Altitude Training: An Overview

The Basics

There are some guidelines we will cover, that provide the ideal way in which to train at altitude. At altitude, there is less oxygen in the air, making training harder and making you fatigue quicker. Training with less oxygen than normal forces the body to adapt and therefore build fitness and progress. When you return to sea level or whatever you class as ‘normal’ altitude the body will be able to utilise oxygen better, improving your cardiovascular endurance. Many elite athletes take part in altitude camps as part of their training to enhance their performance.

What are the adaptations?

Altitude triggers a ‘hypoxic’ response within the body due to a lack of oxygen. Training safely in this hypoxic state is what is beneficial for performance and physical wellness.

Some of the adaptations we see include;

–        Increased cardiac output and stroke volume (more blood is pumped around the body faster)

–        Decreased Odelivery (to the muscles, due to the lack of oxygen in the air) HOWEVER, and increased oxygen extraction (meaning a better utilisation of the available oxygen)

–        Increased VO2max

–        Increase in haemoglobin and red blood cells (more oxygen carrying capacity in the blood)

–        Ventilatory acclimation (you start to breathe easier at altitude)

–        Significant improvements in EPO (…and done ethically)

There will always be a reduction in max power in the hypoxic state and you need to make sure you don’t push yourself too far and over-train. There is also the risk of acute mountain sickness and poor sleep quality that should be addressed and taken seriously

Live High Train Low

The live high train low model was found to be a successful method for training at altitude.

It includes:

–        Living high enough and long enough to acquire the essential features of altitude acclimatisation that may improve sea level performance.

–        Performing enough high intensity training sessions at a low enough altitude to maintain work quality by ensuring high rates of oxygen reaching the muscles.

There are some specifics you should follow in order to get the most you can out of it.

An ideal training camp consists of three main objectives

  1. How high?
  2. How long?
  3. How long per day?

  1. The optimal height for a worthwhile altitude camp is 2,000-2,500m. Research showed a training camp at 1,700m was not sufficient to reap the benefits and a camp at 2,800 was too high for the benefits to last after the camp concluded (they were just temporary adaptations).

  1. An optimal altitude camp will last for at least 4 weeks. Research showed 1-2 weeks provided no benefits however, it a good way to see how the body responds to altitude. 2+ weeks started to show some adaptations. It was concluded that altitude camps should be no less than 3-4 weeks.

  1. You should be living at the higher altitude for around 23 hours per day, with the minimum being 14 hours. 14 hours will provide important increases to red blood cells however, 23 hours will provide that significant increase in EPO we really want. Ethically it’s a no brainer.

From 48-72 hours after the camp you will have the benefits at sea level. From a week to 10 days after you may feel slightly sluggish and unwell. It is important to return to sea level slowly to adapt to it again. Make sure you organise your competitions around this! After this 10-day period, the adaptations can last from 3 weeks to 3 months depending on the individual.

Nutritional considerations

Nutrition plays a huge role in the progression of an athlete, you need to fuel properly. A main concern at altitude is weight loss due to the increased energy expenditure. At altitude, a hormone in the body called Leptin is increased which consequently supressed appetite. Increased energy expenditure and decreased energy intake is a recipe for disaster for athletes. Ensuring you take in plenty energy dense foods is very important. Protein is a food that creates a sense of feeling full which can compromise energy intake. You need to be aware of what you’re eating and the how much. The best way is to keep a food diary to stay on track. You can try supplementing protein but always try a food first approach.

Iron is part of the haemoglobin molecule (blood) and is very important for haematological adaptations. A deficiency in iron limits how we build haemoglobin and therefore, keeping track of iron levels is a good idea when training at altitude. Research says taking around 200mg of iron every day is optimal. The body has an iron regulating hormone called hepcidin. Hepcidin is lowest in the morning and is increased by exercises so you need to take iron supplements first thing in the morning before exercising to absorb it all. It is also good to take Vitamin C alongside as this enhances and accelerated the absorption of the iron within the gut.

Altitude training camps, when done correctly and safe, can be very beneficial for athletes. However, everyone is different so you may find something different works better for you.

by Katie Forster at AeroFin Performance


Schmidt, W. and Prommer, N., 2008. Effects of various training modalities on blood volume. Scandinavian Journal of Medicine & Science in Sports, 18, pp.57-69.

Chapman, R., Karlsen, T., Resaland, G., Ge, R., Harber, M., Witkowski, S., Stray-Gundersen, J. and Levine, B., 2014. Defining the “dose” of altitude training: how high to live for optimal sea level performance enhancement. Journal of Applied Physiology, 116(6), pp.595-603.

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

Levine, B. and Stray-Gundersen, J., 1997. “Living high-training low”: effect of moderate-altitude acclimatization with low-altitude training on performance. Journal of Applied Physiology, 83(1), pp.102-112.

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