Training at Altitude: Who Benefits and Why?

Training at altitude (typically above 6,000 feet) presents a unique challenge due to lower oxygen availability in the air. This reduction in oxygen pressure forces the body to adapt by producing more erythropoietin (EPO), a hormone that stimulates red blood cell production (Lundby et al., 2012). More red blood cells improve the body’s oxygen-carrying capacity, potentially leading to enhanced endurance performance upon returning to sea level.

Other physiological changes include:

Increased capillary density for better oxygen delivery to muscles.
Enhanced mitochondrial efficiency, improving aerobic metabolism.
Higher VO₂ max in some athletes post-altitude training.

However, not everyone experiences the same benefits. Genetics, training history, and individual response to hypoxia play key roles in determining the effectiveness of altitude training.

II. Who Benefits Most from Altitude Training?

Altitude training isn’t a magic bullet for all endurance athletes. The level of benefit depends on the athlete’s physiology, sport, and training protocol.

1. Elite & Sub-Elite Endurance Athletes

These athletes tend to benefit the most, as they already have strong aerobic engines and can capitalize on the increased red blood cell production.
Long-distance runners, cyclists, and triathletes often schedule altitude camps before key races to gain a competitive edge.

2. Recreational Athletes

Gains are less predictable for amateur athletes.
Some may experience improved efficiency due to altitude adaptations, while others may struggle with fatigue and limited training intensity.
Acclimatization and proper recovery are crucial to seeing benefits at lower experience levels.

3. Team Sport Athletes & Power-Based Athletes

Benefits are less pronounced for athletes in sports requiring short bursts of power.
However, altitude exposure can still improve cardiovascular efficiency, aiding in recovery between high-intensity efforts.

III. Altitude Training Strategies

To maximize adaptation, athletes use different altitude training models:

1. Live High, Train Low (LHTL)

Considered the most effective method, LHTL involves living at altitude to stimulate red blood cell production while training at lower elevations to maintain workout intensity.
Research supports spending at least 3-4 weeks at moderate altitude (~7,000-9,000 ft) for optimal results.

2. Live High, Train High (LHTH)

Athletes both live and train at altitude, but the lower oxygen levels often reduce training intensity.
This method is more commonly used for acclimatization rather than performance gains.

3. Intermittent Hypoxic Training (IHT)

Involves brief exposures to hypoxic conditions through altitude tents or training masks.
Limited evidence suggests that IHT may provide mild benefits, but it is not as effective as prolonged exposure.

Final Thoughts: Is Altitude Training Right for You?

Altitude training can be a powerful tool for endurance athletes, but it requires careful planning and individualized adaptation. Before investing in altitude exposure, consider your experience level, race goals, and ability to recover properly.

📌 Action Step: If training at altitude isn’t an option, test hypoxic training techniques like breath-hold intervals or high-intensity workouts in heat, which can stimulate similar adaptations.