Introduction to Altitude

00:00.00
Alyssa
Hi everyone welcome to the Uphill Athlete Podcast our mission is to elevate and inspire all mountain athletes through education and celebration. My name is Alyssa Clark and I will be your host today. We’ve been brewing a fantastic new season for you. And I’m thrilled to introduce the first episode in our new educational series on all things altitude for our first episode I have 2 of our altitude specialists on the uphill athlete team who are joining me to provide an introduction to altitude. Chantelle Robitaille and Martin Zhor have extensive knowledge in education in altitude training effects considerations and more thanks for being on you two.

00:43.66
Chantelle
Thanks Alyssa! Great to be here.

00:47.87
Alyssa
So before we get into our kind of introduction to Altitude episode I’d love to hear from both of you of what drew you to study altitude and its effects on athletes.

00:48.99
Martin
, thank you me too.

01:04.58
Alyssa
And what your background is in these studies and actually like kind of what is your specialty within altitude because it’s a big topic.

01:14.48
Chantelle
Yeah I would agree. It definitely is a big topic and yeah, we could probably well we will be talking about this for days. I got into studying altitude since I was living in Switzerland once upon a time and doing a lot of running and skiing and things like that and I was also coaching ultramarathon runners and as much as I understood a lot of physiology. What I really didn’t feel I understood enough was the physiology. The impact of altitude on. Physiology and also on athletes at exercise, especially when they’re working really hard in races and so I actually changed careers completely I was sort of a part-time coach and full time corporate woman wearing heels and business suits. I went back to school and I got a master’s degree in high altitude physiology so that I could understand that better and although I dedicated time to doing that. It’s still an ongoing process of learning because science isn’t fixed coaching is a practice. Still always learning so I’m excited to be working with Martin who is actively studying in school now and so it’s cool to continue learning through his experience as well.

02:46.82
Martin
Yes, so thanks Chantelle I think it’s been quite a journey now. Ah today we’re here I’m in uphill team coaching people to climb mountains and all the others. So it’s really dream. Maybe even multiple dreams come true, but while I come from small country Czech republic there’s not really mountains. Ah, we will talk about those categories of what is it like moderate altitude. So it doesn’t even fit into that one. Ah, but I kept dreaming about mountains mountaineering and reading books about legendary alpinists and eventually also became one, also alpinist climber made it to chamonix where I live here right now. Working at let’s say high altitude three thousand eight hundred meters for I think 12 years on aiguille du midi which is pretty legendary around here. Then also performing as an athlete as a runner and climber and actually try. Connecting all those dots then to some faster sense in even extreme altitude and also wondering what actually lies behind it and the physiology of it and so when I started sports science back in 2015.

04:10.36
Martin
Ah, and I was supposed to write the final thesis so it had to be about altitude physiology. So I talked to my professor and he agreed so that’s where I really dug in to the theory and chose a topic of faster acclimatization. And that’s actually what I’m doing now continuing this project as a master student in ostersoond university in Sweden and it’s an ongoing it will take a while to make the experiment to find the right group of ah participants in the study but ah. Yeah, I’m super excited and learning in the process and bring it all together to this job. So yeah, exciting.

04:56.45
Alyssa
Love it and both of you have already I think touched on this is that we use the general term altitude. But it’s really a lot more complex than that Martin said high and extreme. So how do we define different altitude zones because it’s certainly a different effect to be at say Eight Thousand feet or that’s about twenty five hundred meters as opposed to being up in you know, 24 Twenty Five Thousand feet which is above six thousand meters I’m trying to do the conversions right? Yeah on the fly working with a lot of european athletes. So Martin can you kick us off of how do we define altitude zones.

05:37.73
Chantelle
Nice work. Alyssa.

05:42.31
Martin
Yeah, quite .

05:53.94
Martin
Yeah, so I had to actually look look up some papers before this podcast to maybe review this but actually I think let’s just keep it simple and so I would say until maybe eighteen hundred meters Thousand Eight hundred meters.

06:04.59
Alyssa
Yeah.

06:11.44
Martin
There’s just not enough hypoxic stimulus or just the the hypoxia doesn’t really affect the body as much so I would really call it the low altitude and maybe the next category of moderate altitude until three thousand meters which might be ten thousand feet I would call it like a really significant. Treasure hold where okay if you go above that level some people ah might already struggle if they don’t really respect the process of acclimatization. They might even get sick and or just have some severe symptoms. So I think that moderate altitude is quite important because athletes like endurance athletes wanting to perform at a sea level or low level of altitude. , they seek this altitude to train and to get those adaptations to actually then boost the air. Oxygen carrying capacity and so we will talk about these adaptations later but that would be then this category and so the next one would be high altitude three thousand meters until five Thousand meters I would say and truly anything about 5000 I would call it extreme. , because then really is the altitude we find in the highest peaks in the world. So that’s really that’s really realm that you need to take your time for the adaptations to occur to adapt and to respect that process.

07:45.20
Martin
And maybe in these extreme altitudes category I would say above seven thousand meters nobody lives permanently I think it’s actually even lower like 6200 to 400 I’m not sure exactly now. But it’s physiologically almost impossible above seven thousand meters I think you’re like going down slowly but surely. And ah then so-called Death Zone about 8000 the hypoxia is so severe that ah you don’t really want to be up there for too long without supplemental oxygen now here we’re talking not many people go there without supplemental oxygen anyway and so I think it’s also good to know that what does it actually relate to with altitude we’re looking into the reduced oxygen availability and this is actually a function of the barometric pressure which is lower and lower the higher we go. So think . I like to think of it also that way just to have an idea what is actually happening in altitude.

08:48.66
Alyssa
Awesome Chantelle. Okay.

08:51.10
Chantelle
Martin I think that’s an important distinction I was just going to say I think that’s an important distinction that I feel ah some people don’t quite understand well about you know they think that you hear different ways people describe about there’s less oxygen in the air things like that. It’s actually. We always have about 21% of oxygen that’s around us in the air. But when we are going up to higher altitudes and the barometric pressure is lower that means the concentration of the oxygen molecules that we breathe is going to be less. So I think that’s an important distinction for people to understand about altitude. , and I think that’s a good definition and as Martin said he had to look it up I think there’s lots of different definitions right of these different categories of ah, you’ll see some different tables that will have.

09:41.86
Chantelle
3 distinct altitude zones some will have 4 some will have 5 I think the important differences is you know we think about the altitudes where we do have a lot of people who tend to be living in training we have places that people will. Altitudes that people will visit in a transient way for a particular mountain objective. We have you know different places where people will go very seldom. , so those are important distinctions for us to be able to make to learn some of the differences in terms of how our bodies will adapt. How we will be able to perform and places where we absolutely shouldn’t be spending too much time or should be spending time carefully. So I think that’s what we’ll try to focus on today is talk about that a little bit more to help understand a little bit more of what’s happening to our bodies when we are going to higher altitudes or.

10:38.54
Chantelle
Ah, than we’re used to and what’s actually what we will experience and actually what’s happening in our bodies.

10:44.59
Alyssa
Amazing. Yeah, so that I mean Chantelle you teed it up perfectly of in a general sense because again this is a massive question I mean just years of study but generally how is the body responding in different zones. What are some key I guess I don’t know reactions or indicators of the effect of altitude, what’s happening within your body and what are those kind of reactions that we’re seeing.

11:21.14
Chantelle
So yeah I think we sort of have 2 levels of this right? Like what are we experiencing? What are we noticing about our bodies and then what is actually happening in our bodies. So typically when we are going to a higher elevation. So let’s take a typical example of someone. Lives in Austin Texas and they decide to visit. Ah well I live near Jackson Wyoming so pretty typical. They’re going to a different elevation some of the things they’re going to notice probably big ones. Maybe they’re going to notice that it’s a little bit harder to breathe. So their breathing is a little bit faster breathing rate is a little bit faster and that’s lungs trying to keep up with the change in the barometric pressure and the amount of it of available oxygen their heart is. Heart rate is a little bit faster so they’ll notice that their resting heart rate is a little bit faster. That’s also normal response to altitude. That’s the blood pping or the heart rather beating faster to increase the amount of oxygenated blood in the body. They may also notice that they are peeing more often. And increased urination rate. That’s also a common symptom. , and that’s body trying to ah that’s one of the early symptoms as the body is trying to it kind of comes from a hypoxic stimulus that we’re getting to our kidneys and the body is initially.

12:52.13
Chantelle
Getting rid of plasma essentially from the blood to concentrate the red blood cells and so your blood is becoming thicker the red blood cells carry more the oxygen in your blood. So that’s a good way to help your body get through that. If you’re going a little bit higher in altitude. You may also notice some difficulty sleeping so some people may find that they are experiencing a lot of frequent wakeups. Typically this is happening above twenty five hundred meters so above Eight Thousand feet but it could be some people might be a little more sensitive to that. , so they could be experiencing that. Ah, we’ll get into this a little bit more later on specifically but tends to be that men will experience this this sort of sleep apnea more often than women at the higher elevations. And these are all normal responses to altitude. , it means that your body is starting to make some really cool changes under the hood so to speak to help you cope with altitude and so in the early days. You know these are the types of things that you’re going to start to notice. The breathing heart rate things like that. But what’s happening over the days and weeks is that we are getting an increase in hemoglobin we are getting an increase in red blood cell mass eventually the plasma vole that we are.

14:27.55
Chantelle
Initially kind of dping it’s going to start to increase again over time as our heart rate and cardiac output starts to level out. That will happen within a few weeks and we won’t continue to have this sort of hyperventilation that we experience initially. Over a couple of weeks that starts to decrease as we’re able to counteract the hypoxic stimulus that we’re having so all these things are really normal and they’re all necessary for the different physiological changes that we need to experience for our bodies to be able to. Stay healthy and stay alive at higher altitudes and then as we go even higher. This is a little bit different and maybe Martin that’s something you want to expand on a little bit.

15:16.71
Martin
Sure yeah I think ah, that’s a great overview I would maybe stay a bit more with the timeline of those adaptations. So the body when we go to that altitude as I mentioned the first kind of threshold maybe eighteen hundred meters what happens is that the body senses the hypoxia so reduced the amount of like oxygen molecules in the air we breathe and so , body works in a very smart way. So there is actually these receptors in different parts of the body. But the main important ones maybe are the ones in the brain. So very sensitive obviously because we are highly dependent on oxygen to function our brain specifically and obviously when it comes to performance because it’s for us. Ah for athletes. It is a lot about performance so you can imagine that we need the oxygen. So if there is a lack of it. The body will start to the response basically and so as Chantelle now described some of those adaptations happen very quickly within minutes. Let’s say so the increased breathing rate of breathing that depth of breathing increased heart rate. and then if we stay at that altitude or at Hypoxia so the other adaptations will start to happen later on because it’s some of those that actually take a while and it’s all interconnected and

16:49.34
Martin
Obviously the study of altitude physiology is an ongoing thing. We still don’t probably know a big part of it. We I think we know that about maybe fifty sixty percent very large part of our genome actually does something it expresses something under hypoxia stress. So you can imagine that it’s not only about these points but I guess the way we understand it and we can agree on these are really very important ones. , it’s really about trying to bring that oxygen into the body. Ah, more efficiently. Ah because there is a lack of it and then also utilize it within the tissues within the muscles and becoming more efficient. So all these adaptations are actually the way for the body to just bring that to keep the function and possibly even to improve them so when it comes to higher or extreme altitude. It’s really about being careful to respect that process because if we really cross maybe that 6500 meter threshold maybe it’s not a threshold as such, but just the level then we are really risking. Some of those altitude sicknesses or illnesses to occur because we’re just going too fast and the body just kind of cannot deal with the hypoxia. This is very individual. Some people have a tendency to get these illnesses more often or just randomly we just don’t exactly know why they are the the mechanisms behind this but just what I want to say is to relate the timeline of those different adaptations. When we go to high and extreme altitude needs to be there needs to be certain times. So maybe a week or two to relay try to stay at then lower levels and then for those first adaptations to kick in to then so that the first ones actually can relax so the heart rate starts to go down. Saturation is actually improving saturation of oxygen and blood. Ah the breathing as well. And so because the other adaptations that take more longer time they already happens and so sort of like replaces one another and so then. For the high and extreme multitude. This relay needs to be weeks spent at those levels and actually try to even progressively increase that level.

19:28.91
Alyssa
That’s amazing and that also brings us to kind of a next question you alluded to altitude sicknesses. What are the common ones I think we hear the terms hape and hace used quite frequently. Where do we draw the line and Martin again, you kind of touch on this between feeling these you know changes and these reactions and really beginning to worry about this is going in the direction of an altitude sickness.

20:01.40
Alyssa
Yeah, go ahead. Martin.

20:02.80
Martin
So right? So let’s say the first stage of some kind of illness because we can already talk about some kind of discomfort when we go to altitude or we’re using hypoxic tents for example at home. And so-called simulated altitude. It’s definitely work to observe those symptoms. So the way we feel the way brief the heart rate the saturation all those outputs of the body can give us some kind of insight into if we are acclimatizing our body is just struggling too much but then obviously that comes the symptoms like headache nausea dizziness like of cognitive function. So you obviously might not even realize but people around you can see that you’re confused that you’re losing balance for more severe symptoms. So they are different ones. So the first stage is the AMS Acute mountain sickness. So the acute is very important really usually happens in this acute stage of acclimatization or when we at altitude. So acutely exposed to hypoxia. So if we really don’t respect the acclimatization process and we just go a bit too fast too high. This can happen and so acute mountain sickness visualize the headache.

21:36.87
Martin
, some kind of nausea or vomitting and so the best way is to go down to lower altitudes and to recover and just to give the body sign to further adaptations and if we don’t recover or we just people then have a tendenency to just ignore or just to push even higher. Definitely not recommended. So then there are the other 2 more severe conditions and they are very life threatening so hace and high altitude cerebral edema and pulminary edema so those 2 are always the very serious conditions and come with very severe symptoms and this is really minutes and hours like it’s really usually that the only not the only but the main important solution is to bring the person down or just use the hyper. Hyperbaric chamber or something else, but it’s really important to say that this is very serious. Maybe Chantelle you would like to talk about those symptoms.

22:41.53
Chantelle
Yeah I think that’s something ah those are really good distinctions. Martin I think 1 important thing for people to recognize when they are spending time in higher altitudes is to really pay attention to the small things making sure that they are really.

22:58.75
Chantelle
Ah, getting a proper amount of rest that they are staying well hydrated that they are fueling well and that they’re truly paying attention to how they feel like don’t ignore your symptoms don’t not tell your tent mates that you’re having a headache for the last three days something like that and acute mountain sickness. Is really defined by headache plus some other type of symptom some other type of symptom right? So headache plus gi symptoms fatigue dizziness impact on your activities and so if you have just a headache be aware of it. Share about that pay attention to how you’re doing try to get a little extra rest and see how that goes if you’re getting a headache and you’re feeling a little bit dizzy and you’re having some stomach problems then that’s a little bit more serious and then as Martin said you definitely want to consider. Going to a lower elevation and waiting until you’re feeling a little bit better before you attempt going higher because if you are ignoring the small warning bells then big warning bells are really serious like high altitude cerebral edema and pulmonary edema both are life threatening. And for cerebral edema that’s fluid acculation in the brain and that causes potentially fatal neurological dysfunction. And that’s extremely serious. So the symptoms for that would be headache loss of coordination, confusion, hallucination.

24:27.46
Chantelle
You could have someone. That’s a little bit combative. You know you’re trying to help someone and they’re just like really angry, really aggressive. Those are really signs to look out for in yourself. But also in your mountain partners to be really aware and really talk about what you’re experiencing on a daily basis. And throughout the day for pulmonary Edema. That’s when we have fluid acculating in the lungs. So that means that the Oxygen exchange with outside and in your lungs is going to be impaired so this leads to some respiratory distress. So really difficulty breathing short breath maybe pain in the chest coughing pay attention to someone’s skin. You might see that they’re looking a little bit Blue. That’s extremely serious and extremely life threatening. So you really want to pay attention to how you’re doing. How your partners are doing and thinking about monitoring your symptoms on a daily basis. So how are you sleeping how well are you able to eat and stay hydrated. Are you having any GI symptoms ah monitoring the oxygen concentration in your blood. So having a monitor and sharing that information with your partners and noticing how you are changing day-to-day and if you are noticing that you are you know, getting worse. You need to speak up and you need to really take care of yourself.

25:55.37
Chantelle
So it’s normal that you’re going to feel a decrease in your performance or decrease in your strength and endurance particularly in those first few weeks. Totally normal but honor that slow the heck down takes some take some rest. , but if you’re noticing. You know at the higher elevations. , definitely, you’re going to also notice maybe slower reaction times impaired decision-making and again notice those things in your partners talk about these things before your expedition or your trip as well to talk about these things make sure that everyone in the group. Is on the same page about these symptoms about the dangers and how you can potentially help each other because you really depend on each other when you’re in these types of environments and so you really need to speak up and never think about I think the biggest mistake that I see people making is like they’re afraid to slow others down in the group but you’re going to slow someone down a lot if you need to spend some time in a hyperparic bag or you worst case scenario need a rescue.

27:08.74
Alyssa
Ah, this. That’s excellent and I think it really it just emphasizes the fact that this mountain climbing you know, honestly, all these sports that we do are so team dependent. This awareness of yourself of others and that we have to work together. You know it is not an individual endeavor by any means. Ah, and so just looking out for each other and being really conscientious and I think that’s actually another reason why we emphasize training so much is because. You should have a baseline of how your body feels when you are in your home turf whether you live in Colorado whether you live you know by the seas that you understand how your body’s functioning. You understand some of your basic vitals. , and so hopefully you have some awareness. So feelings of like this is uncomfortable and then this is like not good to put it. Yeah, this is dangerous. Yeah, so say not good’s a very ah, simple way of putting it. But yeah, so just you know so much of training is really just understanding how your body feels in.

28:06.94
Chantelle
Yeah, this is dangerous.

28:22.39
Alyssa
Measurable circstances and kind of safe circstances so that you can feel hey this is really drawing the line between ok and over the top. , great. Well you all keep go ahead.

28:38.25
Martin
Just add here if I may just that here I agree hundred percent with yeah, what would you just said I think it really comes with also experience you know, try to maybe.

28:38.97
Chantelle
Oh Martin you have something extra.

28:41.70
Alyssa
Yeah, go ahead. Martin.

28:55.67
Martin
Take it as a process if you’re aiming to climb high mountain. So reach out to our team and or you know the guiding companies that usually have some kind of climbing plan. For example, right to take it from some easier mountains and then higher and higher so that you actually are getting that experience in like technical side of things. But also yes, knowing your body the way it reacts to altitudes because this is quite individual as we mentioned already.

29:29.49
Martin
People still every year there are reports about accidents about people getting sick and people actually also dying. Ah and it’s totally avoidable. It’s really important to become hble to these vices and to really take this learning and knowing that you know. Ah, it might have worked 5 times but this 6 time you you might still struggle or just randomly full sake so you have to go down or so yeah I think just adding that this approach is usually better also for you in general for your health. Ah very ah, very important.

30:13.55
Alyssa
Yeah, and to tee off that as you said it’s individual and also Chantelle you pointed out a difference with sleeping between men and women at high altitude that can often come up altitude. Has a different effect on a man or versus a woman and so I’d love to hear what you see some of these differences are why these differences may occur and how a man and a woman should approach going into altitude.

30:52.25
Chantelle
Yeah, there are a couple of things that women might experience a little differently than men on the good side women tend to not experience the level or degree of sleep Apnea that men do not to say that women are never going to experience it but generally speaking. Ah, that’s an observation but something that I think both men and women need to be aware of for women who are premenopausal they will experience typically a higher hypoxic ventilatory response when they are in the early to mid part of their luteal phase of their menstrual Cycle. So we’re talking about like post ovulation. , and this might sound like a positive thing. Ah but since women already have an elevated breathing rate during this phase of their cycle. Anyway. It means that this could lead to them having some higher instance of respiratory distress at higher altitudes. So throughout the menstrual cycle women experience changes in their ventilatory rate heart rate and even their body temperature. So these are things to really consider that these things for women that do experience that normally during their menstrual cycle know that some of those symptoms may be exacerbated when they are at higher altitudes so something to be a little bit aware of they may have to move a little bit more slowly when they’re at that.

32:21.98
Chantelle
Phase of their cycle if they are experiencing that if they’ve never experienced any breathing issues. They may definitely experience some asthmatic type issues. Even if they’ve never had problems before at their home elevation. Ah post when they are postmenopausal. They will have a similar hypoxic ventilatory response but their cardiac response is going to be a little bit different so their cardiovascular system’s ability to increase output and increase stroke stroke vole may be decreased because of the. The difference in ah, their hormonal profile at that point in time. So again, if you you know that’s why I say for for everyone and I think Martin you’ve you’ve stated that as well. It’s always really important to know how does your body really perform normally and being able to recognize when it is performing. Or behaving abnormally when you’re in a new environment. Altitude is obviously 1 environmental stressor but you could also at altitudes sometimes have compounding environmental stressors as well. You could also have altitude and heat. You could have altitude and cold. It’s really important to really always be monitoring. How you’re feeling how your body is responding regardless of whether you’re male or female and regardless of what a hormonal profile. Your body is experiencing at that time a secondary effect that we typically see with women is that women carry more body fat.

33:57.99
Chantelle
And so women tend to be able to spare carbohydrates when they are at higher altitudes compared to men. So men’s bodies will rely more on carbohydrates for fuel and since women have more body fat. We’re better able to burn fat at altitude for energy. But that also means that when we are trying to do work at a higher intensity at Altitude. It’s harder for women particularly for premenopausal women who still have estrogen in their bodies because estrogen triggers the body to spare carbohydrates and we actually need our bodies to burn carbohydrates for harder efforts and so that can be kind of hard to perform at a higher intensity task for women and also for premenopausal women. Progesterone naturally increases breathing rates. So depending on where a woman is at in her cycle if she is in a phase of her menstrual cycle where progesterone levels are on the higher side so you know that’s post ovulation into that luteal phase. The breathing rates are going to be naturally higher because of the hormones and then if we compound that with being at higher altitudes. And breathing rate being higher from that we have kind of a double effect. So again, just something to be aware of of knowing how your body normally responds how you’re feeling what your effort level is like it may mean that you need to slow down a little bit and be really careful about.

35:29.33
Chantelle
Pushing your body into ah higher intensity and really being mindful of your breathing and your heart rate. So those are some of the main ones. But I think in general for any person at any phase of their life. , you know male hormones fluctuate throughout life as well. It’s no matter who you are. It’s always important to be monitoring your body monitoring your effort level monitoring your unique experience I think that’s really critical.

36:03.59
Alyssa
Do you want to add anything Martin.

36:06.28
Martin
Yeah I would maybe just yeah I would like to add maybe just couple of points but great ah overview from Chantelle here. Ah but women have a tendency or the female body as a tendency to hypoventilate in hypoxia which also. Relates to exercise in general. Not only altitude and so this definitely becomes an issue in altitudes ah related hypoxia. So ah, the body has a tendency to , basically react slower. Ah, with that increased rate of reading so that’s the hypo headbook sig ventilatory response. , but it’s kind of natural. It’s related to slightly different physiology and women also in general obviously in very general lung size is smaller. The absolute lung vole in women is slightly smaller in in general again. So that definitely affects the gas exchange surface and reduces the capacity so that might be also 1 important point in altitude. , and maybe just another last point here is for people with have a menstrual bleeding.

37:35.17
Martin
There is this risk of Iron deficiency. It’s definitely important to monitor that to to do testing and in the time before you go to the expedition or to altitude. Ah, to make sure that you get some supplementation if needed because iron and Ferritin They are very important in those adaptations specifically the producing the hemoglobin. That’s the particle in your blood that will carry the Oxygen Around. So If you’re deficient in iron that definitely can affect negatively the the production of their neuroal blood cells.

38:17.42
Chantelle
Martin I think that’s a really great ah point and I think something important for all athletes male and female when they’re preparing to go to altitude or they’re doing some type of preacclamation protocol with a tent or some other method for all athletes too. Ah, in advance have their iron tested have their ferritin tested to know what are your iron stores so that if there is a deficiency you have time to correct it before you go to altitude and that you get some good medical advice about supplementation potentially when you are out on your expedition or out on your hike or trek or whatever you’re doing because without your iron stores being in a good place. You will absolutely struggle to acclimate. So that’s really low hanging fruit so women for women. It’s particularly important for people who are on vegan and vegetarian diets. They also tend to be lower in iron so that you know they may need some supplementation and there are some non-animal sources of iron supplementation that you can take as well. But even for some people. It’s just maybe something that is normal for them or genetic about their genetic makeup that they tend to store iron a little less and for some people they could be on the other end of the spectr.

39:43.80
Chantelle
You could have some people that are like just taking iron supplementation because they hear that it’s good for altitude and actually their bodies now have too much iron. So please don’t supplement iron without being tested and without doctor supervision so that you make sure that you are taking the right amount. , and you are only taking it if you need it.

40:08.53
Alyssa
Definitely agree on that I mean I’m a huge fan of getting blood panels. Particularly if you’re going into hard training cycles or you know quite a bit before you’re going to do your hard effort to make sure that everything’s in a good spot I did want to touch on 1 thing Martin you said just to get a definition of the difference between hyper ventilation which I think most people have heard that term before in hypo ventilation and you said hypo ventilation. So can you tell us the difference between the 2.

40:44.10
Martin
Ah, yeah, so hyper ventilation or actually whatever you actually follows that hyper is something increased or higher rate. Ah and then hypo is the lower. So specifically what I mentioned about the hypo ventilation. Is that woman female physiology for different reasons works in such a way that so compared to man the reaction to actually increase the rate of reading to actually catch up with the like of Oxygen is a bit slower. And so related to Altitude. This can have an effect but just want to say that the reading about this specific topic but the sex differences between men and and women in a high altitude or in altitude is still nonconlusive. First the studies, the big studies about alitude. Physiology were just big groups of people and so now you know they’re trying to actually say okay are these differences and so I think it’s a really good discussion. What we’re doing here and trying to array.

41:59.24
Martin
Talk about these topics that we already know. Ah, that’s going to help you out there to actually make your decisions and so , yeah, but it back to your question hyper ventilation. How hyper ventilation is definitely that for one of those first adaptations. When you come to Hypo when you come to altitude and it’s actually then related to the sleep apnea so that Chantelle mentioned before so that’s actually related in a way that you breathe in more air and oxygen so that’s what you want? That’s what but the body wants. That’s why. It’s kind of automatically happening. Ah involuntarily mean, not automatically. But what it also causes is that we breathe out more and what do we breath out is the carbon diox out and that actually offsets the the balance in our bodies and the brain. Also has the sensors for the carbon dioxide. Not only just oxygen and so the brain sees that or senses. There’s lower levels of carbon dioxide and so basically stops breathing for seconds or it’s until the point where it’s actually apnea so basically some brief stops. So for 10 seconds even longer sometimes and then you start to suffocate so then there’s this huge loud inhale and usually people.

43:29.44
Martin
Experienced this during the sleep and so that’s why it’s called sleep apnea and it’s not very nice. It’s not a very nice feeling I experienced it myself just the fun factor. Ah on Ama Dablam last November and it’s just so annoying.

43:47.39
Martin
And ah the whole night I was just basically falling asleep and and woke up myself because I was not breathing and you cannot do anything about it. It’s out of your control and yeah, so basically spent the whole night doing this on a on a repeat and.

44:04.98
Martin
It’s just a first stage of the acclimatization. That’s a good thing and that actually usually but I think for most people you acclimatize better and so within days this disappears this? Ah very annoying symptom.

44:20.26
Alyssa
That does sound incredibly ah frustrating I actually and please jp in on this would asse that just based off of historical nbers of men and women that are going into high to extreme altitude that probably a lot of the studies are just naturally geared towards men because there just weren’t women. who were doing it and so able to participate in the studies is that a correct assption.

44:53.17
Chantelle
Yes, and also the propensity for a lot of scientific studies to think like well women have menstrual cycles and so they’re quote unquote more complicated to study so we’ll just study it in men you know and then we’ll just extrapolate for women so that I think that sense in science is now changing to realize that ah there are more you know and we have a lot more female athletes that are challenging themselves in different ways and we have more female researchers and even male researchers who recognize the the importance of studying both sexes to understand this better to give. Ah, better recommendation. So thankfully, that’s changing but you know we still have you know if you think about general population of people who are going to these more extreme environments. You know we’re still an odd little funny group of people right? It’s still a small group.

45:51.11
Alyssa
Yeah, so let’s, jump to it’s our first episode. Let’s just get this out of the way. But what are a few common myths that you see around altitude experiences and you just want to be like let’s get that right out of the way.

46:09.50
Alyssa
Martin if you want to lead off and.

46:10.47
Chantelle
Oh oh boy, it’s a fun one. What he got Martin.

46:15.35
Martin
Yeah I can start here.

46:23.20
Martin
Repeat with my coaching work but also with my direct experience in the mountains is that can really be people still don’t ah don’t respect the acclimatization process enough and as I mentioned before . Even these years these seasons there’s you know there are accidents that are easily avoidable if people really follow that process if they inform themselves or just reach out and also again, the acclimatization takes time. Ah, so adapting to altitude takes time we can adapt. It’s individual so everybody reacts slightly differently. But it’s definitely important. I think what I’ve seen a lot is that people maybe young people in that category. Think that they’ll be fine. They’ll be better off but it’s actually not really correlated the fitness level and then being able to tolerate altitude is not actually that correlated definitely helps. But I’ve seen people collapse or just faint at a high altitude here being working at Aiguille du Midi and really really clearly see that they were young. They were ready to climb so they were geared up but at the same time there were people around that were just clearly not the very sporty.

47:57.60
Martin
And they were totally fine. So there is something about it. So also knowing that from Nepal and and other big ranges that people just go and just go directly to the basecamp and actually die the next day they just completely ignore the process ah to really stage it to go. Step by step and go directly to five thousand meters an higher and it goes terribly wrong? I would say just ah related to this. I would encourage people to do the research when they plan the trips to these mountains to ah, really specifically if you haven’t had some experiences in those mountains. Ah because there is a tendency for some companies to organize these trips in a very short time so people already are asked to or just basically. The plan is to climb the mountain within like one week one week time which is which is totally short for people for mountains that are about five thousand meters or six thousand meters so for some of them. It works out pretty well. But I just like to to tell my clients specifically that ah, if you climb the mountain. Without preparation in seven eight days you’re weaving and your body is actually still acclimatizing. Ah and you already climbed it you got lucky but it might have gone wrong. You might have gone sick also and also you probably didn’t enjoy it as much because you just kind of suffer through it.

49:31.70
Martin
I encourage them to take their time and to and actually respect the the timeline of of those adaptations and actually enjoy it. So I would say that would be something I experience quite often.

49:47.10
Alyssa
And yeah I think that really goes to the idea that just because you get away with something doesn’t mean you should have done it and I think unfortunately that happens a lot in the mountains where it’s like oh I got away with it this time or like well I did it. It’s like well. You might have gotten just really lucky that one time and that’s probably not going to be something you should hang your hat on all the time or the basis of your your future endeavors. But Chantelle what are what are some of your favoritea ltitude myth debunks and.

50:30.67
Chantelle
Yeah I think the Martin you touched on one of my favorites is people thinking that their fitness is going to protect them. I think sometimes you have these like really fit people are often working pretty hard in their training and they’re maybe not giving themselves enough time to rest and recover before they travel so they’re training really hard and then they get on a plane or you know they they try to do something without being very well rested and so they are going to struggle to acclimate. Maybe their body is depleted. In some way you know could be iron stores for example it could be that they’re just fatigued and so the body cannot adapt. Well so it’s important to you know, really manage your health, take care of your health make sure that you’re healthy before you go, and there’s no magic pill. So your fitness certainly being fit and being well prepared is definitely an advantage but you still need to respect your body and respect the mountain and listen to your body as you’re going through the the process. Some people also tend to think that they’ve been to altitude plenty of times before they’ve climbed a mountain with a specific aggressive ascent rate and gotten away with it before and so they think that it’s always going to happen. Definitely not There’s no guarantee.

52:00.30
Chantelle
I had an athlete who had a super scary experience who had been to altitude multiple times been to quite high altitude multiple times never experienced any issues and then one summer he was planning to race in Leadville.

52:16.81
Chantelle
That’s you know, spending a significant amount of time around ten thousand feet but he’d been to that level of elevation before multiple times and even higher never had any problems and he ended up being helicoptered off the mountain because he had hace never had any kind of problem before so again, just. Can’t say this enough to really listen to your body pay attention to how you’re feeling take care of yourself. Well and speak up if something that before it’s too late. This is a little silly one. Ah, that you cannot have caffeine at higher elevations. That’s I think a common one that people say it’s not that you have to avoid caffeine but don’t overdo it if you’re someone that’s used to drinking caffeine, quite regularly, you might actually get a headache from removing caffeine. So if you’re planning to you know, avoid caffeine on your trip or your expedition then do the caffeine detox before you go to the mountain. Don’t do it on the mountain. Then you know that wouldn’t be good for you and another one is sometimes people looking for the magic pill and so for some people they may think that taking diamox is kind of a cure-roll and it’s going to help them avoid altitude sickness or it’s going to help them ascend more rapidly. And it’s going to avoid any kind of problem right? It’s kind of a magic bullet.

53:49.46
Chantelle
And the truth is. There’s no magic bullet. Diamox is certainly helpful for certain people under very specific circstances but it’s not something that everyone needs to take or that someone should just blanket take you know, learn about it learn what it does to your body learn how it helps. Learn how it may hinder and make the right decision for yourself. We are not doctors but there are really wonderful doctors out there that can give you really good information and the truth is. There’s no magic bullet. There’s no guarantee the mountain always decides and we have to do the best job we can of taking care of ourselves monitoring our own symptoms and doing the best job that we can to follow a good ascent protocol that’s going to keep us safe and keep us healthy so that we can continue. The goal is always to get back down the mountain right. You know whether you summit or not or whether you finish the race or not the goal is always to make it back down the mountain safely healthy back to your loved one. So always keep that in mind.

54:58.71
Alyssa
Absolutely I like to say the summit is the parking lot when you’re back down good Martin.

55:06.77
Martin
I would like to add maybe one more because obviously we are talking about different levels of altitude again. But maybe, related to the high and extreme altitude.

55:22.87
Martin
Ah for those who don’t know or are not aware of there are ways to acclimatize also at home one whilst you’re at home. So just for you to know that all these that we just talked about the sicknesses illnesses and how it’s risky. Definitely.

55:41.53
Martin
It needed to be mentioned but then for some people it’s just impossible to leave for a long period of time. Let’s say for several weeks for when it comes to these high-mounted so nowadays there are so systems available that you can actually. Ah, use at home. So hypoxic tents or hypoxic chambers those are actually becoming more available in the cities like in the commercial gyms but mainly it’s about the hypopoxic tense so you can actually preacclimitize before you go to the mountain so you can still stay at home with your families at leaving at sea level. Keep working having your business and then pre-aclimatize per to the really good level before you leave and ah and actually do even reduced time on those expeditions because I mean everest takes usually eight weeks to actually completely acclimatize. To the basecamp and then do the client so it really is a long time for most people to leave the job and the family so using these systems. Ah, you can definitely make it possible and so it’s just another myth that I think we can confirm it works. Ah, we adopt an uphill athlete. We’ve been using these methods and so reach out if you want to know more.

57:08.18
Alyssa
That’s great. So this is just I mean gosh, what a great start I feel like we really covered a lot of amazing information and so I’m super stoked to see where we go from here.

57:24.63
Alyssa
Is there anything else you 2 would like to add before we wrap up our intro to altitude.

57:33.70
Chantelle
I think we covered a lot of good stuff and Martin you touched on an important piece as well that there are ways that people can pre acclimate before their trip or before their acclimate before and we’ll have some great future episodes on specifics of what that looks like what some of those methods are I think you know the ability to purchase or rent 1 of these hypoxic tent systems is becoming much more affordable or even some gyms and other facilities where there are actually climate controlled rooms where people can train which is also pretty cool. There’s also the ability to do. There’s sometimes people do like a poor man’s preacclimatization where they will do like a heat training protocol which helps them to improve or increase red blood muscle mass. But I think aside from those things other things like basic stuff. People should pay attention to is your general health really matters your iron and iron stores and other important blood values to make sure that you’re healthy before you are putting your body in a really stressful situation physiologically. We also touched on the importance of getting proper rest staying hydrated, eating more carbohydrates. So for those people out there that are following high protein high fat diets and avoiding carbohydrates.

59:07.13
Chantelle
Ah don’t do that and then go to your expedition and then find that in the base camp everything they’re providing is high carbohydrate foods. That’s not going to be good for your your body So make sure that you are also following a well balanced diet because carbohydrate consumption’s really important at higher altitudes. Other things you can do is you know, avoiding alcohol. Obviously that’s going to be an additional stress when you’re at higher altitudes. Ah respect the mountain respect the ascension rate that works for your body and listen to your body. Most importantly listen to your body. Listen to what’s happening and pay attention to those things already now in training know what’s normal for you know what feels normal for you know what is a normal. What does your breath sound like when you are working really comfortably and sustainably.

01:00:04.48
Chantelle
And know what your breath sounds like when you’re working really hard and unsustainably because when you’re going even if you’re training now with your watch and your heart rate strap and all of that stuff your quote unquote normal heart rates where you live are not going to be the same as they are going to be at fourteen thousand feet or above four thousand meters right? That’s obviously it’s going to be different but you’re still going to know like what it feels like what it sounds like that’s going to be something that’s consistent so start paying attention to those things and really you know we as athletes I think we work. Really hard for a good chunk of our lives to ignore those signals and so I think a lot of what we do as coaches is helping our bodies our athletes to learn to actually listen and actually pay attention and learn what your body’s trying to tell you before. It shuts you down.

01:01:00.88
Alyssa
Yeah, that was fantastic.

01:01:04.10
Martin
I agree I think it’s as Chantelle said it’s just learn just listen to the mountain and listen to yourself your body and I think for most people they can rely stay up there for some kind of physical challenge. But it’s ah, definitely a big mental challenge and sort of some kind of spiritual as well. A lot of self discovery there. But I think, it’s not only about the summit maybe a bit of a different topic here. But it’s not only about that you know it’s really what you put into it how much effort but in a way that is not putting you and your life and your health at risk. So definitely if you listen to this. You probably have a better idea now what to look out for. So I think great. Ah great point about the the heart rate. So I like to tell my clients that to work with rpe already during those weeks and months before the expedition because.

01:02:12.37
Martin
When you come to the high altitudes. The heart rate doesn’t make much sense and so that the zones will not make sense as you know. So if you’re only relying on that I mean you will run into trouble. You will probably either push yourself too hard or too little but I think it’s mostly that pushing too hard. So knowing yourself already working with the RPE so rate of perceived exertion. So really knowing yourself you just obviously you can keep using the watch but I really use it for knowing the time how long I had been going and the elevation. The altitude, the elevation, speed but the heart rate is really I’m not really watching that at all. So this is really important point and the two to learn through the other process of training, but otherwise we could just keep going for hour or 2 but let’s leave something.

01:03:16.15
Alyssa
Though, it’s been It’s been amazing and I love having both of you on and actually, again, you you both just teed up everything so perfectly because our next episode is bringing our dietician. Alyssa Leib on to talk about nutrition at altitude and considerations in the carbohydrate element and also just saying like hey get used to the food that you’re going to eat on the mountain. And in the base camp because that will be a huge shock to the system is a great primer. For that so yeah, thank you both for being on as you can see we have a wealth of knowledge at uphill athlete. So if you want to talk to Chantelle or Martin and learn more from them. You can visit uphillathate.com to chat with them through phone consults etc. Also there are presentations about altitude in our level 3 memberships I’ve had the privilege of seeing these presentations and they are top notch really helpful to learn more about this. So thank you both. Very much and thank you for listening to the Uphill Athlete podcast if you could reate rate review and subscribe on your favorite podcast platform that really helps us to help more people do their best and be safe in altitude situations. It’s not just one.

01:04:48.62
Alyssa
But a community we are uphill athlete.