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Altitude training has been shown to be a successful method of improving an athlete’s aerobic capacity and their subsequent endurance performance. The primary adaptation occurs in the blood with an increase in oxygen carrying capacity; a process driven by the reduced oxygen availability at altitude (hypoxia) causing an increase in the hormone erythropoietin (EPO), which in turn accelerates red blood cell production, increasing haemoglobin mass (Hbmass).

Research reveals that some of the increases in Hbmass may be lost within a one- to two-week after the return to sea level. Therefore, in order to derive the benefits of the enhanced Hbmass after altitude training, the interval before the priority competition should be kept to a minimum. However, this decrease in Hbmass (and the associated sudden decrease in EPO) after an altitude training camp shows considerable variability across individuals, both in terms of time-frame and magnitude of effect. Contributory factors include the ‘sensitivity’ to hypoxia, and the interaction of physiological status (eg. iron status, inflammation), training load (before, during and after the camp) and the effect of altitude itself on exercise capacity at altitude. A better understanding of this variance and identifying the method by which these responses can be assessed with simplicity and rigour and before an altitude strategy is employed would offer great benefit to the athlete, coach and scientist.