Acclimatization Strategies, Part 2: High and Extreme Altitude

00:01.56

Alyssa

Hi everyone, welcome to the uphill athlete podcast. I am here with Martin Zohr for part 2 of talking about acclimatization strategies for high and extreme altitudes. So, Martin thanks for coming on part 2

00:19.47

Martin

Hi Alyssa, I’m glad that we can finish this one and talk about the higher levels of how did you at this time. Okay.

00:29.24

Alyssa

Yeah, I feel like that’s when people think about Altitude. They really start thinking about these areas and it gets pretty Exciting. Um and a little bit daunting I think for a lot of people to know how to handle the really higher. Higher elevations that we’re gaining So I’d love for you to touch on what more traditional acclimatization strategies have been and kind of the essential history of what we’ve done in the past and where we are now.

01:04.91

Martin

Yeah, yeah, it makes sense I think to mention for those that the listeners that haven’t maybe um, listens to all the podcasts before we spoke about altitude physiology and then some of the strategies. That are more applicable for lower moderate altitude like last time but also why do we need these strategies right to start with ah like how the altitude affects our body and our physiology and why is it important right? So, but maybe back to the basics. Ah. Ah, why do we need it? To climatize is first ah first of all really to avoid any um, any sickness. Ah so and that that is of course the one very important point because the higher we go. The more the body struggles to get the oxygen in because of the lower barometric pressure. It’s really hard and harder for the four-hour lungs for our body to extract the oxygen molecules from the air to our 2 to the blood. So um, that is the main challenge. So of course, the body is trying to adapt to it acutely. So, for in its sense is the hypoxia There are first adaptations. The higher heart rate increased heart rate the hyperventilation and then the whole cascade of adaptations that eventually actually.

02:20.19

Alyssa

Um.

02:33.69

Martin

Um, level off and allow our body to somehow function at that altitude. But it comes sort of at a price and if you kind of push through that process too fast if you go up the up to higher altitudes too fast without. Giving the body sufficient time to adapt can definitely backfire and you can you already feel some effects already on your performance of course. But then things like headache dizziness nausea vomiting and then actually more severe. Ah, symptoms like acute mountain sickness are the first one that actually is with actual sickness and then more severe HAPE and HACE which are high altitude cerebral and pulmonary edema and those are very serious and potentially illegal. Ah conditions. So, we definitely want to avoid that. That’s actually the first right and that can actually that can really happen and often happens for people that who don’t know and I will talk about that actually with feed people athletes that actually.

03:48.73

Martin

They like to push themselves that might be actually that the factor where is like oh I’m just I’ll be fine I’m sure I’ll be fine. Ah I know how to push myself my body will handle it and so you know that so happens that they just push in all of a sudden, you’re run into trouble, and you start to feel these adorers’ effects. So. Um, yeah, I think for everybody, it’s good to just know what is happening up there and what to expect but then whatever what are the traditional acclimatization strategies is ready to take it progressively to do sort of greatest. Ah, send to higher levels now we then talk actually about the high and extreme altitude so compared to the last time in the last podcast we spoke about at moderate ah de dude maybe maximum for four or five thousand meters um but here we actually are talking about the higher mountains like the great ranges. So um, the Karakorum and Himalayas but also Denali um to some extent rainier. But I think it’s maybe kind of that borderline. But.

04:54.40

Alyssa

Not so yeah.

04:58.81

Martin

Maybe Aconcagua and these mountains like above five six thousand meters that’s really you know, considerable and we need to really make sure that the body has enough time to actually acclimatize. It’s really that kind of altitude that will affect our performance a lot and so um.

05:17.48

Martin

So yeah, I mean people have been climbing these mountains ah for many decades now. But even maybe a century when people actually started to go there for some kind of research, or I know that there is here in Chamonix where I live these explorers and researchers because before Chamonix. And it was just postures and glaciers where all the way down the valley was super wild, but nobody really was going up to the mountains because well why would you.

05:53.50

Martin

Um I guess the tourism or mountaineering really is the minor main reason why actually millions of people potentially go to these altitudes and so naturally people notice the adverse effects of altitude on the body on the health on the performance and they notice they’re okay. You really need to slow things down, you need to slow down the pace you need to slow down. Um, you’re a progression on the mountain and so that’s actually where we talk about the first strategy related to do the slow ungraded ascent. Um and the kind of common rule that is that is ah. That is kind of taken for granted these days is about five hundred meters um elevation gain per day. Ah, what is it in feed. Maybe that’s good to know him just because of that.

06:41.83

Alyssa

Um, yeah, so that would be. It’s about three thousand feet

06:49.50

Martin

It’s maybe 1600 double

06:50.56

Alyssa

Ah, know it or I’m sorry yes, three hundred meters is about totally off three hundred meters is about twelve hundred feet so we’re probably talking about like tooth.

07:01.88

Martin

I think sixteen hundred feet yeah, yeah, but I think it’s really usually when you go up those valleys like for example, Kumbu Valley where many people are now going to east base camp and.

07:04.39

Alyssa

2006 yeah maybe a little bit more than 1600 maybe like 1800 yeah

07:21.48

Martin

That’s really now the season so you are going from Lula where the airport is you land there and then you start walking up this long valley and naturally that ascends at the incline of the trails and the way the valley goes you are. Naturally doing like ten fifteen kilometers and abouts about that elevation gain and naturally then you stop in the village and the guides they will guide you there like they will not push you further because ah, of course you can go all the way to Namha bazar which is then the main village up there. Ah, but that’s ah more than two Thousand meters elevation gain so that for most people already most likely would bring some effects some bad symptoms bad sleep and headache and stuff like that. So, you really want to avoid that and just take it day by day and gradually. Ah, gaining that altitude. Um, but possibly then because your body is of course going through that process of acclimatization we talked about before it’s quite a stressful process. It brings a lot of oxidative stress as well. In general, to be at that altitude. There is more of the oxidative stress than usual and so and it’s really good to take that into account and take it easy. Take an extra hour a day. So usually, every 2 or 3 days you actually stay at that one or 1 place and take it easier.

08:53.77

Martin

Or you just reached that bigger village like Namche Bazar for example, and you stay there for one day one night extra and then you just do the daily hike above usually people go to that Everest hotel view which is actually the first point you see Everest from there. So, other mountains of course Amma Dablam and, that’s actually the first moment you see it’s quite emotional it can be um, but then you just come down back to the village and you sleep an extra night at that lower altitude. So, um I guess that’s really what this. The basic strategy is. And then eventually if you we’d talk about Everest, so the Everest base camp is to five thousand three hundred meters at least on the south side in Nepal and so people usually take ten twelve days to actually get there. Ah and so on the way they.

09:50.51

Martin

Maybe go on these acclimatization hikes and so again they reach a village, and you can always do like a five-hundred-meter elevation gain hike above it. There are so many trials around so that’s usually the strategy and you just kind of walk around the trails. There are a lot of tracking options. There. Um, and you really are gaining more and more altitudes. So, starting at Lukka in Lokelani is 2300 I believe two thousand three hundred meters, so you are really then moving to 7000 meters and so most of the valleys are at that level and you are just gaining more and more. That acclimatization. All those adaptations increased hematocrit which as we talked before takes days and weeks and it actually keeps increasing and so ah, by the time you reach a basecamp. Um as I as I said it was it is around. Thousand three hundred meters altitude so by the time you should be acclimatized to that level and then of course that’s the first stage that’s really the first 10 days two weeks and then you’re okay to this if you really speeded it up and you were straight. You went straight to this level. Most people would get saved or some people actually even died when they tried to, I heard about and actually about people who just ran up there in 1 or 2 days without acclimatizing at all and um, yeah, went badly.

11:26.48

Martin

They just died in their sleep or something ah the body just didn’t do it so it can definitely happen and so that’s why it’s really important to take it slowly. Um I think what I would like to say it might be actually possible to get there faster but again then.

11:26.87

Alyssa

Wow.

11:44.64

Martin

Back to the timeline of adaptations. The whole cascade of adaptations that happen in the body. What is important to understand and maybe just remember um they take days and weeks and months some of them, so it just really embodies the time and.

12:02.77

Martin

And just follow along and once you get there then yeah, that’s the next stage actually to of course acclimatize to the higher levels on the mountain.

12:13.79

Alyssa

Gotcha so what for traditional strategies say we’ll do what does it look like timewise for Denali, Aconcagua and then 7000 meters and higher and then eight thousand meters and higher. What are those odd? Time. What does that time look like?

12:35.57

Martin

Well, um, it’s ah, kind of naturally evolved actually that the expedition companies even offer the trips for a given time, and I think it’s actually just ah the least amount of time. That is sort of healthy I think because you know everybody would just get there. Get it done and go home. Ah, but ah as I mentioned last time we talked about one Blanc. For example, that you know people actually come here and some of the companies or guides they take you up there in four- or five-days ah

12:53.49

Alyssa

Um.

13:10.40

Martin

Some of them. Are you an inch for a time and it’s you know, just really, um, playing it not very carefully but it may be that one extra day like first 1 or 2 wo days You just go through 3 three thousand five hundred meters to acclimatize quickly. But it’s really just that first one day or 2 and that that will allow you to not actually get sick. So. It’s really that first point discovered not to get sick and just get to the summit. But of course, you cannot expect miracles your performance will be average. You might actually feel not so great if you sleep in the hot your or your sleep who might be really bad. So. I would definitely recommend to ah to come to Chamonix and just spend here at least one week and really to climb some lower mountain and acclimatize so when we then talk about a higher mountain like an Aconcagua so when I was there a couple years ago, I was there almost twenty days and that that was quite enough time to acclimatize. Um logically but also, I wish I could actually stay there longer because also for that performance I knew that I was still acclimatizing. But let’s say for Aconcagua most companies I think aim for about two weeks sometimes three weeks but the permit for the mountain when you enter the national park on Aconcagua, and then you leave the park, so you have twenty days I think that hasn’t changed since I was their last time. So.

14:42.10

Martin

That you as you can be there twenty days so also logically, they must know that that’s enough for this almost seven Thousand Meter Mountain for people to be acclimatized. But yeah, just knowing that some companies will try to make you summit in maybe ten days to twelve days um Aconcagua definitely is known for bad water. It can be super windy, so you need to wait for the summit window especially with the wind and Windchill the cold or sometimes even snow of course. But then you know if you really are running out of time then you have to just kind of throw this all these things. Acclimatization strategies that are ideal just throw them out of the window kind of and then you just go for it even though you know that you’re really, um, still not exactly acclimatized, but the strategy up there is really ah, similar to what I just talked about for with Everest base camp. So. You arrive to about three thousand meters by car and then you start walking to trekking up the valley. Ah, and you really gain maximum six seven hundred meters to the first camp the next day people usually stay there actually to leap and then you walk ah do this trekking trip over to the south side of Aconcagua come back. Ah, to the camp and stay there I think it’s about 3000 to maybe seven hundred meters I don’t I don’t remember exactly but you’re still, you’re still staying the I safer zone and spending an extra day and then day 3.

16:13.64

Martin

You are walking towards the basecamp which is 4300 on this on the on the blooded muss side and so naturally you’re just gaining gradually that ah that altitude again as we talked about that’s the ideal situation and from there you usually take an extra as they and. From there. You do the rotations come back to the base camp and that’s already like day six day seven so that one week is done naturally and then you actually start going up the mountain yet usually the companies don’t mess around. They actually start the um.

16:46.44

Alyssa

Um.

16:50.44

Martin

The ascent of the mountain camp to camp. Um and they tried to summit so it really goes quickly. So yeah, then I think it’s usually it’s really, ah, quite a fast ascent. So, for my clients who are preparing for Aconcagua, in this case specific mountain.

17:10.33

Martin

Ah, because it is a tough one. It is a big mountain, and it doesn’t feel like it. It technically isn’t any. It’s not difficult but it is really high altitude and so I try to prepare the clients before that, so you actually are pre-acclimatizing. So, you actually are trying to spend some time in the real altitude or the simulated which we will talk about later Denali. Usually, the companies or people go there for three weeks Denali. of them so you really want to be ready physically that’s a whole different.

17:48.29

Martin

Level how to prepare. But I think there were other podcasts talking about specifically Denali. What would it take? What factors are really the determinants of performance there but that’s look about the altitude. So. Ah, you are landing on that glacier first and that’s not really high very high I think it’s about 2 three thousand meters and then you gradually go up but the physical effort there is very important, so you need to really be ready for that. Ah, you are pushing your surface way hard. You’re carrying your weight I mean you’re.

18:23.00

Martin

Wait and like the backpack everything all your equipment you usually are carrying yourself and pulling it in the slut. So. It’s a huge physical effort and actually then you’re doing that graded in a sense to the higher gams. But usually, you have quite a little lot of time to acclimatize. But still the combination of everything, the weather, the colds, the conditions there. Ah you want to really make sure that you’re ready. But I think most of the companies manage this quite well with the timing for to acclimatize. So that is just good to know that now that the timeframe is about 2 three weeks so that should be enough again as we talked about it before um altitude as it’s a function of the barometric pressure. Um the further you go to the north or to the south on earth. Um, the biometric pressure changes. It’s related to the temperature of the air so the colder it gets and the lower the pressure the hotter the air gets I mean the yeah, the gas actually the gas molecules. Um, are denser with heat. So, we can. We’ve been. We observed that actually mountains for example, equator close to equator the altitude doesn’t feel the same as the Ali then all is really far up north and it’s very cold. So um, even if it’s.

19:56.99

Martin

Um, lay six thousand two hundred meters it definitely feels like a 7000 at least. So, it’s quite good too good to be aware of that and on these on these on these on these on these mountains and then we. When we then talk about higher mountains so anything higher than an Aconcagua is in Asia, so Aconcagua is the highest mountain outside of Asia, so all the seven Thousand Meter peaks and Eight Thousand Meter peaks are either in Pakistan in Karakorum.

20:27.61

Martin

Or Himalayas and then some of them also in the in the in Kyrgyzstan and those countries so bemire there I think there are five of them just know that of course now we talk about the extreme altitude anything above seven thousand meters is very serious and so you definitely need to spend more time. To be acclimatizing to those to those levels. So, I would say at least three weeks but if not more because all the travelling, usually the mountains are quite remote, so it takes a while to get there and then you get there. Maybe after one week leaving your home. And then you’re actually only at the base camp. So, then you really need to acclimatize. Usually, it’s quite a traumatic elevation gain from the base from the base camp from the valley floor to the top. You got to 3000 Mets, sometimes even more on some of the mountains and so.

21:23.21

Martin

You can imagine then the ascent will take a long time and more and higher and higher you go the effect on your performance will be more serious and so you just need to invest more time. So normal ascent of arrest. For example.

21:40.99

Martin

Um, even with supplemental oxygen ah takes at least six weeks but usually it’s 7 eight weeks

21:46.81

Alyssa

Yeah, it’s not. It’s not a short commitment. You’ve got to be willing to put in the time plus all of the training before that. So yeah, I think it’s good to be realistic in that regard.

22:02.74

Martin

Definitely um I think then you know we in up a lot of lead. We have our clients at leads who are aiming for these mountains so we naturally talk to them about this and so I think it’s also worth mentioning.

22:19.86

Martin

How far away from the actual climb Should you start with training right? So actually, also is a function of that the higher the mountain the more serious it is the bigger. The bigger the factor of Fitness is so um, you know its definitely worth it.

22:39.10

Martin

Work starts to work properly and really starts to understand. Ah how your body works and then because all that fitness will go down with altitude or that’s the tricky bar right? So, you definitely want to arrive at the mountain. As fit as possible because that capacity or Aerobic capacity. Um, and the whole fitness will be um yeah will be cut down and so um, it’s really definitely worth of 2 Prepare as much as you can.

23:14.76

Alyssa

Absolutely yeah I mean I think I can probably speak for most coaches when it is very relieving when you have a client that says hey I have a long-term goal of climbing Everest in a couple of years versus hey I want to do it in six months it’s just a. Ah, more realistic timeline also shows. There’s a deep level of dedication to thinking long term versus the more immediate gratification of it a shorter time. Zone.

23:47.89

Martin

Yeah, definitely I think it is ah like ah quite a big educational aspect of this job that we tried to do here and it’s also the part I actually like a lot you know, just try to show the people show the clients my athletes though what it takes. And actually, pick some different mountains to actually build that build up that level won the physical, the physical preparation but also of course mountaineering is ah is a sport where the technical aspect is super Important. Um. The scales and all that management gear knowing yourself in in you know, just really being able to deal with the conditions and so yeah, it’s multi factorial and so it definitely helps if we have enough time.

24:40.65

Alyssa

Yeah, yeah, no, there’s ah, there’s so many pieces to it but 1 of those pieces which I think is a great place to touch on is cardiorespiratory fitness for all to 2 mountaineers high.

24:41.21

Martin

Ah to build out right.

24:57.45

Alyssa

And can you get into what is like an upper athlete. We don’t talk a ton about v o two max, we tend to focus a little bit more on lactate levels. But in this case V O Two Max is a really interesting way of measuring ours. Fitness in um, also altitude has a significant effect on v o two mac so love to hear more about that from you.

25:23.69

Martin

Yeah, that’s exactly and I think Uphill Athlete we mostly tried to maybe emphasize the importance of the of the sub maximal performance, right? So mostly that zone 2 ah and then maybe some of them. Higher intensity. But what is most important for most people? Of course it’s individual, right? We deal with each ah with each athlete individually. But what do you really need to have been a large aerobic capacity but the Vo Max really what is what is the maximum aerobic capacity so how much oxygen can you actually. Ah, get ah gets to your body distribute and utilize right? So, it’s the maximum actually defining your gun of the cap. The top of your aerobic fitness and so of course ah we will never better likely that we will note. Do that on the mountain where you will not be reaching that level or you’re the intensity. Ah, but of course you will always be at that like a fractional utilization which is which is more or less the blockage threshold or below or some percentage of it right. So, I think in that sense. It’s useful to know what your VO2 Max actually is first of all but compared to other endurance sports. Um, it’s less of a factor that’s I think where we come coming from with an uphill athlete so because like running in.

26:57.57

Martin

And you’re with incur sports running cycling in low altitude. Of course, science says that the main determinants of performance are the VO2 max, the fraction utilization which is the luck they threshold and the running economy or cycling economy. But here. Let’s talk about what actually happens then at a high altitude. So that’s where research has been ah the researchers’ scientists, they have been actually testing it for as well since the beginning since actually the climbers went up there and just really trying to find out what was going on and so I think that’s. There are some fun points just to realize what actually happens because I already spoke about the aerobic performance generally going down generally actually for all people it just going down. It hits you right? So again, back to the biometric pressure is decreasing. What does the effect is actually the density of the molecules of the air of and for 1 the oxygen that is the 1 we need and so um, all of a sudden when you’re at five Thousand meters for example so if I’m not mistaken here. It’s about 60% of the biometric pressure. It doesn’t exactly correlate to that you’re on 60% of your aerobic capacity. But I think you can imagine and it’s pretty close that you’re almost on a half when you stand on Everest without utilizing the supermajor oxygen that of course affects. Everything.

28:31.90

Martin

But without oxygen you’re on 30% of barometric pressure compared to sea level. So, imagine then if ah, that affects your aerobic capacity by that largely which actually doesn’t exactly work that way so you can imagine that you definitely want to have you. Aerobic capacity as high as you can because you will be at a various you will be working at a very small rate of it. Ah, the higher you go right? So, it’s in your best interest to have the best possible aerobic capacity and the maximum. Is the Vo2max so it has been um in the science there. There are some interesting numbers that when we go above fifteen hundred meters our Vo2max decreases about 2% to 3% every three hundred meters of the additional increase. So, it’s going down. It’s going down real fast if you if you if you start counting right? So um, and then ah, um, some other interesting numbers that if we are at in five Thousand Meter level um so

29:45.47

Martin

Then we talk about the maximum uphill rate speed. So, for me I’m really working at that level so when I’m train running when I’m doing my training workouts in the mountains here around Chamonix or on the mountains, I don’t really measure my speed on my watch by minutes per kilometer or. Minutes per mile I guess because that’s usually what you do, right? When you’re doing, you’re running on the flat. That’s the metric to go for, right? But in the mountains that doesn’t really make much sense. So, it’s really good to know when you’re in the mountains. Ah, what elevation you gain.

30:21.80

Martin

You do it per hour. That’s usually the metric you can actually choose on your watch. It’s super helpful for me. So, I know that if I’m going at Thousand meters per hour that’s sort of my zone to more or less depends really of course the higher I go then actually goes down, right?

30:33.77

Alyssa

Um, interesting.

30:38.10

Martin

Ah, when I’m doing my races uphill races vertical races then of course this number goes up but it’s really good for me to know super useful number. But then when I wasn’t now in Nepal for example, and I was running and at that altitude around five thousand meters then you can really see how is that changing right? If I was at 800, I was happy you know, and I could see that if I pushed 2000 which is normal speed for me here in in Chamonix which is thousand two thousand meters like down in the Valley. Ah. Definitely doesn’t feel the same at that high altitude. So. It’s just good to know that for most people when you’re hiking with your backpack. Of course you have some weight of your gear. So ah, usually people are hiking around three hundred five hundred meters of elevation gain per hour and. That actually you can measure in the lab that this requires some oxygen like oxygen utilization the metabolic cost of that exercise, right? So actually, based on that the researchers said that the must around 50 milliliters is actually ah per minute per kilo is actually what is required to be able to do that speed at five Thousand meters so that’s actually giving you some idea because you can actually go to the lab you need to go to the lab. Actually, that’s the only way to have a precise.

32:03.78

Alyssa

To do it.

32:08.53

Martin

Assessment of your maximum aerobic capacity. Your max. So maybe that’s actually something that people can do and just to see okay I’m at 40 so that probably will be fine for five thousand meters but if I want to climb at five six thousand and I still want to do a solid speed then I will need to do something about it and so. That’s where the training comes in and you can. You can definitely improve your max by training right.

32:34.56

Alyssa

Yeah, absolutely I am curious so say because fifteen hundred meters is not that high are their labs that are at or above fifteen hundred meters that people are being tested at. And how do they account for the decline? Do you just say they add 1 % to this because we’re at seventeen hundred meters or do you know as much about that?

33:08.60

Martin

And that’s ah I think that’s a good question I don’t really know but I think at least in my area here I know that the lab close to Chamonix is down in the valley actually and it’s 700 met at the bottom of the valley. The city actually is in Thousand meters

33:16.38

Alyssa

Okay, yeah.

33:23.20

Alyssa

Okay, so.

33:25.95

Martin

Altitude and it might have a bit of effect I guess ah you know, based on what we just talked about so um, but I think it’s really only just a couple of you know the number will be very low and so I think logically the universities. That’s where usually the labs are with sports science. Ah, center or the performance lab. You know they need to account for this because ah as we talked about it in the last podcast the fifteen hundred meters actually really marks maybe the eighteen hundred meters ah kind of marks that level where you are actually going for a training camp for an altitude camp right? to get those. Additional gains. Ah usually getting ready for the increased hemoglobin and actually pushing your vo2max by that you’re actually increasing your oxygen carrying capacity of your blood so that actually increases the vo2max so in that sense, I think. Those test centers would tell you? um you know, oily speaking but I guess in the states might be different some of the cities ties where the universities are they are actually at the at these altitudes and it might be tricky but then I think we tell you definitely.

34:33.80

Alyssa

Kind of about that. yeah, I would be curious especially in Colorado I mean 1 of where Sean tells our director of coaching went is quite a bit over fifteen hundred meters so

34:41.28

Martin

Ah, from.

34:52.32

Alyssa

But to check in with her about what they accounted for on that. Um, but yeah, I’m sure there’s a formula somewhere. Yeah, any last pieces you want to touch on with improving V O Two max and how that can boost.

34:53.70

Martin

Yeah, it’ll be interesting here.

35:11.89

Martin

Yeah, so again I don’t want yeah people to think that you know I did the Vo2 Max is ah something that you absolutely need to improve. Of course you want to? but again there is a whole lot about training, right? So, you definitely want to spend the most of your time as Most endurance Athlete least do anyway with so-called polarized training, I mean maybe of course that can change but ah with different scenarios, but polarized training means that you really are spending most of your time in the lower zones. Let’s say low moderate zones of intensity really are trying to work on your aerobic endurance and that’s definitely sub-minimal that also improves your pom max but actually then there are specific ways to improve that vo2max that that like on top of your aerobic capacity. By doing high intensity work. But I don’t want people definitely not. Don’t think that it’s the only way that’s the only thing you should do that would be wrong and you would yeah that that would be a bad plan but just ah I think it’s good to touch on that and just to um.

36:22.46

Martin

Just to have some numbers there in your mind. What actually does it take and so for example for Everest climb which is the highest mountain. What does it take to climb without oxygen so and you know we mentioned this before, but I think until that until this. Time or until today it’s about 8000 people who climbed it but most of them climbed it with supplemental oxygen which really kind of brings you down to maybe fifteen hundred maybe two thousand meters slower right? So, the air d the oxygen you’re breathing actually brings you lower. And that’s what allows most of these people to actually climb that mountain without supplemental oxygen is quite a different beast or actually entirely so only two hundred around two hundred people have succeeded. It’s a big undertaking and very risky and. But it takes a lot of physical capacity. Ah, but again I think what is important maybe just to put a conclusion. There is VO2 Max is really just one part of it. The just I think it’s just good to mention and talk about it a bit. Um. In general, you really want to be as fit as possible when you go for these mountains and for that high altitude. But then let’s talk more about that acclimatization and what’s going on and which adaptations you need to actually survive and be able to function and then could go fast right? because.

37:54.30

Martin

If you’re not fitted if the people are not fit and go up there so again that uphill speed gives you pretty good idea where you are so if you are at low altitude and you are not even making maybe three hundred meters per hour of elevation gain on some steeper hike on some steep incline right? so. Ah, you know that it will take you quite a long time to actually go from point to a point b to the next but nitro from camp to camp. So, imagine what it will take you 6000 years for example then you’re just taking too long, and it will be dangerous, and it will actually be probably impossible that the way the body.

38:32.13

Martin

Reacts to that altitude and how that altitude affects your performance is so big So important then you really need to make sure that you are faster and faster to add to be safe and to actually make it to the top.

38:44.82

Alyssa

Yes, no, it’s so key I mean when we are talking About. We’re not just talking about hey I finished the race faster we’re talking about very direct living or dying in extreme situations. So yeah, it’s crucial when we’re really. Getting into these much higher altitudes so that I think takes us to the use and effects of intermittent exposures to simulated Altitudes. So, we’re going to get into a simulated aspect of Altitude Training. We’ve talked about how we can do it with more just going up to higher elevations. What does that look like? So now we’re going to talk about hyperbaric and Norma Baric Chambers Norra baric. Ah, let me pause this again. Okay, ah.

40:21.33

Alyssa

Perfect. Awesome! Okay, yeah, all right? So that leads us perfectly into one of the main topics of the conversation today which is use and effects of intermittent exposure to altitude. So, Martin, can you take us? Into this.

40:43.80

Martin

Yes, ah so now that we know what time it takes to acclimatize to these big mountains. So, then we can actually create a strategy where we pre-acclimatize, right? so. Usually these make mountains take so much time you have to really spend so much time over there that you might just want to try to acclimatize before if you can if you have that opportunity and so that you don’t need to spend weeks and weeks and meet sometimes months. Ah. And in those mountains. So, for most people this is of course a big deal because you’re just away from your business, from your life, from your family etc. So definitely there are strategies to get around it. So, I guess there are 2 options 2 to 2 options were. You live close to the mountains, so you actually have that real altitude available. So, then we actually talk about the intermittent exposures to altitude in most cases because you’re not really spending all your pure time in hypoxia in altitude but what actually matters is the hypoxia right the hypoxia y is that that’s what the body senses the body doesn’t sense I’ll did you as such. It’s actually hypoxia. So, the reduced amount of oxygen that you’re breathing, and the body senses it. There is a lot less oxygen in the blood and that’s actually.

42:09.83

Martin

Ah, the reaction and the cascades of those adaptations starts to happen. But then imagine you go to the mountains for the weekend or even for a couple of hours you take the lift up to here in Chamonix you go up to Aguille du Midi which is three thousand eight hundred meters and you ski up there but in. 2 3 4 hours later you back down in Thousand meters elevation and as we talked about it. That’s not really significant enough to bring any of these adaptations. So, then we’re actually really talking about the intermittent hypoxia so can that work is that enough. Well, that’s a huge chapter. Ah.

42:47.31

Martin

Look about it and we cannot really cover it here. So, I just want people to understand that yes to some extent you will be acclimatized if you live here for a season or you just live here for long-term or places in Colorado I guess where you are actually living already at significant altitude. Actually. Um, is that enough or you know how much you need then is will that be enough to when you are planning to go to Aconcagua. So, for example, I had clients that were going to Aconcagua this last season in January February and so we actually plan for some extended weekends or. One week actually they went to ah places this in Colorado where they were actually in the hotel in three thousand meters so that was actually real altitude exposure also being able to combine it with a really good physical training right? You all of a sudden have great options going for the uphill hikes. Etc. so you know combined. It’s a great benefit combined benefit to actually spend time in the real altitude pre-acclimatize but again there are some costs too. Of course it costs you money. But that’s where the strategy comes in, so we talked about it extensively. This will be the best strategy because the athlete is really worried about how he’s going to respond or she’s going to respond to altitude. Um, yeah, it really is different scenario some of my clients they live at altitude and at 3 closes to three thousand meters so for them it’s a huge advantage.

44:23.12

Martin

Um, of course so and so that’s one kind of chapter where you really want to consider. Ah what are your options? How much is it going to cost you and also is that enough actually is it actually enough of that altitude exposure for you to climatized and acclimatize enough then. That is when you fly to the mountains then to the big mountains and to a foreign country. What can you actually expect are you to what level are you acclimatized already. Then there is a second chapter which is the normal barrack one. So maybe we can discuss. But.

44:57.94

Alyssa

Yeah, let’s get into what are the different types of simulated altitude that someone who doesn’t have access to getting these mountains or at least needs to supplement. What are their options?

45:13.90

Martin

Yeah, I think that actually most people don’t live in the mountains, right? at the biggest cities they are close to ocean. Not really the mountains and around the world. So ah, but it doesn’t mean that you don’t go and climb the big mountains. So how what can we do about it of course want to. The best option is ah again to go to the mountains and they just maybe move to mountainous area. But it’s not always possible of course so actually there are nowadays so-called normal Barak um hypoxia generators. Ah. Why normal barra. So, when we talk about hypobaric hypo means in general something lower right? So, Barak is actually the pressure in this case, the atmospheric pressure. So hypobaric hypoxia is actually the hypoxia caused by the lower atmospheric pressure which is the case in the mountains. Normal barrack is that something is normal so it’s ah that the pressure stays the same, but the hypoxia is actually um is actually created artificially by generators that actually change the ratio of the molecules in the air. So, um. Usually well usually around us the air we breathe if we are at sea level, or we are at five Thousand meters or we are actually on the top of every app doesn’t matter. There is always around 21% of oxygen molecules out of all the molecules of the of the gas’s different gases.

46:45.84

Martin

The most prevalent is nitrogen, that’s about 80% and then there is a very small fraction of the other guesses that are not really important right now. What matters is the oxygen. So, what are these generators actually doing here? They are actually increasing the ratio of nitrogen and reducing them. The oxygen so you’re going from 21% to then lower fraction and I think if I’m not mistaken around 10% level is about five to thousand meters, so every percentage of oxygen has corresponding. Simulated altitude. You’re trying to simulate altitude by reducing the oxygen, right? So, there has been this has been this has been used for a couple of decades now. Ah so there are also actually chambers that ah actually are. Ah, functioning as ah as a well kind of training facility or being used for research some of them are actually hypobaric so they actually are reusing the pressure in there and then actually affecting or causing the hypoxia. But that’s really rare actually that’s ah, that’s very expensive and very complicated to make and usually is done for a use for research, but what is actually the most used is the normal baric one so you are then changing really the ratio of the moles and that you can find the facilities now in the gyms.

48:17.58

Martin

Um, commercials for gyms. They already have that there are actually ah different uses for this as well. Not only to prepare for high altitudes just saying that you can actually ah prepare for your trail race or just basically trying to increase the stress of the exercise by ah, but you also know you’re in the city at sea level and you are just. Go to the gym and you will run two thousand meters so you can expect that there will be some additional effects to it. But now what do we? What do we can? actually how we can use this in our scenario when we prepare for the big mountains right? So, there are also generators that you can bring home. And you connected to um to a mask. Um that you put on your face, and you breathe this hypoxic air, or you have a tent and you put it over your head. It’s like small version or it’s basically big tent over your bed and. Generator is actually changing the air and you’re actually in hypoxia. So um, this is the norma baric hypoxic strategies where we actually can be training at home and of course intermittent hypoxia because you’re not staying there all eat all day right. That’s impossible or I mean that would be pretty extreme and why is it important to talk about it like in a way that it’s intermittent is that when you go to the real mountains you go to the Valley. You start at 5000 meters wherever it gets you to.

49:51.92

Martin

You get there by playing with an apiculture or just you know by car or whatever and then you start going up that altitude and actually you’re staying there, right? So that’s the important part where actually the use of Hypoxic tans or the chambers is that you spend some hours in there. And then you get out and you’re breathing the normal the normal error of course so this is the important distinction to ah to realize and so it still Works. We of course do these like and its sort of like an interval training. We do hypoxic training and then we. We Work. We spend the day out and let me go back to it and then of course it’s important to know does that work to what extent How long do I need to do this. You know and that that’s ah, that’s the whole different chapter.

50:42.75

Alyssa

Yeah, that’s much more specific to the individual. The goals of the expedition. How high you’re going. You know there’s so many factors that we can’t you know say do Xy and Z and be in it this many hours and such and give you a prescription on a podcast. Ah, but that’s where people like Martin come into play where you can use him as a resource by hiring him an athlete um, many of the guiding all ah pretty much all the guiding companies have some kind of protocol have the means to allow you to pre-acclimatize.

51:22.00

Alyssa

But I’m curious How has it been shown that hyperbaric Hypoxia and Norma baric Hypoxia work. You actually seem to have some pretty cool facts of like pay it does work.

51:39.20

Martin

Yeah, of course so you know usually the research works that you take a group of people you test them at the base level. So, of the low altitude and then you take them to some whatever Mountain Hut or yeah to. Actually, the basecamp or other places where you can actually really do the study in a comfortable way and really compare the base level base level and then the high level or you do the protocol or lead the test. You actually do that? um. In the lab, right? So, where you actually are using that normal varying hypoxia. But I think it’s good to just mention. Um, what? what? they have found or that there’s been so many studies about this but just to actually see what the effect is so um. For example, five days per week um of Hypoxia for 4 hours which was actually hypobaric in this case so we’re not actually talking about that lower atmospheric pressure. Ah that actually improved the aerobic performance so actually doing some kind of physical testing right? You are doing some biking. And they were measuring some metrics to actually evaluate your performance. So, the first day in that hypoxia was really bad. You know your performance went down but after this exposure to the hyperbaric hypoxia ah that it improved ah quite significantly like by a large number and.

53:13.31

Martin

Then the am so that’s usually the acute mountain in sickness you evaluate it. You basically have a questionnaire the like whose cool questioner is usually the 1 you use so you basically are kind of taking off the do you have any symptoms right? So ah, that’s the best evaluation. If you’re experiencing mountain sickness to some degree and so ah, when you actually are taking these people who are not acclimatized to about 3000 years but higher it is of course than most of them actually will get sick. Um, after. This last one week of Hyperbaric Hypoxia there were zero symptoms, right? So, it actually shows you that after several days maybe one week ideally and longer. Um the main effect as we talked about it right? The Ams just disappeared so it really works. Um, I think the most what the people ask more often is actually does that normal baric work compared to the hyperbaric 1 right? The wetness we know that when you spend some time in the re mountains in the real altitude. Ah, you will acclimatize very individually because ah this is actually something. We keep mentioning that um acclimatization process is a very individual and we don’t exactly know why the scientists are still trying to really figure that out. What is it? What is it about? It’s not only a 1 factor but it’s not about physical fitness.

54:47.89

Martin

To be physically fit. We encourage everybody to do that when you go to the mountains. It’s a big factor but it’s not the only one you know it’s a like I’ve seen it on funny. It was an amenity I used to work up there for twelve years and that’s really nice. Nice kind of testing.

55:05.40

Martin

Testing situation. You take people from the time they arrive here. They laid on the bus or whatever and then like oh let’s go up there. It’s amazing. It’s going to be amazing view and stuff and so from 20 minutes it takes to three thousand Eight hundred meters I mean the amount of puke I’ve seen in my life over there has tried impressive. They can tell you get wonderful sometimes but it’s just normal and people find that they just collapse right there on and on the spot you kind of open the door of the lift and then you are at three thousand eighty hundred meters really it takes you that fast within 20 minutes on a busy day you go from Thousand meters to almost four thousand meters and so it was just amazing to see that you got ableness like people sporty young and then you are you have old people. Well actually the.

55:58.28

Martin

Those the alpinist fainted sometimes the old work So that’s actually where it’s in involved me realize that physical fitness definitely helps. But it’s not the only thing you know it’s ah it’s there are there are definitely some.

56:12.98

Martin

Many probably many factors in the body that need to be there and that’s where the individual response to altitude is and it’s good to know it’s well to be aware of that. Um, yeah, do 2

56:28.70

Alyssa

Yes, so let’s okay, we’ll take no, that’s great. Um, okay I actually wanted to ask you So now. We’ve heard that hyperbaric works are amazing. How about Norma Barrack What if what if they found because that’s probably on the more there’s more skeptics on that side than the hypobaric.

56:56.21

Martin

Definitely um, people definitely have been skeptical and still are of course because it’s kind of strange right? You are how does that work. How does that machine work? It’s sometimes very uncomfortable to use that. Also, you know it’s not the same. Of course it’s not exactly. It’s not the same as the real altitude as that thin air. We call when we actually go to the mountains. Ah, but there have been many recent research studies on that and some of them actually didn’t really find much so there may have been some skepticism about that. But nowadays, um, we can actually confirm that it works to a large extent. Leading and guiding people in the big ranges and right now it’s Everest and actually now they are our collaborators. We have been helping them with the physical preparation of their clients and so they are actually using the hypoxic tense. To prepare the clients for so-called flesh expeditions. So. It’s actually a situation that I talked about, right? So, for example, every Sd you need to be there more or less eight weeks two months to be on the mountain to acclimatize slowly with that graded ascent all the way to the base camp and then.

58:23.73

Martin

Slowly going up the mountain of course then it really takes a long time and so for many people. It’s actually not possible and so using actually that pre-acclimatization in an in the tent where you’re actually in your home you set it up. Of course it’s not nothing. You have to still. Work around it, prepare it and know how to use it. But it’s a day for adventure. Specifically, they have been using it for many years now and with success they are able to bring their clients to the mountain and help them basically go straight to five Thousand meters or base basecamp level. And basically, start climbing to a higher level. So um, but yes of course it’s a very complex thing. You really need to know how to do that, right? It’s again, the individual approach there is important as I just talked about and. So, you cannot have one like a 1 approach for any and but for everybody right? Otherwise, it would be simple. You just follow a simple protocol, and you just send it to everybody the same thing and that’s not how it ah.

59:30.54

Alyssa

Doesn’t work like that. No.

59:34.80

Martin

And worldwide that and actually can really black wire and that’s where maybe some of the skepticism has been coming from but yes there ah this is requires quite a specific notch. But again, this this is working and so um I think it’s pretty fascinating and yet so just saying this. As an acclimatization strategy or more like a Pre-acclimatization Strategy is very important and I think for some people might be very interesting.

01:00:03.91

Alyssa

Definitely and within so you’re working on the protocol. What are some of the variables that you are monitoring that people should be aware of?

01:00:16.42

Martin

Yeah, so I think most people already are using usually when you go to the mountains there um in in Nepal or the great ranges. Ah not only Nepal of course. Ah, the best is to have that bow ox meter which is the c clip. Ah you put it on your finger, and it measures your heart rate and saturation, right? So that’s pretty much the cardiovascular parameters. The basic ones. How is your body responding to that altitude heart rate? Um, we know now that that’s one of the first acute adaptations of the body to root that the way it reacts to altitude to hypoxia, so it goes up right? The increased heart rate. So, you can already see that your resting heart rate is much higher than it is at the sea level or back in back at home. Ah, saturation is really how much ah, how many um red blood cells are saturated with oxygen um, and so usually it’s around 90 I Eight ninety nine percent sometimes hundred but it’s actually usually actually not in that nine high ninety s ah the levels of situation at sea level. Um, and in the medicine when you are in hospital and you’re in some bad situation. The doctors measure this continuously. It’s super important and if it goes below eighty-five, I think that’s the level where they put you on oxygen or you know they.

01:01:33.35

Alyssa

Yeah.

01:01:44.83

Martin

It’s a really kind of important borderline between you being okay and then not so okay so um, in in that I altitude this is actually happening naturally so already at 2 three thousand meters you’re probably somewhere around 95 maybe 92 and then higher you go, you can expect that it will actually start dropping down but with that graded acclimatization. You are actually trying to stay within some healthy range but knowing also that some kind of hypoxia so which is showing in that lower saturation is important. The body is actually adapting to it. But that’s where also it’s good to know. Okay, my sat situation is 85 I don’t think I should go up tomorrow I should actually at this level, or you have a person that is really struggling, and their situation is 75 and well logically they are struggling even like being super pale and really kind of.

01:02:42.78

Martin

But not there completely so you need to bring them down. It’s a really good metric to measure always and I definitely encourage everybody going to high altitude to start testing this again. It will be slightly individual but naturally then even if you’re acclimatized then. And you are actually going for your summit push on these big mountains so you’re sleeping maybe at the highest kemps at six thousand sometimes seven thousand met depends which mountain. Ah, you know your situation will not be very high but your kind of you’re already acclimatized. You are your body is actually able to support. That this set the saturation and so you’re able to handle it. You’re not feeling great but you’re not getting sick. That’s the main difference. So yeah, I think the heart rate saturation and then in the process of the acclimatization whether it’s in the. Mountains or you are using that hypoxic band. It’s actually really the time spent in hypoxia, right? So, between those different strategies like going ready to you leave for you leave for those mountains and you’re up there all the time so you’re actually. Leaving that mountain really is spending training and also living high so those different strategies train high live high. So, the time is counting right? But then if you are in the situation when you are going to the mountains only for the weekend, right? So that’s actually as I told you.

01:04:16.83

Martin

Time in Hypoxia actually matters when you’re not in hypoxia. Well, your body will not be really adapting so much so you really want to be aware of that you want to really know okay is that enough or not so that’s where you should get in touch because we can help you out. It’s not 1

01:04:35.94

Martin

Way to say this. So um, yeah, ah, this is the important metric and that also actually is the case with the with the tense or with the normal, Barric Hypoxia So You are actually trying to accumulate the time and that how much time is that demand. Um, there are many things to talk about that and kind of also keep it safe of course so please ask someone or get in touch but or talk to those companies that actually are using this these strategies because they know how to and there are many details that are really very specific. But yeah, this is really. Those metrics are the most important. Um, yeah, I guess.

01:05:17.60

Alyssa

Perfect. Yeah, is the way that’s now that’s amazing and I think it’s really helpful for people just to know when to ask for help as well of like helots is not let’s just guess on or look at something. Briefly on the internet and decide that that’s going to be how our rule go about this any last things you want to touch on before we wrap this out.

01:05:47.89

Martin

Um I Guess maybe it’s worth mention. Ah, that Also nutrition is very important during acclimatization, right? So, in order for us to Acclimatize. What is actually happening to the body? One of those adaptations is the hematological. Adaptations, right? So, increasing the Hematocrit the hemoglobin the red blood cells and what is important there is iron levels and ferritin. So. It’s really good to do some blood work test blood work or testing talk to specialists or coaches that know how to. And why and what are the levels that you want because it definitely affects. Actually, your capability your capacity to Acclimatize. Um, because if you are on low levels and that can definitely happen already with extensive endurance training or with women. Ah, women athletes. Definitely There’s so many cases where the iron levels are low and so if you are actually preparing for a month and I would definitely encourage you to do that Also to some extent inflammation in general that can come from different sources but also has. Has a negative impact on acclimatization Processes. So, you know you see that there’s a lot going on but it’s just well to start that work really way before the expedition to talk to people who now talk to us talk to our team.

01:07:17.21

Martin

And we know we get you started, and we can. Can we really tell you? Okay, what is the best strategy already and make the plan.

01:07:27.38

Alyssa

That’s fantastic and we do have an episode with Alyssa, who’s our nutritionist on staff, talking specifically about altitude because there’s a lot of considerations that come into play when you are going much higher than usual. So yeah. Thank you, Martin, for all of this wisdom. I think we’ll have you on a couple more times without them throughout the series. So, thanks for sharing your wisdom today.

01:07:58.38

Martin

Thank you. It’s been great to talk about mountains again. And yeah, I’m happy to share and all this and just free feel free to get in touch and there’s so much to talk about and maybe just the last point where for athletes that are. And trying to actually go out fast. There are there are differently more and more people who are trying to challenge themselves in them in altitude and actually extreme altitude whenever we talk about ah fkts fast. It is known time but also some races there are more and more of these that are. Ah, Trail Races Stage Trail Races like in the ball there. There are many of them now. So, you really are actually trying to perform at a higher level and so that’s another topic we don’t have time to discuss today. But you know what? What to do then? how to acclimatize and actually. Prepare your body for an excessive effort performance and then level.

01:08:59.83

Alyssa

Yeah, the plan is to touch on that in a future episode So you’re foreshadowing it. Well yeah, that’ll be fun. Yeah, it’s exciting I mean it’s pretty incredible that not only are we surviving but we’re trying to excel.

01:09:07.38

Martin

As it’s made of.

01:09:18.20

Alyssa

So, I think that’s a pretty amazing topic to cover comes with some trials and tribulations though we’ll say but.

01:09:26.53

Martin

Yeah, naturally I think yeah, we that we are We are athletes, and we are looking for the challenges and so yeah, um, anyway, think now I physically mountains. So.

01:09:33.72

Alyssa

Yeah, yeah, me too. Well thank you Martin and thank you for listening to the uphill athlete podcast if you could rate review or subscribe on your favorite podcast platform that helps us help more athletes be safe in the mountains. Thank you for listening and it’s not just one but a community we are a full athlete.