EPO is effective, there’s no doubt about that. But the research on its function in altitude-adapted athletes is limited. A study from The Journal of Medicine and Science in Sports and Exercise suggests that EPO does work in runners living and training above sea level.
The study compared chronic altitude-adapted runners with runners living at sea level. Altitude-adapted runners are people who live and train high, and are used to breathing the thin air. The authors said, “Twenty well-trained Kenyan endurance runners, living and training at approximately 2,150m received EPO injections of 50 IU/kg body mass every two days for four weeks and responses compared with another cohort that underwent an identical protocol at sea level.”
The authors found that runners who lived at altitude started with higher levels of hematocrit and hemoglobin concentration (measure of red blood cells compared to total blood concentration). While the altitude-adapted group finished with less of an advantage from the administered drugs than those who lived at sea level, they still received a 10 per cent increase in hemoglobin compared to 17 per cent for those living at sea level.
If you’re looking to increase your hemoglobin levels the legal way, you could consider doing a training camp at altitude or purchasing an altitude tent. Altitude tents allow runners to mimic a hypoxic (lack of oxygen) areas of high altitude, before coming down to sea level to train and race. Exercise physiologist Greg McMillan explains that EPO is a naturally occurring process, so when living in a hypoxic environment, the kidneys react to send erythropoietin (EPO) to the bone marrow, which produces new red blood cells to carry more oxygen. The more oxygen that gets carried in an athlete’s bloodstream, the more accessible it is to skeletal muscle, and the better those muscles can function in aerobic activity.