Natural Highs: Replacing EPO with altitude in modern cycling
Lance Armstrong's doctor Michele Ferrari said, "Armstrong could have reached the same level without doping"
Looking through the numbers it's easy to see how it was possible to have achieved the same or similar performance enhancing results without resorting to illegal methods to boost your blood profile.
One of the most significant players in the infamous doping scandal that rocked cycling, Dr Michele Ferrari, was quoted that Lance Armstrong could have achieved the same blood results by using altitude training methods. He went on to claim that the increase in haemoglobin mass caused by using the methodology outlined by the riders who testified to USADA would have been possible through altitude training.
“EPO and auto-transfusions, in the manner reported by [Armstrong’s] teammates (micro-doses of EPO and 1-2 units of blood) correspond to an increase of Hb-mass by 5-10% for an endurance athlete weighing 75 kg, who has 9-10 liters of blood,” Ferrari wrote. “Such increments of Hb-mass correspond to performance improvements in the order of 3-6%. Equal increases in Hb-mass can be achieved with appropriate periods of altitude training".
Sleeping in an altitude tent set at 3,000 meters is a well-established method used by endurance athletes to enhance their performance, specifically through adaptations related to increased hemoglobin (Hb) mass and improved oxygen-carrying capacity of the blood. Here’s a breakdown of the information provided, particularly in regard to Lance Armstrong's practices, research findings, and comparative strategies for achieving similar blood alterations through altitude exposure:
Blood alterations from altitude training
1. Hemoglobin mass increase: It is well-documented that training at altitude promotes an increase in hemoglobin mass due to several physiological changes. As the body senses lower oxygen levels, it responds by producing more red blood cells (RBCs) to improve oxygen transport to tissues. This occurs through the increased production of erythropoietin (EPO), which stimulates RBC production in the bone marrow.2. Expected blood value alteration: According to the study conducted by the Australian Institute of Sport and published in the British Journal of Sports Medicine, individuals can expect an average blood volume increase of around 6.48% after approximately 41 to 56 nights spent at an altitude of 3000 meters. This alteration reflects the body's adaptation to hypoxia.
3. Comparative strategies: Athletes like Lance Armstrong utilised methods such as EPO administration and autologous blood transfusions to enhance performance by increasing hemoglobin levels artificially. These methods allowed for quick increases in RBC mass, but they also carried significant health risks and ethical concerns.
Sleeping in altitude tents is a legal and safer alternative. By simulating high-altitude conditions, athletes can naturally and gradually increase their hemoglobin mass in a controlled manner, which takes longer than EPO or transfusions but does not pose the same risks.
Benefits of altitude tents
- Natural EPO production: Sleeping in an altitude tent stimulates the body’s natural production of EPO, leading to increased RBC count and hemoglobin levels without the risks associated with synthetic EPO.
- Gradual adaptation: The gradual increase in hemoglobin mass through altitude exposure allows the body to adapt more effectively to elevated levels, potentially leading to lasting benefits in performance.
- Improved oxygen utilisation: As hemoglobin levels increase, athletes benefit from improved oxygen delivery to working muscles, which is crucial for endurance performance.
Conclusion
Altitude training, whether through sleeping in an altitude tent or training at high elevations, can lead to significant adaptations that enhance athletic performance by increasing hemoglobin mass and improving blood oxygen-carrying capacity.
The figures cited from the Australian Institute of Sport regarding a 6.48% blood volume alteration after 41-56 nights at 3000 meters illustrate the effectiveness of this training approach. Compared to practices like EPO administration and blood transfusions, altitude tents provide a safer, legally permissible method to achieve similar physiological benefits while minimising health risks
The strategy of combining altitude training camps with the use of altitude tents is becoming increasingly popular among endurance athletes, such as cyclists, as they seek to maximize their physiological adaptations to hypoxia (reduced oxygen levels). Here's an overview of how this approach works, its benefits, and its implementation:
Combined Altitude Camps and altitude tent use
-
Altitude Training Camps: These camps are typically held at elevations of 2,000 meters (m) or higher, where the lower oxygen availability stimulates various physiological adaptations, such as increased red blood cell production and improved oxygen utilization.
Riders participate in structured training at altitude to enhance endurance and performance. The combination of training at high altitude and the hypoxia experienced during physical activity provides a significant stimulus for adaptation. -
Sleeping in Altitude Tents: Athletes often use altitude tents to simulate high-altitude conditions while sleeping below 1,500 m. This allows for greater flexibility in training schedules, enabling athletes to recover adequately while still benefiting from the adaptations that come with hypoxic exposure. Sleeping in these tents can help maintain elevated erythropoietin (EPO) levels and promote additional increases in hemoglobin mass over extended periods.
-
Back-to-Back Training Sessions: By organising back-to-back altitude training camps, athletes can expose themselves to prolonged periods of hypoxia, maximizing adaptation. The stress of training at high altitude, combined with sleeping in altitude tents, essentially enhances the overall hypoxic stress on the body.
Benefits of this approach
-
Increased Hemoglobin Mass: The dual approach can maximise erythropoiesis (red blood cell production) and increase hemoglobin concentration, leading to better oxygen-carrying capacity, which is crucial for endurance performance.
-
Enhanced Recovery: While training hard at altitude, athletes can benefit from the additional recovery provided by sleeping at lower altitudes (when not in altitude tents), allowing them to train more effectively without the fatigue that might result from extended high-altitude exposure.
-
Longer Training Blocks: The strategy allows for longer training blocks in a controlled environment, helping athletes to accumulate more high-quality training time without excessive fatigue.
-
Diverse Training Stimuli: Alternating between high altitudes and the controlled environment of altitude tents allows for greater variation in training stimuli, potentially enhancing adaptations.
Considerations for athletes and teams
-
Altitude tents can Iindividualise responses: The physiological adaptations to altitude training can vary significantly among individuals, so personalised approaches are essential to maximise benefits.
-
Monitoring adaptations: Teams have for years tracked athletes progress through performance metrics (such as VO2 max or hematocrit levels) as well as blood lactate levels to evaluate the effectiveness of their altitude training strategies.
-
Nutrition and recovery: Proper nutrition and recovery strategies are crucial when participating in altitude training. Adequate hydration and iron levels are particularly important for optimising performance and adaptation.
Conclusion
Using a combination of altitude training camps and sleeping in altitude tents provides endurance athletes, particularly cyclists, with valuable strategies to enhance their performance. By maximising the physiological adaptations to hypoxia, these approaches help athletes better prepare for competitions and improve their overall endurance capabilities. As with any training strategy, ongoing assessment, monitoring, and individualisation are key to ensuring effectiveness and safety.