Volume 29, Issue 156, February 2025

Altitude training: Exploring the benefits and risks for athletic performance and health

Jan Karczmarz^1♦, Paulina Fijałek¹, Aleksandra Paprocka², Marika Gutowska³, Agnieszka Kosińska⁴, Urszula Świrk⁵, Wiktoria Belcarz⁶, Karolina Kalinowska⁷, Michał Orzechowski⁸, Joanna Orzechowska⁸

¹Southern Hospital, Rotmistrza Witolda Pileckiego 99, 02-781 Warsaw, Poland
²Jan Mikulicz-Radecki University Clinical Hospital, Borowska 213, 50-556 Wroclaw, Poland
³Józef Struś Multi-Specialist Municipal Hospital, Szwajcarska 3, 61-285, Poznań, Poland
⁴District Hospital in Chrzanow, Topolowa 16, 32-500 Chrzanow, Poland
⁵Independent Public Health Care Facilities in Przasnysz, Dr. Wojciech Oczko Hospital, Sadowa 9, 06-300 Przasnysz, Poland
⁶Murcki Hospital Sp. z o.o., Sokołowskiego 2, 40-749 Katowice, Poland
⁷Health Care Team of the District Hospital in Sochaczew, Batalionów Chłopskich 3/7, Chaczew, Poland
⁸Jędrzej Śniadecki Specialist Hospital in Nowy Sącz, Młyńska 10, 33-300 Nowy Sącz, Poland

^♦Corresponding Author
Southern Hospital, Rotmistrza Witolda Pileckiego 99, 02-781 Warsaw, Poland

ABSTRACT

The approach of altitude training has since become a popular method for improving athletic performance by taking advantage of the body's inherent response in a low-oxygen setting. These physiological adaptations, including increased red blood cell production, improved oxygen transport, and enhanced endurance, are due to exposure to hypoxia. Multiple altitude training protocols have been developed to maximize the beneficial effects of altitude, minimize possible performance impairments, and abate altitude acclimatization-related issues, including "Live High, Train Low" (LHTL). Outside of sports, altitude training holds medical potential. Studies indicate controlled hypoxia can bolster cardiovascular and respiratory health, promote neuroprotection, and stimulate metabolic function. But altitude exposure involves risks as well—such as acute mountain sickness and cardiovascular and cognitive strain—that require personalized protocols and greater vigilance. This review is focused on the physiological mechanisms involved in altitude training, its benefits for athletes and clinical populations, and the risks associated with hypoxia. By summarizing the existing research, we hope to inspire further optimization of training strategies and their applications within sports and medicine.

Keywords: Altitude training, intermittent hypoxia, endurance athletes, acute mountain sickness

Medical Science, 2025, 29, e41ms3533

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DOI: https://doi.org/10.54905/disssi.v29i156.e41ms3533

Published: 23 February 2025