to have a minimum of eight hours a day and ideally 16 hours a day, really to get the beneficial effects. So that means not just sleeping at altitude, but But living at altitude, and then going down to low altitude to train or putting on an oxygen system to train.

Trevor Connor  15:54

The national team. Coach Jim Miller has a lot of experience with the commitment it takes to get benefits out of an altitude camp, let’s hear his thoughts, including alternate ways to get the same gains.

Jim Miller  16:05

I think it helps most athletes, I can only think of through the years only one, maybe two athletes that don’t respond super well, that altitude. So I think in general, I’m a huge fan of that I built it into everybody’s training program. But for this one athlete I didn’t. And he could come to he could come down to do it he could race provided wasn’t five, seven day stage race. But if you brought the altitude, he didn’t have great adaptations. And his training typically was just, it’s just volume and everything for him. It didn’t work.

Trevor Connor  16:38

So what do you find are the benefits of training at altitude? What What effects do you see it having on your athletes,

Jim Miller  16:45

everything you know, I mean, I mean, this is not a secret, it’s red blood cells, it’s oxygen carrying capacity. If you have a little bit of heat, then you get some, some plasma expansion, which is also nice, anything less than seven days is a waste of time. And then up to 21 days, up to three weeks, I think is ideal. If you can do three weeks, and you have the means to do that. And the time and everything works out that you can do it. That’s my preference. If it’s if it’s a quick hit, it just you just don’t get that much out of it. I’ve actually used heat stress training, in some cases, I think, as effectively as altitude training in terms of red blood cell, increase hemoglobin, hematocrit, etc.

Trevor Connor  17:23

And how do you do heat training with your athletes,

Jim Miller  17:25

I do it at the end of training session. So it’s it’s for the first week, we’ll do primarily just volume. And then they come when they come in from training, they immediately go on to a sauna initially starts with 10 minutes, and then we build up to 20 minutes. But over the first week, we do it every day. And you just add two minutes each day, the last hour of the ride, you don’t hydrate in the sauna, you don’t hydrate, but then when you get out, you hydrate like crazy. And then once you built up to the 20 minutes, 22 minutes, then it’s just every other day as a maintenance. But if you take blood draws during the course of that you can you can see the evolution of that was profiles like a year ago, you don’t and broski is one of these guys who doesn’t acclimate great altitude. He wasn’t the guy was, in particular speaking up, but we tried it last year with Joe altitude, didn’t really see any benefits. He didn’t race better, he didn’t produce more power, us just isolated on the mountain by himself. And that’s what came out of it. So then we went before the JIRA, then we just did heat stress training. And he hadn’t bumps in red blood cells. He had bumps in amount of credit, he had good plasma expansion. And I think it actually worked better for him than then altitude would actually rode really well, right. I mean, a DD he was he’s 12, the Giro, he had a shot at top 10 It was more of a tactical error that he wasn’t topped. And then it was his capacity or fitness is brutal in the amount of fatigue that it generates. And not not just fatigue, like we’re thinking of, oh my god, I’m tired. But that autonomic stress is huge. So if you track HRV, resting heart rate, etc, etc. You’ll see everything tank is a big stress on the body

Trevor Connor  19:05

when you’re at those moderate altitudes, so again, we’re talking that over 2000 meters, the length of time that you need exposure is actually quite long. So I’m actually looking at a study that was led by Dr. Brothers and this was a study conducted not too far away from here at the the US Air Force base at about 2200 liters. And it took over seven months to see an acclamation. So this isn’t if you even at that altitude. Do you go there and go I’m gonna do a one week training camp and get all these games. Well, no, you’re not sorry.

Jon Jonis  19:39

You know what’s interesting, though, is I think that listeners are saying, hey, you know what, I took a vacation in in Breckenridge last year and man, I felt terrible on the first day. But once I was three or four days in, I was starting to feel a lot better I must have been acclimatized to altitude, but it doesn’t sound like that’s the case what’s happening in that situation onward. Just talking about the first three or four days that somebody has gotten to altitude,

Dr. Peter Hackett  20:04

that process is called a climatization. And what we were talking about was the Eco response, which is different than a climatization. So the anecdote you relate is entirely true people go to Breckenridge and day one is the worst, the first night is often pretty bad. And, or if they get up there late in the day, and then they sleep the next the next morning, they will have mountain sickness. And then it takes two or three days to pass that process is called a climatization to altitude. But it’s a little different than what we’re talking about. And that has nothing to do with the increase in EBO, or red cells that has to do with the increase in ventilation, which eventually raises the oxygen saturation over the course of two to three days. So the moment you arrive in Breckenridge, your oxygen saturation might be 8887 89%. The next day, it’ll be 90%. The day after that, it’ll be 92%. And then maybe 9394, that’s about as high as you can get at that altitude. And that has to do with a reset of your peripheral and central chemo receptors so that the peripheral chemo receptors are jacked up, and you start breathing more. And the central chemo receptors allow the co2 to drop without causing apnea. So that your carbon dioxide level at Breckenridge after four or five days is going to be your co2 content would be maybe 33 instead of 40. Like it would be a sea level. And that’s because you’re you’re breathing so much more. But the equal response in people confuse this all the time. They think that oh, if I’m acclimatized in the altitude, because I want to attract in Nepal is because my increase in red blood cells? No, it takes weeks for an increase in red blood cells to cause an increase in red cell mass. As you all know, and most of our listeners will know, it doesn’t happen in a few days, what does happen is that you lose plasma volume in the first 24 hours to 48 hours at altitude. And as a result, your hemoglobin concentration is higher. So actually, your hemoglobin level is higher, but it’s not because of new red cells is because you’re physiologically dehydrated. So we’re diving into

Trevor Connor  22:15

the the physiology here. And yeah, I think this is a really important thing to point out and the little bit of research that I was involved in with altitude. And what I read, this was probably the thing that surprised me the most, which is that short term adaptation. And you just mentioned some of it. But the the best summary I ever heard of it is your body’s immediate adaptation has actually make you a little bit more of an anaerobic animal so that you you can handle anaerobic metabolism, you can handle acid production better than you normally do when you’re at sea level. And actually, in the short run, some of those aerobic adaptations get brought down. So something that else had happens in a relatively short period of time, is you might see a bit of a decrease in mitochondrial function or mitochondrial mass. Because if you’re not handling the aerobic side very well, well, mitochondria produce a lot of reactive oxygen species, which are damaging to your body. So if you come up to altitude, and your body’s not good at handling, it goes, I don’t want all those Ross produced. So I’m going to bring that down and actually rely a little more on anaerobic metabolism. So it’s actually the exact opposite of what you think,

Jon Jonis  23:24

in Trevor, can I ask as a follow up to that? Was there an altitude component in there? I know that as you know, high altitude mountaineers right, they tend to have very high anaerobic sort of energy contribution to exercise, as opposed to a robic and you know, so I’m wondering, Is that happening at this 5500 5600 V 2000 meters? Or are we talking you know, kind of when we’re in the Himalayas and where it many 1000s of meters at that point,

Trevor Connor  23:49

but I get a bit too I always struggled with this because when we were talking about altitude and studying it, you know, I think we’ll boulder for Collins, because I’m a cyclist, that’s where I trained. But normally when people are talking about altitude, and Dr. Haggard, you could talk to this better and I can, but frankly, boulders not even considered practically moderate. Right. When you’re talking high altitude training, you’re up over 10,000 feet well over.

Dr. Peter Hackett  24:16

Yeah, I mean, everybody in the medicine community in high altitude community uses 2500 meters, or 1000 feet as the definition of high altitude but, but from an athletic point of view. I mean, you all know that Bo, to max starts to drop at a lower altitude than that.

Trevor Connor  24:32

Let’s hear for Payson McElveen, who lives at high altitude and hear his experience of whether he finds it beneficial for training.

Payson McElveen  24:40

You’re a professional World Cup Racer, I think living at altitude is a negative. If you are a marathon racer, I think it’s a positive. That said I still do sea level training camps for sure. And I know that I can’t be at my best or my fittest unless I do some sea level training camps. You can just handle more training load, you can put your your muscles through more, it just creates different physiological adaptations. So I think the Holy Grail is both if you’re doing the Leadville, 100, and you’re really trying to cross all your T’s and dot all your eyes, you absolutely need time at elevation. If you’re getting ready for the sea otter classic or that Iceman Cometh something like that. I don’t think an elevation training camp is going to help you that much.

Trevor Connor  25:26

So why don’t we go into the basic adaptations of what happens when you’re exposed to altitude? So for example, if you went to a training camp it at 1000 feet, how does your body respond? What are the major adaptations that we see? And and is it set science on what the impact is and how our bodies respond? Dr. Hackett would you like to take this first.

Dr. Peter Hackett  25:50

So I’m glad you use the words both adaptations and how our body responds because they’re two different things. We always think of adaptations as useful, but the way our body responds at altitude is not always useful and positive. So there’s the hematologic adaptation, which is within two hours of going to high altitude. The kidney senses the drop in partial pressure of oxygen in the blood, and stimulates the release of a hormone called erythropoietin or EPO, which then acts on the bone marrow and few other places to produce red blood cells. Red blood cells take a few days to produce. And it takes a few weeks to actually get an appreciable increase in what we call red cell mass or hemoglobin mass hemoglobin being the molecule in the red cell that’s so important for carrying the oxygen. So the hematologic response takes time. To have a good hematologic response. You have to have adequate iron stores is very important. For any athlete considering altitude training, to make sure that they have adequate iron stores. This is particularly true of women, but men athletes as well, serum ferritin should be 50 or higher, to get the beneficial effects of the Eco stimulation. And then secondly, not all beings are created equal and genetically speaking, and some are going to have a good eco response in some, some aren’t. But on average, there is an increase in April and an increase in red cell mass and in hemoglobin mass. In other areas, there’s a change in cerebral blood flow, which is responsible for the headache that people get when they first go up. And after four or five days at altitude, that returns back towards normal that cerebral vasodilation is associated with mountain sickness, and its resolution is associated with getting over mountain sickness. Although the cause and effect isn’t entirely clear. Other cardiovascular adjustments are there’s an increase in resting heart rate and an increase in basal metabolic rate. So that heart rate at 8000 feet will be slightly elevated over sea level at rest and with exercise, it’ll be elevated even more. And Cardiac output is a slightly diminished Despite the increased heart rate. And that is because of the decrease in plasma volume, and plasma volume changes are finally starting to get the attention they deserve. In altitude studies, for example, there’s this big argument about who’s better adapted to high altitude the Tibetans are the Quechua in South America. And it turns out, they both may have similar hemoglobin masses, but their plasma volume regulation is different. And so they have different hemoglobin concentrations. So to be clear, you go to Breckenridge or 1000 feet, say go to Dillon. And you may or may not notice an increase in urination. But but there’s a fluid shift within your body from the extra vascular space so that plasma volume goes down. In essence, your body is dehydrating. And it doesn’t matter how much you drink to overcome that, because it’s a reset of the cosmos center of the brain, in the more water you drink, the more you’re going to pee, you know, after a certain point. And I’ve been trying for 45 years to figure out why the body would do that at high altitude. And the only thing I can come up with is that when you have lower plasma volume, you do have more oxygen carrying capacity, because for every 100 mils of blood, you’ve got more red cells in there than you would without the loss of plasma volume. So if plasma volume goes down, then by definition, the percentage of red cells goes up. But it’s not because there’s new red cells. It’s because there’s less plasma. So that’s an important adaptation. And that doesn’t really change over a period of time your plasma volume will always be lower at high altitude until you get maybe get an increase in total blood volume which can take months and then of course there’s the changes in muscle which is not my specialty, but unless you’re doing high velocity training, high intensity training at a lower altitude in between. You develop muscle atrophy at altitude, you get a detraining effect. Muscle fibers are thinner. As a result, capillary density and mitochondrial density look higher. But it could be Artefactual only because the muscle fibers are thinner. There’s a debate about that there’s a change in metabolism that George Brooks can tell you all about. And there’s changes in an anaerobic capacity. There’s also an increase in oxidative enzymes. So, you know, there’s metabolic changes that take place that I’m not the best one to speak about that.

Trevor Connor  30:29

As Dr. Hackett explained, not all of our changes are beneficial. Let’s hear from Dr. Andy Pruitt, Colby Pierce, and Todd Carver as they discuss the downsides of altitude training.

Colby Pearce  30:40

I don’t believe it’s always beneficial, it depends on the context of the athlete, what their goals are, who’s the athlete, how they’re presenting? And what are the demands of their event? What do you gain when you go to altitude, baseline aerobic conditioning, most likely, assuming that your adaptation curve is dealt with and you recover properly, and you hydrate properly and you’re eating enough probably red meat to offset the impact on blood chemistry. So you’re up regulating aerobic capacity, we’ll say, or maybe we’ll say aerobic metabolic conditioning, that that would be our baseline expectation for going to altitude. But there’s several ways that can go a foul. And if you’re a writer, who, who, you know, I’ll disagree with cognate here for a minute, he likes to say it’s an aerobic sport, dammit. And that’s so easy to emphasize that aspect of conditioning. And I think that’s a default the way a lot of people think. But the reality is there are a lot of bike races that are highly neuromuscular or biomechanical or torque oriented in their demands. And so if you’re training for an event that has a big torque demand, and also if you go to altitude camp, and you’re already a rider who is will say, you’re not expressing a high ability to deliver a lot of glycolytic power, then you’re just going to make your strength stronger, but it’s going to be further from the goal you’re trying to achieve. So practical example for American writers. If you’re training for Joe Martin, and you’re already a climber who’s lacking a lot of explosive power, and you went did three altitude camps all summer, to get ready for Joe Martin, in the hypothetical fall scenario where it’s an COVID year, you might do really well be one of the strongest riders but never be able to express a good placing because those races are so explosive. Right? That’s a good hopefully, it’s a practical example that people can figure out it’s at 40 Staters a lot of poppy hills. So for those of you who aren’t familiar with it,

Dr. Andy Pruitt  32:19

then I don’t know that room yet. But when Chris Carmichael was the national team coach, they would go to Winter Park for their altitude camps. But he also had trucked in huge tanks of oxygen. So they would do an endurance ride at altitude. And then they would do their intervals without to supplementation. So it’s like they were doing or altitude endurance, and then their their quality at sea level or below. So they could do the huge amounts of work because they were submitting their oxygen. So that’s the best case scenario with semi semi load of oxygen tanks to supplement. Sure,

Colby Pearce  32:53

sure everyone has access to that. Sure. Sure. Sure. Sure.

Dr. Andy Pruitt  32:56

But the point was that you can’t have to have to have that balance.

Todd Carver  32:59

Yeah. You should train at altitude if you’re going to race at altitude, right. The adaptations are specific in total, I think Kobe saying if you’re gonna raise it in the Midwest, Joe Martin or something, it’s like, do you really need altitude training?

Colby Pearce  33:12

It might help you it might not. Yeah, it depends on your content. But yeah, if you’re training for Mount Evans hill climber, then you should, you should probably train at altitude regardless of who you are, if that’s your goal.

Todd Carver  33:21

That’s right. So some of the data would actually contradict the altitude training for sea level performance.

Dr. Andy Pruitt  33:28

altitude training makes you slow if you don’t do something about the counteract

Trevor Connor  33:36

Hi, everyone, this is Coach Connor, fast talk lab has just released a newest module from the craft of coaching with Joe Friel, which we’re really excited about here at fast talk labs. We all know that it takes plenty of analysis, critical thinking and decision making to create performance. Joe Friel unpacks the complexity of this topic with a guide to the common training metrics and tools for the data analysis, you’ll learn more about balancing training load over a season, how to get athletes race ready, and best practices for post race analysis. Hear from pros turn master coaches, Ben day of day to day coaching, who talks about how to best measure and cultivate performance, and Julie Gibbons, who describes how to help your athletes grow from failure and disappointment. If you are results driven, this module is not to be missed. Contact us to learn more at fast talk Let’s now dive into that more practical side. So we have an athlete who’s decided to do a couple week training camp at altitude. Let’s talk about how to get the most out of that. And Dr. Hackett. I know you wanted to talk about sleep, which can be a big factor and something that a lot of people don’t think about when they’re going to altitude.

Dr. Peter Hackett  34:51

Absolutely. And the first thing I was I would advise the athletes to do is try to extend the camp to three weeks instead of two weeks. But one of the ad, not an adaptation, but a response of the body when they go to high altitude is trouble with sleep. And this has been identified and studied for many decades, there appears to be a direct effect of hypoxia, that has low oxygen levels on sleep centers of the brain. That’s all it seems to be a direct direct effect of hypoxia so that sleep is a little more superficial, it’s the more interrupted, subjectively, people feel like I can get a good night’s rest, even though physiologically you can actually measure their total sleep time might be okay. But to sleep, our architecture does change a bit between the stages, and between REM sleep starting probably at about 1000 feet, although some people are more sensitive than than others. And it generally improves with a climatization. But sometimes it doesn’t. And people can have terrible night’s sleep for years. Like in Telluride where I practice medicine, it’s at mountain villages, 9500 feet, I have clients there that have what’s called Sleep, periodic breathing, which wakes them up during the night, all the time, I mean for years. And this periodic breathing is worth mentioning, because it’s a physiologic problem that can be very frightening. But it’s not really dangerous. And what happens is that during the night, after I go into sleep, a strange respiratory pattern takes over, where there’s big breaths, four or five big breasts followed by a period of apnea for six to 12 seconds, with no breathing at all. And then the body senses that your blood oxygen level is dropped, your carotid body does little kind of a gland and your carotid artery that senses oxygen, it sends a signal to the brain to take a breath. And that next breath can be a big one. And it can often wake a person up with a feeling of suffocation. And then they take four or five big breaths, and then you stop breathing again, because you’ve dropped your co2 too low. So the bottom line is, that’s the only one reason for why you might might not sleep well at high altitude. And the other has to do with these direct effects on sleep architecture. Some people have trouble falling asleep, some people have trouble staying asleep and awake up. And it can impair recovery, it can interfere with recovery, and it can interfere with general sense of well being. So one of the problems with altitude tents, for example, if you’re preparing for a mountaineering expedition, if you go up a little too quickly, like 8000 10,000 12,000 14,000, your sleep will start to become a problem. And then your recovery time can suffer as well or your recovery process. So that’s kind of the bottom line on sleep. How can you improve it for somebody going through an L to do can’t be what just won’t be aware, it can be a problem, you want to make sure you get a good night’s sleep, no caffeine after 4pm. And you know good sleep hygiene as we call it not being on your screen for an hour before going to bed, that sort of thing that people know about.

Trevor Connor  37:58

And so that brings up the question of recovery. And, Jon, I know you wanted to discuss heart rate variability and the impact of altitude on that.

Jon Jonis  38:06

Yeah, it’s just, it’s such a common metric that most athletes are tracking these days with either an aura ring or a or a whoop band. One of the things that we encourage people to do is, you know, this is a lot easier to do with simulated altitude than real altitude is to go up very, very slowly. And for an athlete who’s training really hard, and they’re in their bodies already in a stress state, we only have them go up 500 feet per night, even in some of the metrics that they can look at when they’re during this ascent phase is heart rate variability, REM sleep and deep sleep. And oftentimes, if any of those three metrics start to drop, then you’ve gone too high too fast. And you need to let your body catch up. And one thing that’s a little bit counterintuitive, with like the live high train low as it relates to recovery, is that you initially see your heart rate variability go down as you as you go to altitude, as you acclimatized, it will come back up. But then, if you’re living low, you’re now sort of in this supersaturated oxygen state during the day. And so recovery scores actually improve, compared to if you were living low training low. So we see sort of across the board with all of our athletes, that the recovery scores, initially they drop, because their physiology has not caught up with them yet, but then after, you know, say like four weeks of being at altitude and training low and living low, their recovery scores are actually improved compared to baseline.

Trevor Connor  39:50

Do you feel that legitimate or is that overestimating their recovery because of that effect?

Jon Jonis  39:56

I mean, it’s just as measured by whatever device they’re they’re aware Right. So

Jon Jonis  40:01

we’ve definitely identified, you know, some difficulties with going up to altitude. We’ve said, hey, it’s not always positive. We’ve said that you need to balance the adaptation from the deleterious effects. And we know that now going to altitude is going to affect recovery and sleep ability. How do we design an altitude camp? That is the most likely to get these positive adaptations without causing anything negative? How do we design something that an athlete can use to improve their performance in subsequent events? After that, Dr. Hackett, you had mentioned three weeks. Yeah, there’s two

Dr. Peter Hackett  40:40

components here. One is designing the right program for the person. The second is, whatever the program is maximizing your chances that you’re going to benefit from it. So for example, I think the first thing you need to tell athletes is that altitude training is not magic. Ingredients, they get

Jon Jonis  40:57

magic, but altitude training isn’t.

Dr. Peter Hackett  41:02

Yeah, the second thing is that in terms of narrow response to your question, I think you want to shoot for, ideally, three to four weeks, but even but two weeks, would be minimum, and terms of the dose, you want to be ideally around 1000 feet, and you want to incorporate lower altitude intensive interval training or intensive training into that program. So that’s the basics of of the program, you also want to pay good attention to nutrition, and you want to maximize your sea level training first. I mean, if you really want to get the benefit of high altitude training, it’s not for the weekend warrior that is not part of the training program. And he’s gonna go to high altitude. This is for people that are serious about their training, to take out the time and money and time away from work, or maybe they’re working remotely is not an issue time away from spouse, which may be an advantage, I don’t know. But you want to, you want to maximize your sea level training for so you want a good solid base of training, you want your nutrition to be in place, you want to know where you are your training cycle, and incorporate the altitude into that. And you want to come up with a comfortable place to train. You don’t want to be sleeping in a chicken coop at 8000 feet, some friend’s backyard, I mean, you want to be comfortable, you want to eat right? One good sleeping space, you want to hydrated, etc. So I think those those are the basics. And then if you’re also serious about it, you might check your serum ferritin. And make sure that we generally recommend 50 a level of 50 or higher, make sure you got adequate iron. If you don’t, you want to get your iron up to normal levels before you go on the altitude camp. And you also want to be careful, there’s other things that are blocked the Eco response, for example, infections. And one of the studies Levine did, the guy that actually had a drop in eople, on a sense of altitude was the only one that had a respiratory infection. And, you know, he didn’t make a study out of it. But anecdotal experience suggests that any kind of cold influenza, or infectious problem, oh, actually, you know what he had a subject that had a dental infection, and had a negative EBO response to something altitude. And then when he went back without the infection, he had a normal Ebola response. So in terms of maximizing the benefit of a training program, you want to make sure that you don’t have any current medical problems. Even simple things like a tooth infection, a skin infection, a sore throat, any kind of infection turns on an inflammatory cascade that can actually Buncher EBO response. So you want to be good health, you want to know where you are in your training program, whenever comfortable place, and you want to avoid overtraining, it’s very easy to overtrain with altitude training, especially when you come down to a low altitude to do high intensity or put on an oxygen mask to do high intensity. Want to make sure you don’t train hard during your recovery time. And I think for if somebody is serious about a competition, a big competition coming up, and they want to do an altitude training program. I mean, don’t make this your first altitude training experience. If you try to get one on your belt first before you train for the competition of your life to make sure that you understand how it works, whether it’s going to work for you. And you know, I liked this term competitive a climatization I forget who came up with that. One of the authors in the exercise science, which is the concept that it’s a learning process climatization to altitude, like and mountaineers, they all you know, they’ll say, oh, yeah, my body remembers how to climb that your body does not remember how to acclimatized, you remember how to improve your climatization you learn the right rate of ascent, for going up to altitude. You learn what to eat and what to drink, what to avoid. You learn to stay healthy, not get diarrhea in Nepal, you know. Same thing with an altitude training camp. You learn what works for you, you learn how to sleep well you learn with food If you might like you learn what climates you might like what temperature you like to ride at, whatever. There’s a learning process that allows you to maximize the experience. If that makes sense.

Trevor Connor  45:11

Tim Cusick has a lot of experience running out to two camps for his athletes. Let’s hear his thoughts on how to maximize one of those camps.

Tim Cusick  45:20

So the first question is, is the athlete and adapted to altitude training. So the reality is, you need to know that before you spend a fair amount of time. For me the main measurement, you need to do some I mean, again, I work with professional athletes, so they have access to things that the average person might not have, but still have to explain it this way. Hemoglobin testing probably is the best answer a lot of focus on hematocrit, but hemoglobin will probably give you some better insight into their adaptability to altitude, if we know they’re adaptable to altitude. The second thing is diet and their nutrient, they need to have a certain amount of iron in them before they go to altitude training. I see this mistake all the time people aren’t ready, their nutrient content, they don’t have enough iron in their body, I have a number I’ve looked for I’m sure others have their own. If my athlete is below that I would delay altitude training to they get above it if they’re an adaptor. And if their body is ready for altitude training, altitude training can have a benefit, but it’s touching. Meaning, the hardest thing about going to altitude and altitude training is you are introducing a lot of overall stress to the system, you have to be there long enough to actually not only acclimatized. But to adapt to that overall stress, be able to train in that overall stress and then adapt. I see a lot of people go through altitude training too short, they might have some blood markers, they might know their athletes and adapter, they might even figure out the iron and nutrients in the blood and make sure that’s all right. But then they go to altitude training for seven to 10 days. So altitude training takes longer than most people think to really make it a measurable effect and adaptation. And then unfortunately, it doesn’t last all that long. So one of the key things that you have to do is time your training really well at altitude. When you get out of altitude. What you do with all that enhanced performance is super important, whether it’s race, and sometimes it is race, and sometimes it’s trained, and people who figure out how to use altitude camps as then training boosters thought necessarily, you know, I’m doing an altitude camp and I’m not going to a race right after you’re going out to camp and then you’re doing some Super Training, post out that you can’t go back down to sea level, we have extra watts to spare you train at those extra watch, take advantage of that, while you have it to do some really super strong training. Those two methods work well meaning one method one, you have to try and come down, let your body adapt to sea level for a little bit, race, or come down with your body adapt to sea level for a day or two and train really hard for a short block. Those two combinations can all work well. But you got to do those those things, right? You got to know the athletes and adapt there. You gotta have the body set up to adapt to altitude, you got to be there long enough to actually have the adaptation, and then how you leverage the post altitude timeframe, which probably is 14 days, 17 days. That’s super important.

Trevor Connor  48:15

I think you raised a really important thing earlier on, which is, this is something you do after you’ve already maximized your training. This is truly marginal gains, man look at the results of one study, looking at a three week training camp and said they saw on average one to 3% improvements. A huge for an elite if

Jon Jonis  48:36

it is but I think that listeners need to understand it comes at a great cost, right of relocating, which is of a physical, a monetary and emotional or relationship cost and everything else. And you know, we can see one to 3% improvement, you know, by by maximizing other aspects of training that might not, but for the elite athlete who is doing everything right, then yes, this one to 3% can be really important. And they’re the ones that can maybe afford this, you know, the other side, too is, you know, maybe it’s worthwhile, is it worthwhile for people who are going to train or or to compete at altitude? You know, we’re talking a lot about sea level performance. But what if somebody’s coming up to Leadville 100. You know, should that person be coming up and taking time out of their life to help themself?

Dr. Peter Hackett  49:21

I was wondering if you’re gonna get around to that. I mean, that’s an area of great debate about what’s the best way to prepare for competing at altitude. And, you know, there was a good paper by Bob Chapman and Ben Levine in high altitude medicine, biology 2013, titled something like how to prepare or when to arrive and how to prepare for performing at an altitude. And they they review the data and the data from the scientist is a little different than what a lot of the coaches and trainers do. You know, the science suggests that the worst thing you can possibly do is go up to altitude and immediately compete and this Second worst thing you can do is compete in the first 48 hours. And the best thing you can do is compete after three or four days of a climatization. Because then you’re over your mountain sickness, you’ve had your plasma volume decrease, you’re starting to sleep a little better. You know, there’s a number of factors. But I know there’s coaches out there that say, oh, no, we want to just show up and play, you know, like football, pro football teams, for example, we just want to say some of the coaches just want to play immediately on arrival. The science doesn’t support that at all. And I don’t think the anecdotal experience does either, but, but I still hear that in, in some circles. Ideally, if you had two weeks, we know that sub Max endurance increases remarkably, at about 10 days between 10 and 14 days with a climatization to altitude. So the ideal scenario would be to arrive for an event 10 to 14 days beforehand. And before you get a detraining effect, so it’s tricky, and you want to avoid the training, you want to maximize your sub Max endurance improvement at high altitude.

Trevor Connor  51:06

So I guess the final question to kind of round us out, and maybe Jon, this is more a question for you is, what about simulated altitude? For those people who can’t take three weeks off work and come up here to Colorado and enjoy the mountains? What are the benefits of that?

Jon Jonis  51:22

Yeah, I guess, I guess the main benefit is that you can dial in exactly what you want elevation wise. And you can go up like I mentioned earlier, very, very slowly. So for weekend warriors, you know, we ascend at one to 2000 feet per night, pretty easily. But for the more elite athlete who is training very hard, it’s a much slower rate of ascent. And, and you can monitor that, and you you can dial it in, and even pause your ascent. So that’s really the main benefit other than, you know, not having to displace yourself, is that you control your rate of ascent. And a lot of people they’ll go up, say, even, like around six 7000 feet is where oftentimes you see sleep quality start to dip a little bit. So you just pause there, you know, you wait, like two three nights, then you continue your ascent? So yeah, that’s that’s really the the main benefit there.

Jon Jonis  52:22

When utilizing something like an altitude 10, is there a maximum altitude simulated altitude, that begins to have the deleterious effects on recovery performance? You know, and you’ve maximized everything you’re gonna get on the stimulus side of things, like you mentioned, six to 7000 feet, maybe pausing. Do you sleep at 10,000? Do you sleep at 20,000? Where do you stop? Yeah, this guy is not the limit, I am sure.

Jon Jonis  52:49

Yeah. And, and we actually used to, like, in the old days, say, even 10 years ago, many people were trying to really push where they were sleeping at, you know, 1416 18,000 feet. But really, once you’re over 10,000, or really even 8000, you’re just not getting additional benefit. And you you start going the other way,

Trevor Connor  53:12

because it starts impacting recovery sleep,

Jon Jonis  53:16

yeah, your sleep just falls off really quickly, once you’re above 12,000 feet, and, and so you’re not recovering. And you know, everything suffers at that point. So we always recommend people stay in that eight to 10,000 foot band, it’s tough to do, especially with a lot of elite athletes who think well, I’m super fit in, and I can take it, but you can’t. And so while Yeah, eight to 10,000 feet is really sort of that sweet spot where you’re triggering all the physiological responses. But you’re still able to get the good sleep quality and the good recovery that comes with that.

Jon Jonis  53:51

Now, is there still a time component with this? We’re talking about altitude camps, you know, three weeks being ideal two weeks being minimum, maybe even longer than three weeks being ideal. When we talk about the altitude tent or simulated altitude, we don’t have to up end our life at this point. Do you still just go for the three weeks the four weeks before the event? Or is this something that should be 12 months out of the year?

Jon Jonis  54:16

Well, we have a lot of athletes, even just here in Boulder, who who do sleep at altitude every single night. And when they travel, they take their system with them. Pretty portable, you can just put it in as checked as checked baggage. They just don’t want to lose it. But for the average person, if you’re training for specific events, or for specific Trek or you’re going to Kilimanjaro, wherever you’re heading to, yeah, four to six weeks, that’s sort of an ideal amount of time before the event to be sleeping at altitude.

Dr. Peter Hackett  54:50

I think the listeners need to you know, they need to have a clear idea of the science in terms of the simulated altitude that they They’ve been shown to be useful for pre climatization to high altitude trekking and mountaineering. And people getting ready for a trip like that will often use these hypoxic tense devices to sleep up to as high as 14 or 16,000 feet in preparation for Aconcagua or Kilimanjaro, for example, and they can be a useful, there’s also really interesting data on weight loss at the use of hypoxia to induce weight loss, which is an area of of active investigation, in terms of getting an eco response and increasing red cell mass and improving performance for sea level, there’s a lot more studying that needs to be done, the data aren’t clear that a nighttime exposure, which would be only eight to 10 hours maximum is of any use for that particular purpose. I think what has never been studied, and I think would be really interesting. And maybe John, you could take this up and get some people to look into this is to do have a athlete, do an altitude training camp for say, three weeks, and then come down and use the altitude Tet every night and see if that is enough of a stimulus to maintain the consistent eco response and consistent performance response. The US military tried this one time where they went to Pikes Peak and acclimatized everybody improve their exercise performance. And then they went down to low altitude, and they put them in a hyperbaric chamber intermittently during the week for a couple of weeks to see if they would maintain their climatization. And they didn’t. But they also only used a few hours a few times a week. And that’s not enough. But it might be that a nighttime exposure would be enough. I mean, I would love to see that study done. Because then you can really extend the benefits of an altitude training camp. I just want to throw that out there

Trevor Connor  56:54

desperately looking for it. But there are a review that I read last night was is not going to try to pronounce that name p h o s, Zed, see Zed y ca, review the effect of altitude training on Earth pole I attic, I can never pronounce that response and hematological variables and adult athletes. And they did mention a study in there where they did did something similar where they had athletes train at an altitude training camp and then had daily exposure to altitude temps and I can’t find it. But I remember them saying that they were able to maintain those adaptations.

Dr. Peter Hackett  57:35

See, I think that’d be a great use for the altitude 10 .

Trevor Connor  57:38

Is go and get your training camp and then come back and make sure because we didn’t mention this in the show. But the typical length of those adaptations after you do a training camp, once you come back to see lover short, we’re talking two weeks.

Dr. Peter Hackett  57:51

That’s right to about two weeks, you should mention that at some point.

Trevor Connor  57:55

Finally, we just heard about simulating altitude. But what about going the other way and using supplemental oxygen? Let’s hear from Dr. Robert Kenefick on the subject.

Dr. Robert Kenefick  58:04

So that concept of live hire train low became very popular, there’s some some counter work out there, say that might not be the case. But the the idea of for individuals who are are living at altitude, because the partial pressure there is lower. The idea is that because of that they’re never really going to be able to exercise or train at the intensity, they would if they were at sea level, or the partial pressure is going to be greater. And so that idea of everybody knows a good altitude performance, you get a decrement, then that translates to if I’m living in altitude, and I’m training, I can’t train either at that aerobic threshold that I have when I’m at sea level, but I want to be able to maintain or get that high intensity training at altitude. So breathing supplemental oxygen in that circumstance would be a way of doing that of overcoming the idea that you’re still at altitude, but you know, your performance may not be degraded, because you’re overcoming the fact that partial pressure is lower. So I can see in that circumstance, why it would be beneficial. And my it could be a practice that would help short of actually getting in a car and driving down to sea level and doing that higher intensity work there.

Trevor Connor  59:09

So that leads to a second question, which is do you think for somebody who live in at sea level, there’s any benefit because I’ve seen this to training with supplemental oxygen when they’re doing, say their interval work? Again, you know,

Dr. Robert Kenefick  59:24

for the most part, individuals are almost 100% saturated when they’re at sea level. And even though you’re doing high intensity work, people might think, well, you know, I’m there’s some degree of D saturation that’s occurring, and I can’t saturate fast enough. And that’s not that is not the case. So I wouldn’t really have to look at the literature in this area to see whether or not that’s a benefit from a physiological point of view and the simple fact that you are almost 100% saturated at sea level. It’s possible, uh, you know, pushing that up a tiny bit, which is we might just get a little bit more but there’s not a whole lot of change that you can get there by breathing 100 sent might give you a tiny bit of edge, but I can see more of a benefit if you’re living in altitude than a crowded sea level.

Trevor Connor  1:00:07

So both of you are new to the show, we always finish out with our one minute take homes, which is each of you will get one minute to offer what you think is the most important thing for the listeners to take away from the show. So we’ve got four of us here who would like to go first. Jon, do you wanna? You’re gonna be a look?

Jon Jonis  1:00:27

Sure, sure. Yeah. So I guess I would just caution the listeners that not all altitude tents are created equally. And the majority of the ones that are available in the market are fully sealed systems. And so you have a big temperature, humidity and co2 SPIKE when you go into them. So if it’s something that you’re considering, you know, getting into an altitude tent, make sure you have one that has the sensors inside of it, and is continuously ventilated. It makes it cooler, much more comfortable for sleeping. And it allows you to accurately control your altitude, which is really important, especially during that climatization phase. So just shop carefully, when you’re in the market for that. Rob, you want to go next?

Jon Jonis  1:00:28

Yeah, you know, for me, it’s these these debates, you know, Trevor, they always spark a little something in me. Kind of like you said before, when you think of altitude, you think of Boulder and Fort Collins in these places that we live in, right. And I’m always reminded during these conversations, that boulder as much as we wish it was, we’re just not quite there in terms of altitude. And my short forays up into the mountains, or a long ride up to the peak to peak is probably not enough, you know, for me to be getting any altitude benefit as much as I wish and fool myself into thinking that it does. So you know, if somebody is going to do this, then, you know, take time plan, do it right, follow all of the advice of making sure that your body is in a great place that you’re healthy, that you’re maximizing your training, because there is a big cost, you know, to doing an altitude camp, and it’s not something that you want to just go about willy nilly and set yourself up for failure.

Trevor Connor  1:02:14

Dr. Hackett, would you like to go next?

Dr. Peter Hackett  1:02:16

Well, I think in summary, anybody considering an altitude training camp needs to understand it’s not magic, that it needs to be part of an overall training strategy that the person needs to really maximize sea level training first, before going up and try it at least one time, if you consider me in a major competition. And obviously learn about it quite a bit. I mean, there’s a lot of advice out there. Now, not all of it sound, there are still some areas of debate. But I think it’s fairly clear that not everyone is going to respond. And there’s right now there’s no way to predict who’s going to be a responder, and who is in so taking a three week camp, which is probably what you need to get the maximum benefit. I mean, you may get no benefit at all. So it’s a bit of a crapshoot. And a lot of it appears to depend, like so many things in life, and how well you chose your parents. For point,

Trevor Connor  1:03:14

the truth, I’ll just finish it out by saying, kinda kind of echoing what you’re saying, which is, when I first moved to Colorado, I was so excited about going to what I thought was altitude, and all the benefits I was going to get from it. And as it turns out, I am a non responder. So I’ve lived here for years, and I’m not sure I’ve seen that much improvement at all, at altitude. So I’m still waiting at some point, maybe I’ll respond. But I’m one of those people that very limited benefits. And what we did discuss too much, and what a lot of people don’t talk about is a lot of the consequences you feel from it. So for me, talking from experience, it’s a push if not something that hurts me a little. So it’s really important to know, this isn’t black and white, you’re not going to go to altitude and suddenly be a much better athletes. So take it with caution. I think you had the great recommendation of Don’t try this for the first time right before a key event. Go and experiment and try and find out if you’re somebody who responds really well. Or if you’re more like me, don’t be like Trevor, never. That’s the lesson of every episode. All right, thank you both. It was a pleasure having you on the show.

Jon Jonis  1:04:27

Thank you.

Dr. Peter Hackett  1:04:28

Yeah, it’s a pleasure. Thanks for having me.

Rob Pickels  1:04:35

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Rob Pickels  1:05:05

That was another episode of Fast Talk subscribe to Fast Talk wherever you prefer to find your favorite podcast. Be sure to leave us a rating and a review. The thoughts and opinions expressed on Fast Talk are those of the individual. As always, we love your feedback. Join the conversation at to discuss each and every episode, become a member of Fast Talk laboratories at to become a part of our education and coaching community. For Jon Jonis, Dr. Peter Hackett, Dirk Friel, Tim Cusick, Jim Miller Payson McElveen, Dr. Robert Kenefick, Dr. Andy Pruitt, Colby Pearce, Todd Carver, and Trevor Connor. I’m Rob Pickels. Thanks for listening.