Live high-train low for 24 days increases hemoglobin mass and red cell volume in elite endurance athletes

TLDR

The impact of live high‑train low on hemoglobin mass and red cell volume in elite endurance athletes remains controversial. The study aimed to determine whether a sufficient hypoxic dose would raise hemoglobin mass and red cell volume. Ten Swiss national team orienteers lived at 2,500 m for 24 days, training at 1,800 and 1,000 m, while seven cross‑country skiers served as sea‑level controls; hemoglobin mass, red cell volume, blood, iron, and performance were measured before and after. After 24 days, the altitude group showed significant increases in hemoglobin mass, red cell volume, erythropoietin, reticulocytes, transferrin, soluble transferrin receptor, and hematocrit, along with higher VO₂max and faster 5,000‑m times, whereas the control group showed no changes, indicating that the live high‑train low protocol boosts blood parameters and may improve endurance performance.

Abstract

The effect of live high-train low on hemoglobin mass (Hb mass ) and red cell volume (RCV) in elite endurance athletes is still controversial. We expected that Hb mass and RCV would increase, when using a presumably adequate hypoxic dose. An altitude group (AG) of 10 Swiss national team orienteers (5 men and 5 women) lived at 2,500 m (18 h per day) and trained at 1,800 and 1,000 m above sea level for 24 days. Before and after altitude, Hb mass , RCV (carbon monoxide rebreathing method), blood, iron, and performance parameters were determined. Seven Swiss national team cross-country skiers (3 men and 4 women) served as “sea level” (500–1,600 m) control group (CG) for the changes in Hb mass and RCV. The AG increased Hb mass (805 ± 209 vs. 848 ± 225 g; P < 0.01) and RCV (2,353 ± 611 vs. 2,470 ± 653 ml; P < 0.01), whereas there was no change for the CG (Hb mass : 849 ± 197 vs. 858 ± 205 g; RCV: 2,373 ± 536 vs. 2,387 ± 551 ml). Serum erythropoietin ( P < 0.001), reticulocytes ( P < 0.001), transferrin ( P < 0.001), soluble transferrin receptor ( P < 0.05), and hematocrit ( P < 0.01) increased, whereas ferritin ( P < 0.05) decreased in the AG. These changes were associated with an increased maximal oxygen uptake (3,515 ± 837 vs. 3,660 ± 770 ml/min; P < 0.05) and improved 5,000-m running times (1,098 ± 104 vs. 1,080 ± 98 s; P < 0.01) from pre- to postaltitude. Living at 2,500 m and training at lower altitudes for 24 days increases Hb mass and RCV. These changes may contribute to enhance performance of elite endurance athletes.