Thread by @santirun

So, what would you be assessing at moderate/high #altitude for your middle distance, long distance and marathoners athletes, in order to understand their biological response to both, terrestrial elevation 🏔️ + #training🏃‍♀️🏋🏽‍♀️
Here my 10 choices👇🏽

1. Ventilatory response (i.e., monitored tshirt ) AMS or not (e.g., Hypoventilation might induce AMS)
2. Diuresis (minimized might be linked to AMS)
3. SO2 % (faster or slower acclimation according to Schoene, 1984; Sanz-Quinto, 2018)
4. Systolic + Diastolic Blood pressure

5. SG AM & PM (Hydration status daily and throughout the day)
6. Basal Body mass + pre/post training to estimate hydric balance with fluids intake and Urine production in training (Amstrong, 2015/Sanz-Quinto, 2018)
7. Total daily energy intake resting + training hours

8. BMR to adjust total daily energy intake
9. Blood tests pre/post sojourn and on days 7,14,21,28,35... including ferritin, transferrin, transferrin saturation, Hb concentration, red cells and some biochemistry markers as hepcidin, Glucose, few minerals + inflammatory markers

Yo avoid hemoconcetration values important not to perform test in the first 5-7 days of sojourn as greater extracelular body compartment distribution, well explained by Siebenmann et al. Adding Ret count and EPO in the first 24/48 hours of exposure and on days 21/post-7/16 is 👌🏽

CO rebreathing is a luxury or "Diamond" standard for vast majority of athletes attending to altitude. IMHO is a non-practical tool, so 200-300 mL of water pre-drawning might be a practical solution, to avoid hemoconcetration (assessing SG as complimentary marker is 👌🏽)

10. ISAK anthropometry, specially over 3000 m as myofibrillar protein synthesis at blunted at an hypoxic dose of 5500 km/h. In words of Calbet, no matter the amount of protein intake, cortisol at altitude is more elevated, so with training more cortisol, so more difficulties

for protein synthesis (part of his intervention in my doctoral thesis defense).

What I would love to assess without no economical limitation?
1. NIRS in pre-frontal cortex specially in high-demanding sessions (however it seems BF is well preserved until ~5000 m elevation

2. Cerebral Blood Flow of posterior supratentorial area (related to HACE), but still so much unknown so sure many other motor/functional tasks

Why or why not HRV? Benjamin Levine told me, is so much volatile and if assessed must be accompanied by assessment of blood pressure.

The main critic to assessment of HRV at altitude might be found in classic papers from Boushel et al., 2001 and Lundby et al., 2013. Besides I have used in my doctoral thesis studies in Puno at 4000 m and in Íten 🇰🇪 with a Kenyan athlete, I have many doubts on It at low FiO2 scen

To finish with this brainstorming, Lake Louise questionnaire and POMS are useful psychometric tools, which might help to know if AMS exists or not and how total mood disturbance is oscillating throughout sojourn.