The overall "hypoxic dose" associated with altitude training for athletes is typically reported in the literature as hours of exposure. Current recommendations for altitude training are based around the need to acquire a given number of hours within a specific altitude range (typically 1800-3000 m); with the expected erythropoietic change proportional to the hours accumulated. We propose that elevation should also be incorporated when calculating the total dose of altitude exposure and introduce a new metric termed "kilometer hours" to define overall hypoxic dose.
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