Hypoxic training or altitude training, is the practice of exercising under reduced oxygen conditions and has gained momentum in the fitness world among athletes and fitness enthusiasts as a method to enhance performance and improve overall fitness. While there is merit to the physiological responses it triggers, some recent studies cast doubt on its overall effectiveness. This article delves into the aspects of altitude training, how it can be used effectively to enhance performance as well as the limitations that are often ignored.

First of all, let’s look at why athletes might want to be in oxygen depleted conditions. While you are at a high altitude, your body knows that there is slightly less oxygen in the air, so to compensate, the body produces more red blood cells which carry the oxygen. This means that more oxygen can get to and be utilised by the working muscles with each breath. Then once you return to sea level and oxygen rich environments you will have an increased oxygen carrying capacity. But this effect is very short lived and is usually negated after 1-2 weeks.

There are a few common ways in which altitude training is generally implemented.

  1. Live High, Train high: this is where you go to a place that is located at high altitude and train up at the high altitude.
  2. Live High, Train Low: this is where you live your day to day life at high altitude but then come down to a low latitude to train.
  3. Live Low, Train High: This is where you live your day to day life at sea level and train at high altitude (often in a room where the oxygen levels are controlled).

The live high, train low model is widely regarded as the best way to get the most out of altitude training. By training at sea level, you are able to train at the same intensity (speed, weight lifted) as normal, but you still get the physiological benefits associated with living at altitude. The drawback is that it is very hard to do correctly as there are not many places in the world where you can live at a high altitude but then travel a short distance and train at sea level. Some of the best places to live high train low are Flagstaff, Arizona; and the Sierra Nevada, in Spain.

In comparison, when you train in a high altitude environment, your body is already working overtime to get sufficient oxygen to the working muscles. When you add exercise on top of that, your body needs to work harder at the same intensity so that it can continue to get enough oxygen to the working muscles. This reduction in output at the same intensity may compromise the ability to achieve optimal muscular and cardiovascular adaptations, as well as limiting the body’s exposure to the speeds and intensities that it would otherwise be able to achieve, thereby questioning the efficacy of hypoxic training.


At sea level: Running at 10km/h, Heart rate: 145 BPM

At Altitude: Running at 10km/h, Heart rate: 175 BPM


At sea level: Running at 10km/h, Heart rate: 145 BPM

At Altitude: Running at 8km/h, Heart rate: 145 BPM

Training in hypoxic conditions has also been shown to have an impact on muscle growth. It has been thought that the stress placed on the muscles by training in a low oxygenated environment, will help to induce more adaptations so the body can cope with the new environment. A 2023 meta analysis by Benavente et al. discovered that resistance training at altitude resulted in almost no difference between training at altitude and training at sea level to increase muscle hypertrophy and muscular strength. These results were not affected based on the severity of the lack of oxygen either. Recent studies have also shown that training at altitude or in an oxygen depleted environment does not have an effect on muscular hypertrophy, so it seems it doesn’t hold up to spend the extra time, money & energy to train at altitude when training at sea level with a progressively overloaded, specific program will elicit better responses.

Lastly, altitude training can have detrimental effects on your health. As mentioned earlier, the body needs to work harder to get enough oxygen to the working muscles when training at altitude. This can lead to elevated levels of fatigue, hindered recovery, and an increased risk of injury. This stands in contrast to a balanced training approach that prioritises gradual progression and adequate rest intervals for optimal performance gains.

While altitude training may exhibit physiological responses that can be beneficial to performance, it’s important to understand how to apply these training methods in the real world to get the best results. In Australia, the live high, train low training protocol is almost impossible to do properly. You can do the live high, train high protocol but that results in a reduced training intensity, no positive effect on muscular hypertrophy, overtraining risks, limited adaptational transferability, and potential immune system compromise. The live low, train high method has all the same limitations, but without the prolonged stimulus you get with living at altitude for weeks on end. Aspiring athletes and fitness enthusiasts should adopt a comprehensive, evidence-based training approach that encompasses well-rounded principles for sustainable fitness progress.

Amann, M., Pegelow, D. F., Jacques, A. J., & Dempsey, J. A. (2007). Inspiratory muscle work in acute hypoxia influences locomotor muscle fatigue and exercise performance of healthy humans. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 293(5). https://doi.org/10.1152/ajpregu.00442.2007

Benavente, C., Schoenfeld, B. J., Padial, P., & Feriche, B. (2023). Efficacy of resistance training in hypoxia on muscle hypertrophy and strength development: A systematic review with meta-analysis. Scientific Reports, 13(1). https://doi.org/10.1038/s41598-023-30808-4

Feriche, B., García-Ramos, A., Morales-Artacho, A. J., & Padial, P. (2017). Resistance training using different hypoxic training strategies: A basis for hypertrophy and Muscle Power Development. Sports Medicine – Open, 3(1). https://doi.org/10.1186/s40798-017-0078-z 

Jeffries, O., Patterson, S. D., & Waldron, M. (2019). The effect of severe and moderate hypoxia on exercise at a fixed level of perceived exertion. European Journal of Applied Physiology, 119(5), 1213–1224. https://doi.org/10.1007/s00421-019-04111-y 
Kon, M., Ohiwa, N., Honda, A., Matsubayashi, T., Ikeda, T., Akimoto, T., Suzuki, Y., Hirano, Y., & Russell, A. P. (2014). Effects of systemic hypoxia on human muscular adaptations to resistance exercise training. Physiological Reports, 2(6). https://doi.org/10.14814/phy2.12033