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High Altitude Training: How to Elevate Your Performance

High altitude training has become a key training tool for most highly competitive endurance athletes – from Olympians to pro cyclists and marathon runners to swimmers. Why are the best athletes in the world using elevation training to improve their performance? This article will explain the benefits of training at altitude and how to apply the best scientific principles to enhance your own training.

What happens when I go up in elevation? Why do I feel tired sooner?

First, we need to know what differentiates sea level from altitude. As you increase elevation, you decrease the barometric pressure. This change in pressure stresses your body. As a result, immediately upon arriving at high altitude you are forced to adapt to this pressure difference by: increasing your breathing rate, reducing plasma volume, and increasing sub-maximal heart rate [1]. The longer you remain at altitude, the more time your body has to create adaptations that allow you to more efficiently function at a lower pressure.

How does your body respond to the elevation?

Stimulation of the hormone erythropoietin (EPO), increases tissue capillarity and myoglobin concentration. EPO specifically is used by your body to increase the formation of red blood cells. These red blood cells help deliver oxygen to your muscles, a necessary adaptation when exercising at altitude. This increase in red blood cells is evidenced by a rise in your hemoglobin concentration. (You’ve likely heard of synthetic EPO, which is clearly and understandably banned.)

How adjustments to altitude help your performance

The increased red blood cells and oxygenation to your muscles allow you to exercise longer and faster. For example, Levine and Stray-Gundersen recruited 41 distance runners for a 13-week altitude training study. The researchers showed that the use of altitude significantly improved the runner’s 5,000-meter time trail time as well as significantly increased their maximal oxygen uptake [2].

Some caveats

While elevation training has many benefits, it also has some caveats. Altitude greatly influences exercise intensity. The reduced oxygen availability at elevation reduces the amount of time you are able to work out at maximal intensity. Studies have shown that athletes are unable to perform the same amount of high intensity work at altitude as at sea level [2]. On the flip side, working out at sea level will allow you to complete more high-intensity workouts, but you will not receive the enhanced red blood cell production attributes that accompany elevation. So, you are forced to choose between boosted red blood cell production and workout intensity. Many athletes choose to spend time at both high and low altitude to receive the advantages each offer. The chart below outlines the basic options, and pros and cons when choosing to train for endurance at elevation.

Train low, sleep high

The last option in the chart below (highlighted in green) of training low and sleeping high is the current scientific recommendation [2,3]. Training at a low altitude and sleeping/living at a high elevation allows the athlete to maintain sea-level training intensity while reaping the red blood cell production benefits of altitude. This often involves using (sleeping in) an altitude tent or similar device that reduces the oxygen available to breathe.

Train Low Sleep High, Train High Sleep High

Ideal elevation & acclimatization

Don’t pack your bag for Mount Everest just yet. The elevation at which you live and/or train makes a difference in how long it takes you to fully acclimatize. Researchers have found that the ideal elevation for training is between 2,000 and 2,500 meters (6,562-8,202 feet) [4]. Moreover, the time it takes you to acclimatize to an elevation is highly individualized. It is estimated that full acclimatization when ascending from sea level can be calculated by the following equation: 11.4 x elevation (km) = number of days to fully acclimatize [5].

A more precise and individualized method of determining when you have acclimatized to elevation is hemoglobin measurements [5]. When you first arrive at altitude your hemoglobin will rise. This initial rise is a result of plasma volume decreasing in the vasculature in response to altitude causing the hemoglobin concentration to increase. Over several days, hemoglobin concentration will return to normal levels as plasma volume increases. However, from this point forward, the body begins responding to the increased EPO and producing more hemoglobin. Over time, hemoglobin begins to plateau, indicating acclimatization to elevation [5].

Thus, continuously measuring hemoglobin helps individuals to see how long it takes to adapt to higher altitude, and how long their elevated hemoglobin levels last after coming down from altitude.

A powerful tool

Elevation is a tool, and it is up to each athlete to decide how to use it to improve his or her performance.

Cercacor Ember elevation graph

Using Ember Sport daily while training at high elevation can assist athletes in knowing how much they respond to elevation, how long it takes to get a response, and how long the benefits (boosted hemoglobin levels) last after they return to sea level. Using Ember Sport Premium with its seven biomarkers can give even further insights into acclimatization at elevation.

Select the Ember model that makes most sense for you.


[1] Rahn H, Otis A. Man's Respiratory Response During and After Acclimatization to High Altitude. American Journal of Physiology. 1949; 157:445-62.

[2] Levine BD, Stray-Gunderson J. Living high-training low’: Effect of moderate-altitude exposure simulated with nitrogen tents. Journal of Applied Physiology. 1997 Jul;83(1):102-12.

[3] Stray-Gundersen J, Chapman RF, Levine BD. “Living high-training low” altitude training improves sea level performance in male and female elite runners. Journal of Applied Physiology. 2001 Sep 1;91(3):1113-20.

[4] Chapman, R.F., Stickford, A.S.L., Lundby, C., Levin, B.D. Timing of return from altitude training for optimal sea level performance. Journal of Applied Physiology. 2014; 116:837-843.

[5] Zubieta-Calleja GR PP, Zubieta-Calleja L, Zubieta-Castillo G. Altitude Adaptation Through Hematocrit Changes. J Physiol Pharmacol. 2007; 58(5):811-8.

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