Altitude training is still very popular in the preparation phase for the important races. During a stage at an altitude between 2500 and 4000 meters the body of the rider adapts to the rarefied air which contains considerably less oxygen. Then the production of EPO in the kidneys increases distinctly resulting in a stimulation of the production of red blood cells, in a rise of haemaglobin and in an increase of VO2 max. When he returns to sea-level the rider will benefit for about a month. In the most favorable scenario the rider will achieve top performance in that period.


The principle and the theoretical background of altitude training has been known for years. There is still a great deal of doubt about the way in which training can best be done and about the results.

Responders and non-responders

This can be explained by the fact that not every athlete reacts in the same way to altitude training. Some react well to an altitude training stage; they are the high-responders. Others do not react or might even react with a decrease in performance level. The percentage of non-responders is 30 to 40%. Beforehand there is no way of knowing to which category an athlete belongs. This can only be found by trial and error.

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Left-hand curve: increase of EPO level in terms of percentage of the starting level in responders and non-responders during a stay of 25 days at an altitude of 2560 meters. Responders: top line in blue. Non responders: lower line in red.

Right-hand curve: differences in increase of EPO level in terms of percentage of the starting level during a stay of 24 hours at an altitude of 2454 meters. Top line: maximum individual rise. Middle line: average rise. Lower line: minimum individual rise.

Various forms of altitude training: LHTH and LHTL

The traditional form of altitude training ‘live high, train high’(LHTH) has in recent years gradually been replaced by the ‘live high, train low’ protocol. There is scientific proof that the response to LHTL is better than to the LHTH protocol. This can easily be explained. By living high the production of red blood cells is stimulated and by training low the intensity of training and thus performance level can be maintained or even improved.


Even when well acclimatized endurance performance at an altitude is always less than at sea-level. Speed skating and cycling excepted. In speed skating and cycling the advantage of the diminished air drag is greater than the disadvantage of oxygen lack. This is also the reason why the World hour record speed skating and cycling often takes place on high tracks such as the velodrome in Mexico City at an altitude of 2240 m.

Eddy Merckx. Mexico City, 1972. World hour record 49.431 km. Altitude 2240 m.

Elite athletes do not have any advantage from the classical altitude training stages on account of the negative effects. The training intensity needs to be diminished resulting in a decrease of performance level. The positive result is an increase of red blood cells. In practice it comes out that in the most favorable case the gain for well-trained elite athletes is zero. The negative effects are not compensated by the positive effects. So in elite athletes the decline of performance level is greater than the oxygen gain.

The fact that Kenyans live at high altitudes all their lives is often seen as the main reason for their supremacy in distance running. But also the Kenyans were recently confronted with a large doping scandal. It appeared that Kenyan top athletes used EPO at a large scale.

Colombian cyclists, who live at high altitudes, profit by their higher haemaglobin level when they participate in races at sea-level in Europe.

In Kenya everybody runs.

Cyclists living at sea-level try to obtain the same as the Kenyan runners and their Colombian competitors. But the effects of altitude training vary widely and as described above training intensity must be diminished with all the negative results of that. Altitude sickness during the first few days is often another complicating factor. So the effects of an altitude training stage may vary widely.

Nairo Quintana in Giro d´ Italia


Once more the various forms:

  • Live High Train High.
  • This is the classic form of altitude training. A duration of 18 days at an altitude of 2500m is recommended. Results vary widely.
  • Live High Train Low.
  • There is scientific proof that this is the most effective form of altitude training. A month at an altitude of 2500 – 3000m is recommended. So look for a location where you can live on top of a mountain and where your daily training can be done in the valley. A performance improvement of 2.5% may be reached.
  • Staying in a hypobaric room or tent.
  • This may imitate the effect of live high, train low. It will be dealt with later on.


After altitude training performance increases by 2.5%. So when FTP is 300 Watts it rises to 307.5 Watts after altitude training. The speed of the rider in a flat time trial goes up from 40.41 km/h to 40.70 km/h, this being a rise of 0.7%. So speed increases far less than power. This is due to air drag which increases much at higher speed. So the total gain in the time trial of 40 km is 26 seconds.


After altitude training performance increases by 2.5%. The speed of the rider increases from 15.58 km/h to 15.93 km/h, so by 2.2%. This is slightly less than 2.5% because the air drag plays a small role at this speed. The rider finishes after 54.4 minutes and so gains 74 seconds on the climb. This is certainly worth while.