Sucking Wind: Running at Altitude

Check out the view from my hotel!

A few weeks ago it was February vacation week here in the Northeast, which for my family meant our third annual trip to the Canyons Ski Resort in Park City, Utah.  I did some running while we were there and marveled as I always do at how challenging even a 30-minute easy run seemed at 6,800 feet elevation.  On our second day there, returning from a run winded, sweaty and beat, I was teased by the bellmen hanging out in front of our hotel.  “Tough run?” one asked me.  When I agreed, he reassured me, “Don’t worry, you’ll be able to go home and run marathons after a few days up here!”

But was that really true?  Was I really getting any training benefit from the six days we spent in Park City, a mile and a quarter up in the sky?

Our bodies at altitude: At higher altitudes oxygen levels are lower, and our bodies need to compensate so our tissues can still get enough oxygen.  Our kidneys start producing more of the hormone erythropoeitin (yes, EPO, of Lance Armstrong fame, but we all make it naturally too), which tells our bone marrow to produce more red blood cells (RBCs) to carry oxygen around.  The higher up we go, the more EPO our kidneys produce, the more RBCs we make.  This was shown in studies sponsored by the USOC and USATF (Best Practices Recommendations for the 2011 IAAF Athletics Championships in Daegu, South Korea).  Then, when we go back down to the normal oxygen levels at sea level and run, we have lots of extra RBCs carrying extra oxygen, which bolsters our athletic performance.  No wonder spending time at altitude is sometimes referred to as natural doping!

In a post on the Runners Connect blog, RC founder Coach Jeff Gaudette wrote he has seen increases in EPO levels after as little as 3-4 days at altitude and that even a short 7-10 day stay at altitude can lead to some blood boosting.  However, in most of my research it’s generally agreed that it takes several weeks to gain a sustained beneficial altitude effect.  In the USATF-USOC-sponsored studies, 28 days was the time period in which a 1-5% improvement in 3K or 5K race times after altitude training was seen, an amount which was felt to be significant enough to affect race outcomes.

What the elites do: Interestingly, elite athletes do not spend all their time at high altitude during an altitude training camp.  As coach and athlete Kevin Beck discusses in his altitude series for Competitor, instead they “live high, train low”: 2-3 times/week more intense workouts are done closer to sea level, even though the athlete is living and doing most of his/her easy training higher up.  This is because athletes run slower and don’t use oxygen as well at higher altitudes, so if they did all their speed work at altitude it would be difficult to achieve the desired improvements.  Beck references a landmark study conducted in Deer Valley, Utah in 1996 in which this phenomenon was unequivocally shown.  In the USATF-USOC studies, the best elevation for “living high” was between 7000-8000 feet, whereas it was best to do quality training at elevations less than 4,000 feet.  Most athletes return to full-time sea level living 2-3 weeks before major competitions.

For fun, I looked up the elevations of some of the well-known training meccas of distance running and here is what I found: 1) Iten, Kenya: 8, 000 ft 2) Addis Ababa, Ethiopia: 7,546 ft 3) Mammoth Lakes, CA: 7,880 ft 4) Flagstaff, AZ: 7,000 ft. 5) Boulder, CO: 5,430 ft.  The USATF recommends altitude training in the US in Flagstaff, Park City/Deer Valley, Mammoth or Colorado Springs, all of which have nearby low-altitude sites for quality training.

If you are going to be running at altitude: All sources I looked at recommended iron supplementation before and during an altitude stint.  Iron is needed to make RBCs, so you will need extra since you’ll be making many more of these than usual.  Proper hydration is also important.  The low humidity characteristic of high-altitude locales, as well as the increase in your breathing rate that results from breathing thinner air, causes you to lose fluids more rapidly so you need to keep drinking to avoid dehydration.  As far as training, in a Running Times article, coach and exercise scientist Greg McMillan recommends reducing your running volume by 25-50% in the first few days you are up high, and keeping the pace easy even after those first few days of adjustment.  He recommends avoiding hill repeats or running at any pace quicker than your lactate threshold pace.  Jeff Gaudette makes similar recommendations, and also suggests increasing recovery time if doing any interval training.

Finally, Kevin Beck cautions against trying to take advantage of altitude training if you have a cold, as you do not make EPO well in this situation.  Since I had a chest cold during our entire vacation, this was sad news for me.  Oh well, there’s always next year!

Have you ever trained at altitude?  Where did you go, and was it helpful?

Mom of three kiddos and a black lab, running enthusiast, sports-med-doctor-in-training. I love the science and sport of running and all things related.

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  1. Did your runs feel easier when you got home? I live at 6400 ft., so when I race in another state, it’s almost always a decrease in altitude, which is nice. Hubby and I are doing the Bolder Boulder in May, and it’s always fun to hear people in the starting corrals talking about the high elevation while we’re smiling and thinking it’s a 1000 feet lower than where we live. 🙂

    1. Yes, running did feel easier when I got home, though not as easy as I was hoping for as I was still coughing a lot from my cold. 🙁 Do you live in the mountains? That must be so neat – AND great to have that respiratory advantage!

  2. Great piece! Thank you for the research. Went I went to Peru in 2010, I was deathly afraid to even try to run (highest elevation was 12,000ft). Just walking to our hostel when we first got there was a workout! That was a weird/neat feeling for sure. Scary at first. After a few days, it got easier but I would recommend to anyone at higher altitudes to take it easy for at least a day or two before trying to run. And for what it’s worth, I didn’t run when I was there, too scared! Haha, but my friends did and they were fine.

  3. Thanks! I cannot imagine running at 12,000 ft – I think I would have been scared too. But probably there was some great hiking to be done there!

  4. There are lots of things to consider when running in altitude. I have to take water and Gu if I will be out for anything over 7 miles–in Ohio, no problem. The sun is much more intense, and I can wear short-sleeves if it’s sunny and only 40. My intervals are slower than back home, and I do notice I am faster when I go down to sea level. Although–running at sea level is easier for the aerobic system, it can be tricky because you feel good, run harder, then realize your turnover is quicker and you may not have practiced quick turnover as much. This is what I fear at Boston this year, especially with the downhill start.

    The humidity is so low! When going to other places, it’s so noticeable that it can affect your running and racing. A few weeks ago on my long run, my sinuses were so inflamed and sore. Turned out the humidity was 7%!!!

    The elites do it right–train high, do intervals at lower elevations to take the cardio vascular benefits of altitude training and playing with leg turnover.

    When visiting for the first time–good rule of thumb is to not worry about pace since everyone adapts differently.

    And, with low iron, I cannot afford to miss my iron supplement! If I miss 2 days in a row, I’m done!

  5. Great post Rebecca. I found your blog while looking up altitude training articles. I train athletes at altitude for a living. One newer strategy that I employ during training camps is to combine heat exposure after the first week at altitude. Numerous studies show that EPO production starts declining down to baseline after the first 5-7 days. Physiologists are not completely sure why this happens, but it is likely a combination of ventilatory compensation driving up Sp02 and hemoconcentration. Interestingly repeated heat exposure in saunas has been shown to increase RBC production by 3.5%, and the author’s presumed mechanism was a compensatory response to increased blood volume (a major adaptation to heat acclimation). Incorporating sauna or sweatsuit training when EPO starts to decline after that first week may help maximize gains in RBC production by attenuating hemoconcentration’s role in suppressing EPO prod. One study on rugby players has shown that heat combined with altitude can result in longer lasting gains in RBC count after sea-level return. Again, this may be a sign of the same mechanism–larger blood volume tricking your body into not suppressing EPO production. I hope this wasn’t too nerdy and you found some benefit. I am seeing some serious performance gains in my athletes. Keep up the good work.


  6. I spent a week in Colorado in December (Boulder and Steamboat, so altitude) and came back to sea level in time for a trail 10k. I have to be honest, I expected to kill it…but I didn’t feel any different. Heartbreaking 🙂

    Thanks for the info on preparing for altitude – I’m doing a relay in Colorado this summer and I’ll need all the help I can get!