There is no doubt there is a benefit to training at high altitude…. if done correctly. There’s a great book I recommend in order to be well-informed if you ever decide to utilize high altitude–“Altitude Training and Athletic Performance” by Chief Physiologist at the Olympic Training Center in Colorado Spring, Dr. Randy Wilber (don’t know why the book is so pricey now, but it is well worth it). I’ve trained at high altitude several times and responded well every time, going back to when I was a hobby jogger doing research in Montana in 2003.
Not only does the research support utilizing high altitude, but the best marathoners in the world have all utilized high altitude and/or altitude tents. Bill Rodgers said in a recent podcast (listen here: Bill Rodgers and Co podcast) that he thinks the reason why the Africans are better than his era of runners is because of being born and trained at high altitude. How much of a difference does it make? According to the research in the book, there’s great variability of performance improvement, 3-33% (~seen with runners, cyclists, and skiiers)– that seems like a lot, when extrapolated to the marathon (3% = 4.8 minutes for a 2:40 marathoner). From my personal experience, I believe it to be a minimal drop of 2-4 minutes in the marathon amongst elites, if done correctly.
Below, I will take about the key factors to getting the greatest benefit from high altitude training.
There is research showing there are “responders” and “non-responders” to high altitude. I strongly believe the reason for this lies in iron-status. If your ferritin is low or even low-normal BEFORE you go to high altitude (lets say below 50, according to the research), you will have a difficult time responding positively to the high altitude. Ferritin is the protein used to store iron and is used when needed to make oxygen-carrying red blood cells (RBCs), one of the main benefits to high altitude. At high altitude, you have a surge in your endogenous production of erythropoeitin (EPO), which stimulates new RBC formation. If you don’t have enough iron to produce RBCs, you will have a difficult time responding positively to the high altitude. Thus, it is important to get your ferritin checked beforehand (try: www.healthcheckusa.com) and to load up on iron before and during the high altitude stint. I previous did a very detailed blog post about Iron Supplementation .
My personal experience is that at high altitude and with the kind of mileage I do (120-140+ mpw), I have to take 1 1/2 tsps of liquid iron in OJ every day. My first time living and training in Alamosa, CO (2008), I found that taking iron pills 3-4x/week and eating lots of red meat wasn’t enough– my ferritin was low-normal (41)after a month of being there– I felt like crap in workouts and races. Once I got onto the liquid iron in OJ every day, within a week I had dropped 10 seconds off of mile repeats and went onto to run a 10K PR at 6,000ft.! Contrarily, while training at sea level I only have to take the liquid iron in OJ 3-4x/week. I discovered this through trial and error.
How High You Should Go
The research says you need to go up to at least 6890 ft. and below 8200 ft. to ensure a positive benefit. If you go lower than this, you may or may not respond and get the full benefit of the high altitude. If you go too high, it may hinder recovery and not allow for solid quality/speedwork training. As an example, when my hubby and I went to train in Boulder, CO in the summer of 2004 (5430 ft.), he was very marathon fit, while I was only somewhat fit. I responded very well and had great performances in the fall at sea level, while he did not. We believe the Boulder altitude wasn’t high enough for him to get a physiological benefit. On the other hand, we have both had great success living and training in Alamosa, CO (7544 ft.), going up to Fort Garland, CO (8000 ft.), and some intermittent training at Rock Creek Rd. (up to 11,000 ft.).
Below is a list of the altitude of some popular training locations in the US (as listed in Altitude Training and Athletic Performance, but I corrected the Boulder altitude). Of course, this isn’t all inclusive. If you have the option to go live and train somewhere high, check to make sure it’s high enough to ensure a positive benefit. Some of the surrounding areas to the places below ARE above 7000 ft.. Otherwise, if you take a gamble and train lower or higher than 6890 ft.-8200 ft., you may waste away 4+ weeks of your time and not get the positive benefit (like my hubby with Boulder).
Albuquerque, NM– 5,000 ft.
Fort Collins, CO– 5,000 ft.
Denver, CO– 5,280 ft.
Boulder, CO– 5,430 ft.
Colorado Spring, CO– 6,100 ft.
Flagstaff, CO– 7,000 ft.
Los Alamos, NM– 7,240 ft.
Santa Fe, NM–7,260 ft.
Alamosa, CO– 7,544 ft.
Park City, UT– 8,000 ft.
Mammoth Lakes, CA– 8,000 ft.
How long you should stay
The research says you need to stay a minimum of four weeks at high altitude. My personal experience is that I start to feel fully adapted to the high altitude (Alamosa, CO, 7544 ft.) around 6 weeks. This has been a consistent finding with the two times I’ve gone to train there. The first few days I feel great, and then I seem to “bonk” between 1-3 weeks (~having to adjust hydration, sleep, diet, recovery, etc.). Between 3-5 weeks my training picks up and gets consistent. By 6 weeks there’s a noticeable “boost” in how I feel, such that the high altitude no longer feels as stressful. By that point I see a fitness improvement and start hitting times/splits comparable to sea level (which of course means my sea level pacing will be even faster). I like to do a high quality sea level race about a month after being at high altitude.
Personally, I like to spend 2 months at high altitude. This ensure I’ve gained the benefit, adapted, but not stayed too long to get stale/overtrained. I’ve stayed for up to 4 months, and I didn’t find any additional benefit beyond 2 months. If your iron status is good BEFORE you go up, you will adapt very quickly and like myself, see a positive benefit around 4-6 weeks. If you feel like crap after a month+ at high altitude, I can nearly guarantee it’s an iron issue or overtraining/underrecovering.
How long the benefit lasts/When to come back down
As stated in the book, there’s great individual variability in how long the high altitude benefit lasts when you return to sea level. The research supports a benefit of up to 3 weeks. However, this may be because the research studies (at least as presented in this book, 2004) hadn’t looked at blood parameters beyond 3 weeks. Considering RBCs have a lifespan of 90-120 days, the benefits may last up to 3-4 months. Personally, I feel the benefits last about this long.
However, besides the RBC gains, the high altitude also enhances respiration (~strengthens the lungs). When you return back to sea level, this enhancement appears to last only a few days before returning to “normal” (as mentioned in the book and what I’ve personally found to hold true). For this reason, I believe it’s best to plan a big race within a few days of going down to sea level. Some recommend spending 1-3 weeks at sea level and then racing (~working on leg speed, adjusting to the heat/humidity at sea level). However, I find I lose this respiratory benefit fairly quickly and start to feel tired lethargic within a week (~maybe a hydration issue). I’d rather stay in a consistent living/training environment at high altitude, drop to sea level, and race within 48 hours.
Having done a few stints at high altitude, I’ve experienced several different living options. When we lived in Boulder in ’04, we found a room to rent in a house on Craigslist (fairly cheap). We lived with a few post-grads.
In ’08 and ’09 in Alamosa, you can read about my experience in my previous blog post . I lived with some people we know and also lived in a crappy motel room with a kitchenette for nine weeks. Alamosa is very cheap for cost of living. Being a small town, it has easy access to trails and amenities. However, I had to drive to get mountains and hills.
Definitely, cost of housing and living can vary from place to place, $500-2000. If you’re really on a budget, it helps to network with friends to find a room to rent in someone’s house. We did Craigslist and took a risk staying with people we don’t know. If you’re going with a group, you could probably find a condo/house to rent and split the cost. I like the motel/hotel living (~Extended Stays), but of course you want to be careful and make sure you’re not staying somewhere shady. It helps to be close to trails, esp. if you don’t have a car. A lot of high altitude places are fairly far from major airports, so definitely take that into consideration.
Live high-train low, or Live high-train high?
The research supports the “live high-train low” method, as the best way to get the benefit of the high altitude, while also retaining and working on leg speed. However, this may depend on the individual, physiological makeup, the event you’re training for (need more speed/turnover?), and the feasibility of training low. Only a few places in the US (Flagstaff? Santa Fe?) may allow for the ability to live high enough and be within decent driving distance to train low.
As a marathoner, I’ve had no problems doing the live high-train high routine. I do a good bit of short interval speedwork/strides at high altitude to maintain turnover, while also doing some strength work (but not excessively, as to hinder recovery). I’ll talk about the training aspects below.
Considering the research support for live high-train low, altitude tents have allowed a lot of athletes utilize this concept while at sea level. I will discuss my experience with an altitude tent as well.
How to train
In terms of intensity, everything you do at high altitude is slower for the same effort. You have to think about the high altitude as another “stress”– it adds an element of “resistence” to how you feel, feeling like you’re always running into a 40 mph headwind (~when you’re running beyond an easy pace). Considering this added stress, it’s very important to emphasize the recovery (~easy days between, slower easy day pace, longer recovery between intervals, less intervals and and slower, not as much long/hard threshold work)– it’s easier to become overtrained at high altitude. Resting and submax heart rate are elevated– I found a difference of around +4 beats for resting HR, and +5-10 beats for easy runs at the same effort as sea level. According the book, max HR is equivalent or slightly lower at high altitude compared to sea level– however, I still keep my progression run range the same (80-90% of max HR).
We believe in focusing more on the effort than going by splits. However, as a reference, the book states that mile intervals are 7-9 seconds slower (I find it to be ~5-7 seconds slower). Because the intervals are slower and more stressful, it’s a good idea to consider lengthening the recovery– we go with at least 1/2 or longer for the recovery (~tack on another minute or more for 1-2 mile repeats).
The great thing about high altitude is you can better sense your anaerobic threshold and learn to stay below it– this may be one huge advantage for those who train at high altitude. Longer threshold runs are exponentially slower (10-20 seconds per mile slower…. gets more difficult the longer you go)– I prefer to do these with a heart rate monitor rather than pace (see previous post about Heart rate training and HR based progression runs . The heart rate ranges are the same as sea level, but of course the pace is slower– I stay between 80-90% of HR max. The recovery for longer threshold runs is more difficult compared to sea level, so you have to be mindful not to go too hard/too long/too frequently with these runs. I haven’t done more than an hour for these runs.
Considering everything is slower, it’s a good idea to focus on short intervals, strides, and drills to help maintain turnover. I like to do all-out strides barefoot on grass twice a week, 10-12 repeats with walking recovery. I also try to maintain a regimen of drills twice a week. I’ll do 90 second pickups on the roads 2x/month and also some steady rolling hill runs 2x/month. You could also find a long downhill for doing intervals or long threshold runs, to achieve a comparable pace to what you’d hit at sea level. When I first get to high altitude, I like to focus on shorter and slower intervals first (~minutes workouts), to adjust to the high altitude– within 2-3 weeks, I’ll progress to the beefier 1-2 mile repeats (preferring up to a max of 3 x 2 miles…. anything more or longer is very stressful).
Hills– does the town/city sit on the side of a mountain or in a valley? If you’re going up and down, every day, twice a day….. that’s going to be quite stressful to the body! We like Alamosa cause it’s in a valley and pancake flat. It’s easy to recover. You have the option of driving to mountains/hills (Fort Garland, Rock Creek Rd.) when you need to… not running them every day and killing yourself!
In terms of volume, there’s various methods mentioned in the book. It’s definitely a good idea to cut back your volume somewhat (not really a set number) to let the body adjust to the stress of the high altitude. When I did a stint in 2009, I cut down from 125 at sea level to 110 the first week at high altitude. I got back up to 120-130 fairly quickly and held it there for most of the 9 weeks I was there. In 2008, I ran 98 miles the first week (wasn’t as well trained at the time), and ran less mileage for four months. It’s up to the person on what they can handle. We find that maintaining the frequency but cutting back the duration of runs is an effective way to cut back the volume. I’ve heard that aerobically/stress-wise, running 120-130 mpw at high altitude is equivalent to running 130-140 mpw (or more) at sea level.
The book goes into great detail on the physiological impact of the high altitude on recovery factors and metabolism. As I mentioned, iron is of upmost importance– both supplement and eating red meat a few times a week (plus, meat is a source of B12). I buy a bunch of steaks, chicken, and ground beef and freeze it. The biggest thing you’ll notice when you first go up is how thirsty you get! It’s definitely drier, and there’s a greater need to hydrate. I always believe it’s important to have a mix of solutes. I feel better when I go up to 11,000 ft. if I’m hydrating with Gatorade– keeping the blood sugar up. Plus, chewing gum can help the ears. Generally, you need more of everything– carbohydrates, fat, protein, micronutrients. You feed your body what it feels like it needs.
The altitude also makes you sleepy– the high altitude is a stress, and the body needs more growth hormone (while you sleep) to balance it out. When I first went to Alamosa in ’08, the first month I was sleeping excessively (3 hour naps every day) and very lethargic, likely because of my low-normal ferritin. Once I got on the liquid iron, my naps got shorter and I had more energy. Definitely pay attention to things like this– you shouldn’t be dragging all the time.
I should add that I’ve had issues with the dust and hay fever (with drastic weather changes) while at altitude. My nose and ears got stopped up, right before Twin Cities ’09.
Going from high altitude to sea level for the first time can be a rude awakening with the heat and humidity! It’s a HUGE factor, esp. for the longer events. When we trained in Boulder in ’04 (mind you, lots of Olympians preparing for the Olympics), we’d see packs of Africans and Asians training in full track suits in July (while most casual Americans were shirtless)– I didn’t understand the reasoning for this at the time, as I wasn’t a serious runner. Of course, once I became more serious in ’08, I figured it out!
I previously did a blog post about heat training . This has, by far, been one of the most beneficial elements to my training and performance the past few years. Like the high altitude, it adds another layer of “stress”– you have to gradually build up to more layers and let your body adapt. The key is developing a layer of sweat on your skin that will keep you cool and not evaporate. It takes at least 10 days to adjust. As I mention, the biggest factor for understanding how one place compares to another is dew point. Having lived/trained/raced all over the country, the Midwest/East/Southeast is far and away steamier than the Southwest/Mountains/West Coast. Having endured heat exhaustion a few times (including Chicago ’07), this is something to not take lightly! You’ve got to overprepare. We just moved back to Oklahoma (July 2011), and despite the 100+ degree days, it feels “cooler” (and obviously drier) here compared to Indiana.
You definitely get more radiant heat in the mountains/Southwest (more exposed, closer to the sun!), so you have to protect your skin more diligently (see pic above!). This is another reason for wearing the added layers!
Longterm impact of living high
There’s been recent research suggesting that living high permanently/longterm is actually detrimental to endurance performance. However, this is a finding in a special population– I’m not aware of any longterm studies with endurance athletes. As stated in the following ,
“…an extended stay at altitude can bring a loss of the muscle’s ability to use oxygen to carry out work. The number of mitochondria, the oxygen-using powerhouses of the cell, falls with a prolonged stay at high altitude…. Studies of metabolites present in calf muscles under light exercise also indicated that CP patients experienced greater fatigue. Finally, there were differences in expression of metabolic genes in the CP patients’ muscles. This could suggest their metabolism makes less efficient use of the fuel available and may explain their reduced exercise capacity. We found that the metabolism of CP patients is different and leads to poorer physical performance and endurance,’ says Dr Formenti.
Given the above and as mentioned in the article, there might be a limit to how long you should stay at high altitude to optimize the benefit. The research supports a minimal stay of four weeks. Personally, I didn’t feel any added benefit beyond two months (stayed for four months). Thus, it’s probably a good idea for the permanent elite athletes in the mountains to spend some time at sea level. However, from my own experience the biggest adjustments to sea level training is the higher heat/humidity and the fact that you can run much faster for everything…. easy to get carried away!
My experience with an altitude tent
Not everyone can move their life and training to high altitude. To leave a spouse, kids, job, and home behind isn’t feasible for everyone. High altitude tents have allowed many sea-level runners to get the benefit of the live high-train low method, without uprooting their lives. I’ve been amazed to find out how many of my elite runner friends have one of these, but you don’t see many talk about it (is it taboo?)! I want to transparently talk about my experience with one, so far.
I absolutely do not see anything ethically wrong with altitude tents. It’s no different than other ‘technologies’ such as treadmills (~Northerners getting in speedwork and heat training in January), indoor tracks, sweatsuits for heat training, AlterGs, or strength training equipment…. an endless list! It’s a matter of fairness to those who don’t have the opportunity to live and train at high altitude. I’m also not aware of any detriments to your health, beyond what you normally experience at high altitude.
I purchased an altitude tent this year (January 2011, used, made by Altitudetech) to test out for myself. I decided to try the altitude tent, so I wouldn’t have to spend any more time away from my hubby. I used it from late-January until late-April. It was fairly difficult and complicated to put together the first time. We set the altitude fairly low (5,000 ft.) the first day and gradually built up to the max of 10,500 ft.. We’d sleep in the tent (~8-9 hours), and then I’d nap and spend as much leisure time in it as I could. I kept a water bottle in there and fit a standing fan through the velcro to circulate the air. It gets fairly warm/humid, so we cranked down the house temperature and closed the vents. We moved the generator to another room so we couldn’t hear it (the low hum really isn’t that bad).
The first week of using the tent my breathing felt pretty good and body felt good overall. However, over time I noticed myself feeling more and more tired, having breathing issues, and my legs felt abnormally sore and heavy on some days. I was trying to up my iron intake as well (my ferritin was great when I started, 92). Granted, I was running a lot of marathons, travelling a lot, and dealing with the emotional stress of losing a friend. Combined with the “stress” of the altitude tent, it may have been too much for the body to handle all at once. I consulted with the Altitudetech owner, who suggested I only use the tent on recovery days and not on workout days. I started doing this and felt like I recovered better. However, I still was having breathing issues (at rest and during races and workouts).
After getting checked out for asthma/allergies/heart, I finally decided to ditch the altitude tent and see what happens. Within a few days, I noticed my breathing was returning to normal. It was as if the tent was causing me to hyperventilate and affecting my lungs. I wonder if I’m claustrophobic, as I’ve had an issue before in a camping tent? I have not used the tent since, and my breathing has been much better.
Contrarily, my hubby had no problems with the altitude tent. In fact, he felt like it helped his breathing and made him feel really good on his runs. But of course, he wasn’t training and competing at the same level. We concluded that he may be someone who thrives on a “live high-train low” regimen, while I’m someone who needs a consistent living and training environment (“live high-train high”). My body is very sensitive to environmental changes. Apparently you can buy a mask to hook up to the generator, which allows you to basically train on a treadmill at “high altitude”. I haven’t gone this far yet.
I’m not up-to-date on the research with altitude tents, and there wasn’t as much research available when the book was published (2004). Theoretically, it should allow you to live high-train low. It may depend on the individual whether they respond to this stimulus– something you have to try for yourself. It may also depend on how you apply it and what time of the year (base training?). I was applying it at a time when my body was under a lot of stress, which may not have been ideal. We are keeping our altitude tent for now and will continue to experiment with it. I’d love to hear others experience with an altitude tent and whether it worked for you.