We sought to determine whether improved cycling performance following `Live High-Train Low` (LHTL) occurs if increases in haemoglobin mass (Hbmass) are prevented via periodic phlebotomy during hypoxic exposure. Eleven, highly trained, female cyclists completed 26 nights of simulated LHTL (16 h day-1, 3000 m). Hbmass was determined in quadruplicate before LHTL and in duplicate weekly thereafter. After 14 nights, cyclists were pair-matched, based on their Hbmass response (?Hbmass) from baseline, to form a response group (Response, n = 5) in which Hbmass was free to adapt, and a Clamp group (Clamp, n = 6) in which ?Hbmass was negated via weekly phlebotomy. All cyclists were blinded to the blood volume removed. Cycling performance was assessed in duplicate before and after LHTL using a maximal 4-min effort (MMP4min) followed by a ride time to exhaustion test at peak power output (T lim). VO2peak was established during the MMP4min. Following LHTL, Hbmass increased in Response (mean ± SD, 5.5 ± 2.9%). Due to repeated phlebotomy, there was no ?Hbmass in Clamp (-0.4 ± 0.6%). VO2peak increased in Response (3.5 ± 2.3%) but not in Clamp (0.3 ± 2.6%). MMP4min improved in both the groups (Response 4.5 ± 1.1%, Clamp 3.6 ± 1.4%) and was not different between groups (p = 0.58). T lim increased only in Response, with Clamp substantially worse than Response (-37.6%; 90% CL -58.9 to -5.0, p = 0.07). Our novel findings, showing an ~4% increase in MMP4min despite blocking an ~5% increase in Hbmass, suggest that accelerated erythropoiesis is not the sole mechanism by which LHTL improves performance. However, increases in Hbmass appear to influence the aerobic contribution to high-intensity exercise which may be important for subsequent high-intensity efforts.
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