The real moral crusaders of WADA doubt if simulated altitude training in order to increase performance is ethical. In other words: is the use of a hypobaric tent in accordance with the true spirit of sport. Whatever these WADA empty slogans may mean. They are certainly based on the assumption that simulated altitude training is as effective as an EPO course. Meaning a course in which a number of EPO injections take place.

In order to test this assumption physiological and haematological parameters of 23 well trained athletes, who were exposed to a simulated altitude of 2650 – 3000m during 11-23 nights, were compared to those of a group of healthy volunteers who received 150 IU EPO injections per week subcutaneously during 25 days.

For an athlete of 70 kg this is a weekly dose of 10.500 IU EPO. This corresponds to 3 times a dosis EPO of 3500 IU per week.

Subsequently the EPO level was determined and the percentage of reticulocytes. The VO2 max
was determined before and after injecting EPO and before and after the simulated altitude stage.
Reticulocytes (retis) are young red blood cells. When the production of blood is stimulated the number of red blood cells increases.

Average physiological respons to EPO and simulated altitude

increase EPO percentage retis VO2 max
EPO course 422% 89% 6.6%
Simulated altitude 59% 30% -2.0%

So EPO through injections are much more effective than the simulated altitude training. EPO after an injection course is higher by a factor 7 than after a course in a hypobaric tent. Also the percentage of reticulocytes after the injections is higher by a factor 3 than after the simulated altitude course. VO2 max even decreases by 2 % in the simulated altitude Group and increases by 6.6 % after the EPO course.

Below there is a survey of the maximum changes in percentages of the EPO level, the percentage of reticulocytes and the maximum oxygen uptake (VO2 max ) compared to the starting values. The test persons were divided into four different groups.

Group 1: participants in the simulated altitude stage.
Group 2: control group sleeping at sea level.
Group 3: the EPO group receiving 150 IU/kg per week by injections
Group 4: the placebo group receiving salt injections

(average; ± standard deviation; in brackets the spread).

Simulated altitude control EPO placebo
EPO 80 ± 76%
(-11 to 313%)
29 ± 45%
(-33 to 153)
560 ± 316%
(286 to 1445)
44 ± 44%
(-2 to 137%)
reticulocytes 36 ± 26%
(0 to 114%)
34 ± 22%
(-10 to 67%)
95 ± 45%
(27 ± 200%)
32 ± 22%
(7 to 57%)
VO2 max -1.9 ± 4.2%
(-10 to 4%)
0.4 ± 3.8%
(-8 to 8%)
6.5 ± 4.3%
(0 to 14%)
0.4 ± 3.9%
(-4 to 6%)

The EPO increase in simulated altitude is double the value of the control and placebo group. The EPO increase through EPO injections is 7 times larger than that in simulated altitude. Reticulocytes remain more or less the same in simulated altitude, the control group and the placebo group. In the EPO group reticulocytes are 3 times the starting value.
VO2 max does not show large differences in the simulated altitude group, the control group and the placebo group whereas in the EPO Group it is 6 times the starting value.


The persistent idea that simulated altitude training has the same positive effect on the production of red blood cells as injecting EPO is completely banned to the realm of fables by scientific investigation. An EPO course improves oxygen transport during physical effort, which could absolutely not be seen in well trained athletes who went through a simulated altitude training stage. The increase of EPO levels after a simulated altitude stage is much less than the increase of EPO after even low doses of EPO. In the investigation described here the number and the percentage of reticulocytes doubled in 5 to 7 days after EPO injections. After a simulated altitude stage at 2650m an increase of 57% of EPO level was seen, but this increase was not followed by a measurable rise of the number and percentage of reticulocytes. After injecting rhEPO a clear increase of VO2 max by 7 to 9% was found in many investigations. In simulated altitude stages there was no such rise of VO2 max in all those studies. When the results of all these investigations are taken together there is even a low decrease of VO2 max compared to the starting value.

Simulated altitude training in a so/called hypobaric tent is useless. It is a waste of money on expensive gadgets which turn out to be senseless. So do not believe the chatter of manufacturers, slippery salesmen and of many trainers. Keep the money in your own pocket. Have a good night´s sleep in your own bed. And practice your sport without another thing to worry about. Also the fact that WADA has considered banning the hypobaric tent gives fuel to the suggestion that the method works. But this is totally untrue. WADA does not use scientific investigations. Means and methods are banned on the basis of assumptions and conjectures. That is the reason why WADA never enters a discussion. The standard argument is: everything on the list of banned methods and substances is doping. End of discussion!

Hypobaric tent
EPO per injection
Oxygen from a plastic bag


The central committee of the World Anti Doping Agency under Dick Pound discusses in Montreal the idea of banning the hypobaric tent, a means with which endurance athletes might produce more red blood cells. The hypobaric tent in which endurance athletes may rest or sleep leads to a better oxygen transport in the body. The tent is only used by endurance athletes.

de Volkskrant, 06 05 2006