Altitude training has long been the domain of elite athletes who travel to mountain camps for weeks at a time. But what if you don’t live in Boulder, Flagstaff, or St. Moritz? Can you still get the benefits?

The answer is yes. By understanding the physiological principles of altitude adaptation—low oxygen, increased red blood cell production, and improved oxygen transport—you can simulate similar stressors at sea level and build a more efficient engine.

So, how can you train for altitude… without altitude?

The Main Feature

Leg 1: Why Altitude Works—and What You’re Really Training

Training at altitude means training in a low-oxygen environment. The air at 2,000m (6,600 ft) has ~15% oxygen compared to 21% at sea level. Your body reacts to this hypoxic stress by increasing erythropoietin (EPO) production, which stimulates red blood cell growth, improving your blood’s oxygen-carrying capacity. That’s the gold-standard benefit: more oxygen delivered per heartbeat.

But that’s not all. Over time, altitude also triggers angiogenesis (creation of new capillaries), increases mitochondrial density, and improves the muscle’s ability to extract and use oxygen. These adaptations aren’t just for mountain races—they enhance endurance at any elevation.

The challenge: true altitude exposure requires 2–3 weeks to trigger erythropoiesis, and longer for peak results. Most of us can’t move to the Alps. But we can mimic the physiological stressors that altitude imposes.

What we’re really training is oxygen efficiency, red cell support, and the aerobic engine. That can be replicated—with the right tools.

T1: Mental Preparation

Leg 2: Simulating Altitude from Sea Level

There are four key strategies to create altitude-like stressors without changing location:

1. Heat Exposure Training in the heat increases plasma volume, cardiovascular strain, and core temperature—leading to similar cardiovascular stress as altitude. Heat forces your body to pump more blood to the skin, raising heart rate and decreasing oxygen availability at the muscle.

Protocol: 2–3 heat sessions per week (indoors or sauna post-workout). Target Zone 2 effort in a room above 28°C (82°F) or 20 minutes in a dry sauna after training. Hydrate aggressively.

2. Nasal Breathing and CO₂ Tolerance Work Breath control training improves CO₂ tolerance and encourages diaphragmatic engagement, helping the body function with less oxygen. This mimics the oxygen constraint seen at altitude.

Protocol: 1–2 breath-focused sessions weekly using extended exhales, breath holds, and nasal-only workouts. Try the BOLT score test to track progress.

3. Intermittent Hypoxic Training (IHT) While full hypoxic tents are costly, intermittent breath-hold work (such as 2–3 rounds of post-exhale holds during low-intensity walks) can provide a mild hypoxic signal. Some also use masks, although their true effect is more about restricted airflow than oxygen deprivation.

Protocol: Use during warm-up or low-load sessions. Combine with nasal breathing for best results.

4. Nutrition for Red Cell Support Support erythropoiesis by ensuring iron sufficiency and adequate intake of B12, folate, and copper. Low ferritin levels will blunt any altitude-like training response.

Protocol: Periodically test iron and ferritin. Supplement with iron bisglycinate if low (<30 ng/mL ferritin). Add dark leafy greens, red meat, and organ meats to support red blood cell production.

These strategies aren’t replacements for living at elevation—but they can induce enough strain to drive aerobic adaptation, particularly when used in phases across your training year.

Leg 3: How and When to Incorporate Altitude Simulation into Training

Altitude-mimicking stressors should be used in specific windows, just like intensity or volume blocks. If you’re peaking for an endurance race—especially one at elevation—begin integrating heat and breathwork protocols 4–6 weeks out. Use a progressive approach, beginning with light sessions and gradually layering in duration or complexity.

For general aerobic development, consider rotating altitude simulation blocks (e.g., 2 weeks on, 1 week off) during base phases or transition periods. Don’t combine these with heavy intensity phases unless you’re well-recovered—simulated altitude is still a form of systemic stress.

Example Weekly Setup:

• Monday: Zone 2 nasal-only session

• Wednesday: Sauna post-threshold run

• Friday: Breathwork circuit + iron-rich meal

• Sunday: Long ride with CO₂ breath drills every 15 minutes

Track HRV, resting HR, and sleep quality as guides. If recovery dips, pull back.

When done right, these tools make you more efficient, resilient, and ready for anything—even if your training ground is at sea level.

Conclusion

You don’t need a mountain to train like a mountain athlete. By layering simple tools—breath control, heat stress, and nutrition—you can build altitude-ready fitness from anywhere. Oxygen is precious. Learning to use less of it efficiently is an elite skill.

Coaches Corner

Workout of the Week: Hypoxic Endurance Builder

Goal: Mimic altitude constraints through breath control and oxygen stress

Warm-Up (10 min):

• Zone 1 cycling or running

• Nasal breathing only

• 3 x 30s breath holds after exhale (walk between reps)

Main Set (30–40 min):

• Zone 2 steady effort (65–75% max HR)

• Every 5 minutes: switch to nasal breathing only for 2 minutes

• Optional: final 5-minute push with mouth closed and reduced breathing frequency

Cool Down (10 min):

• Light aerobic movement

• Seated box breathing (4-4-4-4 cadence)

Tips:

• Keep intensity low—oxygen restriction is the stressor.

• Stop if lightheaded or dizzy.

• Log session notes on breathing ease, HR response, and recovery.