Menu

Commentary: Disputing Ferrari’s altitude training claims, part 1

  • By Dr. Michael Puchowicz
  • Published Feb. 20, 2013
  • Updated Feb. 21, 2013 at 12:30 PM EDT


Lacking further input from Ferrari, consider the strongest Hgb mass data that is available, shown in Figure 6.

First, these studies used three-week altitude exposures, which are greater than the two-week blocks proposed by Ferrari. Therefore, the data points would need to be adjusted downward accordingly. Next, from the controlled studies with multiple time points, the data suggests that Hgb mass falls fairly rapidly after altitude exposure is stopped. If this same rate of fall occurred after a two-week exposure, it would be unlikely that there would be much remaining elevation in Hgb mass before starting the next two-week altitude exposure.

As a whole, the data suggests that altitude exposure, whether from a continuous three-week block or from accumulation from repeated two-week blocks, would not result in a five-to-10-percent increase in Hgb mass at a time point relevant to a grand tour. Without any of Armstrong’s personal data to suggest otherwise, Ferrari’s altitude claim is not credible.

Part 2 of this analysis will look at the effect of EPO and blood doping on Hgb mass with further discussion from Dr. Ferrari.

Michael Puchowicz is a former lab rat turned sports medicine physician. After the last two years of laying waste to grammar, farce, and pretense in the shadowy world of anonymous cycling blogs and Twitter rants, he’s finally caved and gone legit. Please don’t mistake his views for those of his employer, his friends, or anyone else linked by real or perceived affiliations through the medical and science communities. To do so, would surely end his uncompromising pursuit of all things true and glorious in cycling.

Author’s note: I do thank Dr. Ferrari for engaging in this discussion. I very strongly disagree with the actions for which he is banned from cycling, but I wish him no ill will as a person. There is some concern that engaging Ferrari gives him a chance to pivot away from his own culpability and distracts from more important efforts to clean up the sport. I agree with this concern. However, the questions being addressed have defined cycling for too long for the sport to be able to move on without closure.

In the Hgb mass figures, data from studies with a control group was plotted as the percentage above baseline compared to the control group. Data from studies without control groups was plotted as the percentage above baseline. Data was extracted from graphs when the numerical value was not available. All reasonable effort was made to not introduce additional error.

The Chapman 1998 study was designed to look at the differences in physiological parameters between “responders” and “non-responders.” In order to make this data set usable for the analysis of the effect of altitude, the two groups were pooled together and the average change from baseline for all subjects was used.

Works Cited
Berglund B. High-altitude training. Aspects of haematological adaptation. Sports Medicine. 1992 Nov;14(5):289-303. Review.

Chapman RF, Stray-Gundersen J, Levine BD. Individual variation in response to 
altitude training. Journal of Applied Physiology. 1998 Oct;85(4):1448-56.

Clark SA, Quod MJ, Clark MA, Martin DT, Saunders PU, Gore CJ. Time course of haemoglobin mass during 21 days live high:train low simulated altitude. European Journal of Applied Physiology. 2009 Jun;106(3):399-406.

Friedmann B, Frese F, Menold E, Kauper F, Jost J, Bärtsch P. Individual variation in the erythropoietic response to altitude training in elite junior swimmers. British Journal of Sports Medicine. 2005 Mar;39(3):148-53.

Garvican L, Martin D, Quod M, Stephens B, Sassi A, Gore C. Time course of the 
hemoglobin mass response to natural altitude training in elite endurance
cyclists. Scandinavian Journal of Medicine & Science in Sports. 2012 Feb;22(1):95-103.

Gore CJ, Hahn A, Rice A, Bourdon P, Lawrence S, Walsh C, Stanef T, Barnes P,
Parisotto R, Martin D, Pyne D. Altitude training at 2690m does not increase total
haemoglobin mass or sea level VO2max in world champion track cyclists. Journal of Science & Medicine in Sport. 1998 Sep;1(3):156-70.

Gough CE, Saunders PU, Fowlie J, Savage B, Pyne DB, Anson JM, Wachsmuth N,
Prommer N, Gore CJ. Influence of altitude training modality on performance and
total haemoglobin mass in elite swimmers. European Journal of Applied Physiology. 2012 Sep;112(9):3275-85.

Heinicke K, Heinicke I, Schmidt W, Wolfarth B. A three-week traditional
altitude training increases hemoglobin mass and red cell volume in elite biathlon
athletes. International Journal of Sports Medicine. 2005 Jun;26(5):350-5.

Pottgiesser T, Garvican LA, Martin DT, Featonby JM, Gore CJ, Schumacher YO.
Short-term hematological effects upon completion of a four-week simulated
altitude camp. International Journal of Sports Physiology and Performance. 2012 Mar;7(1):79-83

Rice L, Ruiz W, Driscoll T, Whitley CE, Tapia R, Hachey DL, Gonzales GF,
Alfrey CP. Neocytolysis on descent from altitude: a newly recognized mechanism
for the control of red cell mass. Annals of Internal Medicine. 2001 Apr 17;134(8):652-6.

a Robertson EY, Saunders PU, Pyne DB, Aughey RJ, Anson JM, Gore CJ. Reproducibility of performance changes to simulated live high/train low altitude. Medicine and Science in Sports and Exercise. 2010 Feb;42(2):394-401.

b Robertson EY, Saunders PU, Pyne DB, Gore CJ, Anson JM. Effectiveness of
intermittent training in hypoxia combined with live high/train low. European Journal of Applied Physiology. 2010 Sep;110(2):379-87.

c Robertson EY, Aughey RJ, Anson JM, Hopkins WG, Pyne DB. Effects of simulated
and real altitude exposure in elite swimmers. Journal of Strength and Conditioning Research. 2010 Feb;24(2):487-93.

Saunders PU, Ahlgrim C, Vallance B, Green DJ, Robertson EY, Clark SA, Schumacher YO, Gore CJ. An attempt to quantify the placebo effect from a three-week simulated altitude training camp in elite race walkers. International Journal of Sports Physiology and Performance. 2010 Dec;5(4):521-34.

Wachsmuth NB, Völzke C, Prommer N, Schmidt-Trucksäss A, Frese F, Spahl O,
Eastwood A, Stray-Gundersen J, Schmidt W. The effects of classic altitude
training on hemoglobin mass in swimmers. European Journal of Applied Physiology. 2012 Nov 9

Wehrlin JP, Zuest P, Hallén J, Marti B. Live high-train low for 24 days
increases hemoglobin mass and red cell volume in elite endurance athletes. Journal Applied Physiology. 2006 Jun;100(6):1938-45.

« Previous

FILED UNDER: Commentary

Catch every stage of the Tour

Subscribe to the FREE VeloNews weekly newsletter