(Do you think/know) if there's a big difference between proper altitute training (increasing red blood cells)
and EPO?

Not a big difference in the end result. One is done far above sea level over a long period of time and the other is done anywhere with an injection. EPO allows a person to boost their cell count slightly above that which would be acheived in the mountains but people all have different baselines for hemo levels, much like cholesterol. EPO is a hormone that the kidneys produce and the hormone triggers the bone marrow to produce red blood cells. EPO is expensive as well. When my cat was going through kidney failure, a 5ml vile of the stuff ran about $180. That was a month's worth for a 12 lb cat. Not sure what it would run for a 170 lb rider but I wouldn't want the tab.

If not a big difference why do riders use EPO? Dr Ferrari discusses altitude training, so maybe he's not an EPO doctor after all and his riders are clean.

If you have three months to stay at altitude, then do it. Most riders on the pro circuit are racing every weekend, sometimes twice a week or are riding courses of the race the following week. Some sleep under O2 depriving tents to try and mimic altitude in the hopes of adapting but they only sleep for 8 hours so two thirds of the day is spent breathing heavy air, hardly worth the hassle and the body cancels the request to produce more red blood cells. EPO is a quick fix and give a rider the ability to reach max hematocrit of 50 almost overnight. Some riders have a special exemption claiming they naturally produce more red cells than the average person and they can be legal up to 52 or 53%. Everyone is different, altitude may get a rider up to 47, 49 but the needle will guarantee them a result without taxing their schedule.
Ferarri's case is a bit different. He studies the science of blood, not just ways to boost hematocrit. EPO is just one of the avenues he took to enhance a rider's performance and the evidence against him was overwhelming. A better and more scientific example of this is BALCO. They could take a drop of your blood and custom tailor a vitamin specific to your chemistry. I suggest reading some of the Cyclingnews archives about Jesus Manzano and his exposure of methods. It was some interesting reading.

Something I've never read in regard to altitude tents, but I know from personal experience while mountaineering that things like small scrapes take longer to heal. I can't see that your overnight recovery would be as good as it is at sea level.

I can't see that your overnight recovery would be as good as it is at sea level.
The "overnight" reference was about red blood cell production and not recovery time. Most riders don't have the schedule to train at 8,000 feet for a month and some resort to finding methods to gain those same results.

The "overnight" reference was about red blood cell production and not recovery time. Most riders don't have the schedule to train at 8,000 feet for a month and some resort to finding methods to gain those same results.

Muscle mass starts to decrease at higher altitudes so ideally, you want to train at sea level but sleep at high altitudes.

Muscle mass starts to decrease at higher altitudes so ideally, you want to train at sea level but sleep at high altitudes.


Is anybody in this thread medically trained??????

Are you Oncologists, or have you had hands on personal experience with performing any tests regarding this technology?

Muscle mass can decreas at higher altitudes, however, define higher. Dont you think that folks who live at high altitude would have muscle mass issues if this was in some way the case?

ttug, almost nobody on this site is medically trained. We all read Cyclingnews and pick up dibs and dabs here and there. I just know what I've read, not what I've been taught or experienced. I thought the original post was to question the use of EPO vs. altitude training but just four posts later it's on three different tangents (as these doping discussions tend to take). I'll step out of this one...

Something I've never read in regard to altitude tents, but I know from personal experience while mountaineering that things like small scrapes take longer to heal. I can't see that your overnight recovery would be as good as it is at sea level.
I think the latest theory is sleep high/train low so you wouldn't be at altitude all the time.

ttug, almost nobody on this site is medically trained. We all read Cyclingnews and pick up dibs and dabs here and there. I just know what I've read, not what I've been taught or experienced. I thought the original post was to question the use of EPO vs. altitude training but just four posts later it's on three different tangents (as these doping discussions tend to take). I'll step out of this one...

I meant no offense. Its just a bit absurd thats all.

For example, years ago we had a person in our office have a mental breakdown and she began to wear foil on her legs everyday. SO, one day, someone asks, hey, why are you wearing foil on your legs? (I DID NOT EVER ASK, I DID NOT WANT AN ANSWER) She wore the foil to deflect the radio waves the government was using to control her mind.

Along the same direction, we have had a few threads here where really, most of the "replies" are at best freakishly developed. He has a gap in his teeth, ITS HGH ABUSE. He coughed and his testicle is wrinkled , OH MY GOD,HE MUST BE ABUSING EPO.........

See what I mean? Drips and drabs are just swell, but drips and drabs of cr@p have the unique quality of still being cr@p. ;)

I think the latest theory is sleep high/train low so you wouldn't be at altitude all the time.


Hugging a microwave while you cook a burrito makes you sterile in 2 years. Really, its a fact.

See what I mean!! Now you have a problem with my wearing foil!! The aliens will come for you critics first and I'll have the last laugh while training at altitude... ;o) you shold try foil, especially in the winter. Much better than knee warmers.

The "tooth" thread was a riot, I loved that one. I guess my response was to show that it's great to train at altitude but the average pro is scheduled and ridden to death. So, whant the pressure to perform is on, some choose the dark side. The whole Lance/Ferarri thing really doesn't interest me, I could care less about either one. Also, my cat had a very expensive last year sleeping on the couch and never did return to the peleton.

Off the top of my head, I can think of a few ways in which exogenous EPO administration is different from altitude training. In addition to upregulation of erythropoeitin production by the kidneys, the hypoxia (low oxygen level) caused by altitude exposure has a number of effects:

1) induction of pulmonary vasoconstriction, resulting in a reversible elevation in pulmonary arterial pressure as well as alteration of lung ventilation/perfusion distribution.

2) compensatory hyperventilation, resulting in a reduced partial pressure of carbon dioxide in the blood. This results in an alkalotic shift in the blood, which will be partially compensated for by the kidneys. The mild alkalosis will shift the oxyhemoglobin dissociation curve leftward, which negatively affects offloading of oxygen in peripheral tissues

3) upregulation of tissue 2,3-diphosphoglycerate, which shifts the oxyhemoglobin curve rightward and increases offloading of oxygen from blood hemoglobin to peripheral tissues

4) change in muscle myoglobin isoform distribution

5) at extreme altitude (roughly > 5000 meters), there is a deterioration of muscle tissue in lowlanders. People who live at high altitude are relatively resistant to this degradation.

This is by no means a comprehensive list. I have no idea how clinically significant these changes are in relation to athletic performance. I'm not aware of any studies which compare the ergogenic effects of altitude training and exogenous EPO, though I haven't done the literature search.

Is anybody in this thread medically trained??????

Are you Oncologists, or have you had hands on personal experience with performing any tests regarding this technology?

Muscle mass can decreas at higher altitudes, however, define higher. Dont you think that folks who live at high altitude would have muscle mass issues if this was in some way the case?
Got the info from a doctor who raced for my club. She had a hypoxic tent that she bought from another rider and used to stimulate high altitudes. Must've worked because she won master nat's in the road race and won master world's so suspect she knows what she is talking about. BTW, her name is Joy Shaffer.

to sleep in an altitude chamber replicating about 10K feet I think and living/training at sea level.
a) while at rest, altitude simulation stirs bodies mechanism for increased RBC
b) wake up and use increased RBC's to full extent at oxygen rich sea level.

High altitude training means you don't optimize the increase as altitude and all it's oxygen depriving effects limits your training.

and you don't want to simulate altitude so high it causes aforementioned hypoxia etc..
just enough to tax the system.

Does anyone know what altitude they are using? I wouldn't think it would be 10,000'. That is pretty extreme and would lead to restless sleep for the normal person not used to it. Seems like that would negate the benifits if you wake up unrested. I know from a flight physiology course that the greatest change in the atmosphere where the partial pressure of oxygen reduces the fastest is at 4800'. Above that it reduces at a much lower coefficeint up to 18,000 feet where it depletes rapidly. Makes me wonder why they would go much higher than 6,000' personally. The difference in the partial pressure of oxygen in air isn't that much different from 6,000' to 10,000'.

Does anyone know what altitude they are using? I wouldn't think it would be 10,000'. That is pretty extreme and would lead to restless sleep for the normal person not used to it. Seems like that would negate the benifits if you wake up unrested. I know from a flight physiology course that the greatest change in the atmosphere where the partial pressure of oxygen reduces the fastest is at 4800'. Above that it reduces at a much lower coefficeint up to 18,000 feet where it depletes rapidly. Makes me wonder why they would go much higher than 6,000' personally. The difference in the partial pressure of oxygen in air isn't that much different from 6,000' to 10,000'.

Just from talking to my teammate, she believed that 14,000 feet was ideal but she didn't want to try it because you can actually bring on altitude sickness. So, she just kept trying different settings on her tent, until she found 10,000 ft. worked best for her.

Just from talking to my teammate, she believed that 14,000 feet was ideal but she didn't want to try it because you can actually bring on altitude sickness.

That's what I was wondering because some altitude chambers go up to 14K. I know when sleeping at 16 and 17K your recovery really sucks. I've always wondered if an elite athlete sleeps at a simulated altitude of 14K does it have a detrimental effect on recovery. I've never found much of a difference between sleeping at 10K and 5K, but then I'm not doing world class workouts either.

so all the juicy oxygen can counter all the negative effects of altitude training

I just had bloodwork done, my H-Crit is mid 40's and I'm clean and over 40. not too shabby.

now how much will it cost me to boost it another 4 pts (not that I'm being tested and I'm yes I'm kidding)?

the greatest change in the atmosphere where the partial pressure of oxygen reduces the fastest is at 4800'. Above that it reduces at a much lower coefficeint up to 18,000 feet where it depletes rapidly.
Oxygen pressure reduces fastest at sea level. Oxygen is a constant 21% of the atmosphere, so its partial pressure is always proportional to the total pressure, which goes approximately as 2^(-h/h0), where h0 = 5.3 kilometers (roughly 17,000 feet).

As you ascend, the rate at which O2 partial pressure falls is proportional to the atmospheric pressure at that altitude, so the rate is greatest where the total pressure is greatest: at sea level (Some wise guy will point out that it's actually going to fall faster in Death Valley. Roger that.). There, it falls at a rate of about 12 millibars per thousand feet.

Partial pressure of oxygen at sea level is about 210 millibar
Partial pressure of oxygen at 6000 feet is about 170 millibar (around 79% sea level)
Partial pressure of oxygen at 12000 feet is about 130 millibar (around 62% sea level)
Partial pressure of oxygen at 18000 feet is about 100 millibar (around 49% sea level)

There is a big difference between a hypoxic tent and EPO.

-Most studies have show an 3% increase in hematocrit with a tent. If your natural level is 50 it would increase it to 51.5%. Of course it effects different people in different ways, some people take a long time to adapt and actually drop a few % in the first 2 months, others increase up to 7%, i.e. moving from 50 to 53.5%. Kinda strange that Genevieve Jensen tested at 56 at the WC in Hamilton. The womens limit is 47. She blamed the big jump on here use of a tent. :confused:

-The upward increase in hematocrit from using EPO is almost unlimited....well I guess there is some limit as 22 cyclist died in the early 90's as people tried find the limits. It is possible over a short time to increase from 40 to 60%. If properly monitored and given in the correct doses EPO is as safe a Orange Juice...or so says Lance's Doctor, Michelle Ferrari. Dispite his recent conviction he is correct that it is quite safe.

There are other benfits as well, such as increase in Lactate Treshold but I will save that for another post.

yes it has unlimitied potential. 90's deaths were caused by blood too viscous (too much RBC's) cobined with cyclists' resting heart rates being too low and they just kicked in their sleep.
problem with using too much too often is like steroids, when your body registers it's prescence in high levels it stops natural production. This forces drug dependence to attain normal levels (why Roid abusers testicles shrink). So EPO abusers find themselves having to constantly using the drug to maintain H-Crit which in turn exposes them to more risk of detection. Pantani's crash readings 60 or so on admission to the hospital in the teens a day or so later showed classic symptoms of this and his H-Crit recovery after his "Team Doctors" treated him did nothing but add to the theory. So safe dosage would have to fall in the 'not enough to create dependency'

as for improving LTR, it's a bi product of Hi RBC, the more red blood cells the more lactic acid that can be transported out, the easier the recovery etc...

As far as the cost goes, before my grandmother died she was going through 2k a month (in Canada, I'd imagine it costs more in the US unless you get it from Mexico) worth of EPO. It really did help her for a couple of years though. She wasn't making any new red cells without the help, so she wasn't worried about doing long term damage :)