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Table 8 Changes of haematological variables related to hypoxic training strategies

From: Factors Confounding the Athlete Biological Passport: A Systematic Narrative Review

Authors Subjects Interventions [Hb] Ret% OFFs Hct PV
Living high-training high (LHTH) protocols        
Bonne et al. [58] Swimmers (n = 20) One group of swimmers lived high and trained high (LHTH, n = 10) for three to four weeks at 2130 m or higher, while a control group (n = 10) completed a three-week training camp at sea level. Haematological parameters were determined weekly three times before and four times after the training camps (+ 7, + 14, + 21 and + 28 d) = (NS) ↓ − 34% (7 d) ↑ + 22% (7 d) ↑ + 5% (7 d)
Garvican et al. [59] Cyclists (n = 13) Haematological parameters were measured in 13 elite cyclists during and 10 d after 3 weeks of sea level or altitude training (2760 m). The altitude group participated in a 3-week natural altitude training camp at Passo dello Stelvio, Italy, living at 2760 m and training during the majority of ride time > 1800 m for 2–6 h d−1 = (NS) ↑ + 25% = (NS)
↑ (12 d)
↓ (31 d)
Wachsmuth et al. [60] Swimmers (n = 27) Twenty-five athletes trained between one and three times for 3–4 weeks at altitude training camps. Three training camp were at 2320 m (G1) in Sierra Nevada, Spain, and one training camp was at 1360 m (G2) in Pretoria, South Africa = ↑ + 4% (4 weeks) =/= (NS) =/= (NS) =/= (NS) =/= (NS)
Ashenden et al. [61] Endurance athletes (n = 23) The haematological and physiological responses of 23 well-trained athletes (12 cyclists, 10 kayakers, 13 triathletes and 11 middle-distance runners) exposed to a simulated altitude of 2650 m for 11 ± 23 nights (ALT) were contrasted with those of healthy volunteers receiving a low dose (150 IU·kg−1 per week) of rEPO for 25 d (DOP) ↑ + 36% (17 d)
Living high-training low (LHTL) protocols        
Ashenden et al. [62] Endurance athletes (n = 64) Haematologic data were collected from three groups: 19 elite cyclists who lived and trained 2690 m above sea level for 26–31 d (LH-TH), from 39 well-trained subjects who resided at sea level but slept at a simulated altitude of 2650–3000 m for 20–23 d of consecutive or intermittent nightly exposure (LH-TL), and from six elite Kenyan runners who lived 2100 m above sea level but descended to compete at sea level competitions ↑ (21 d) ↑ (21 d) ↑ (21 d)
Garvican-Lewis et al. [63] Endurance athletes (n = 34) Thirty‐four endurance‐trained athletes (20 runners, 11 cyclists and three triathletes) completed 3 weeks of simulated LH-TL altitude training, accumulating an average of 14 h d−1 at a simulated altitude (normobaric hypoxia) of 3000 m. Athletes received either oral (ORAL), intravenous (IV) or placebo iron supplementation (PLA) ↑ + 0.9 ↓ − 0.2% ↑ + 10 pt
↑ + 0.8 ↓ − 0.2% = (21 d) ↑ + 8 pt
↑ + 0.6 g·dL−1 (21 d)   ↑ + 9 pt (21 d)
Neya et al. [64] Recreational athletes (n = 14) Fourteen male collegiate runners were equally divided into two groups: altitude (ALT) and control (CON). Both groups spent 22 d at 1300–1800 m. The ALT group spent 10 h/night for 21 nights in simulated altitude (3000 m), while the CON group stayed at 1300 m (Takayama, Gifu, Japan) ↑ (17 d) ↑ (17 d) ↑ (17 d)
Voss et al. [65] Runners (n = 10) The participants spent ~ 6 h·d−1 at 3000–5400 m during waking hours and ~ 10 h·d−1 overnight at 2400–3000 m simulated altitude. Venous blood samples were collected before hypoxic exposure (B0), after + 1 (D1), + 4 (D4), + 7 (D7) and + 14 (D14) d of hypoxic exposure and again + 14 d post-exposure (P14) ↑ + 0,9 g·dL−1 (D14) ↑ + 0.4% ↑ (P14)
↓ − 1,3 g·dL−1 (P14) ↓ (D7)
↓ (P14)
Intermittent hypoxic exposure (IHE) or training (IHT)        
Kasperska and Zembron-Lacny [66] Wrestlers (n = 12) Twelve wrestlers were assigned to two groups: hypoxia (sports training combined with intermittent hypoxic exposure) and control (sports training only). An approximately 1 h intermittent hypoxic exposure was performed once a day for 10 d with one day off after 6 d = (NS) ↑ + 350% (10 d) = (NS)
Abellan, Ventura, Remacha et al. [67] Triathletes (n = 16) Sixteen male triathletes were randomly assigned to either the intermittent hypoxia exposure group or the control normoxic group. The exposure group were exposed to simulated altitude (4000–5500 m) in a hypobaric chamber for 3 h d−1, 5 d a week for 4 weeks. Blood and urine samples were collected before and after the first (T0) and the final exposures (T1) and 2 weeks after the final exposure (T2) = (NS) = (NS) = (NS)
Sanchez and Borrani [68] Runners (n = 30) Fifteen highly trained endurance runners completed a 6-week regimented training with three sessions per week consisting of intermittent runs (6 × work-rest ratio of 5′:5′) on a treadmill at 80–85% of maximal aerobic speed. Nine athletes (the hypoxic group) performed the exercise bouts at FI02 = 10.6–11.4%, while six athletes (the normoxic group) exercised in ambient air = (NS) = (NS) = (NS) = (NS)
  1. Numbers represent the relative changes during the most significant measurement: haemoglobin concentration ([Hb]), reticulocytes percentage (Ret%), OFF-Score (OFFS), haematocrit (Hct) and plasma volume (PV). Values in italics correspond to absolute variations