How I Trained for Altitude (it's not what you might think)

View of Mount Audubon from Mitchell Lake

“Everyone has a plan 'till they get punched in the mouth.”

- Mike Tyson

I live in Florida, basically below sea level : ) So when my best friend invited me to hike up to 13,200 ft, I put a ton of pressure on myself to do it. I thought, “I’m The Breathing Diabetic. I better be able to handle some altitude.”

But I didn’t train how you might think. Of course, I initially started with more breath holds. But I realized that the issue at altitude is lower air pressure. To breathe, our lungs expand, the pressure decreases in our lungs, and air flows in from the atmosphere due to the pressure difference. However, at altitude, the lower air pressure will make that process harder.

If each breath is harder, your diaphragm and other breathing muscles will fatigue quicker, and you’ll feel out of breath. Maybe I’m wrong, but that seemed like the biggest issue when I considered everything I’ve learned.

So I decided to focus on lung capacity. With greater lung capacity, the lungs can expand more, pressure can decrease more, and breathing can be easier at altitude. Is this proven? I don’t know. But it made sense to me.

So I did a lot of Wim Hof breathing, a lot of work with the Oxygen Advantage Sports Mask, and a lot of extended exhalations. I also used ocean breathing during my morning breathing practice for added resistance.

Did it work? I’m not sure since I don’t have a control to compare against. But I made it. It was extremely challenging, and all of my plans went out the window once we hit about 11,000 ft. The winds were insane, my hands were freezing, and the continuous uphill was way more brutal than I expected.

To cope, I did some periodic breathwalking, and every few minutes, I took 10 massive Wim Hof style breaths. Going up, I was probably around 40% nasal, 60% mouth breathing (I went into it not caring which hole I used, as long as I made it). Going down was about 90% nasal and 10% mouth.

When I got to the summit, my oxygen saturation was steadily 81-85%. Crazily, my blood sugar was 404 mg/dL (!), which wasn’t helping the situation. But I made it. Mission accomplished.

If you have any thoughts about altitude or my training approach, please send me an email at nick@thebreathingdiabetic.com with the subject “High Altitude.” It was my first time, so I have no clue if what I’m saying makes sense : )

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More Pictures

SpO2 was hovering around 81-85% right when we reached the summit. This was with normal nasal breathing.

“Strategically” giving my diaphragm a rest before we started one of the last pushes. I wasn’t tired, just meditating 😂😂😂

Me (left) and James (right) at the peak hiding from the insane winds. Gusts felt like they were over 60 mph.

James taking in the view.

20 One-Sentence Thoughts on the Wim Hof Method

The Wim Hof Method. For some, it’s easy to point out its flaws. For others, it’s hard to deny its power. But one thing is certain: it’s confusing as hell for just about everyone.

Below, I share 20 one-sentence thoughts about the WHM. You might still be confused, but at least we can be confused together : )

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1. The Wim Hof PNAS paper is breathing’s equivalent of a "4-minute mile," proving scientifically that the impossible is possible.

2. You feel supercharged after three rounds, but you are not super-oxygenated.

3. By offloading carbon dioxide, you discover that you can hold your breath much longer than you ever imagined.

4. The most powerful aspect of the WHM is the mindset it gives you for the rest of your life.

5. Counterintuitively, the heavy breathing reduces oxygen delivery to the brain.

6. If Wim does yoga, then I do yoga too.

7. It’s embarrassing, yet empowering, to hold horse stance for 10 minutes in your room while swinging your arms around like an inflatable air dancer at a used car dealership.

8. The intense physiological stress of the method leads to an equally powerful relaxation response afterward.

9. The showers aren’t even that cold here.

10. The lights you see on the third round aren’t mystical, they’re electrical.

11. Three rounds of the WHM comes out to an average of about 8 breaths/min; thus, from a statistical perspective, the WHM is actually slow breathing.

12. Wait, how does it work again?

13. The hole doesn’t matter, unless you become a chronic mouth breather.

14. Your belief that Wim Hof breathing helps with the cold is what helps most with the cold.

15. You can control your cytokines, immune response, and autonomic nervous system, all with the breath

16. After years of doing it, you realize the WHM has little to do with the breath, and everything to do with the mind.

17. Immersion in cold water is the ultimate test of breath control.

18. Wim insists he’s not a guru, but the world insists on treating him otherwise.

19. Wim’s charisma is an unaccounted-for placebo effect.

20. The Wim Hof Method is a gateway drug into the Oxygen Advantage.

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Please do not try the WHM without supervision from a WHM instructor who can assess contraindications, pre-existing conditions, and so on. It can be dangerous, so be smart.

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The Breathing 411

If you enjoyed this, consider signing up for my 411 newsletter. Each Monday, I combine information from scientific journals, books, articles, and podcasts to share 4 thoughts, 1 quote, and 1 answer (like "Jeopardy!") related to breathing.

P.S. This “one-sentence” idea was inspired by Josh Spector’s excellent post on communication. I highly recommend his For The Interested newsletter.

I'm Rucking 100 Miles + Diaphragmatic Breathing Improves HbA1c

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Announcement:
I’m Rucking 100 Miles for Chronic Disease

On Leap Day, February 29th, I’m going to ruck 100 miles to raise money for the Health and Human Performance Foundation (HHPF).

If you’ve been following me for a little while, you know I’m a huge fan of their mission. They are an amazing nonprofit raising awareness around the benefits of breathing for chronic disease, stress, and anxiety.

Given the impacts breathing has had on my life, I wanted support their cause. What better way than a ridiculously long walk?

I am wearing a weighted rucksack to symbolize the extra weight we carry around as those living with chronic disease. Yet, despite that weight, we can still accomplish anything. In fact, that weight makes us stronger. I wholeheartedly believe diabetes has made stronger.

We are setting up a donations page on HHPF, which I’ll be sending out separately. If you feel so inspired, donate to help support their great mission. And please support me by telling others, sharing our posts on Instagram, and spreading the word about HHPF.

Thank you in advance for your support!

Now, on to the science.

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Last week, we learned that diaphragmatic breathing improved HRV and lowered HbA1c. This week’s research reveals that it also improves antioxidant status in type 2 diabetics.

Diaphragmatic Breathing Exercise as a Therapeutic Intervention for Control of Oxidative Stress in Type 2 Diabetes Mellitus

(Read the Full Summary)

This is one of the early papers I posted to The Breathing Diabetic. I often go back through important papers to reinforce the ideas and see if I notice new things I missed before.

This one did not disappoint. Just re-reading all of my notes on this one energized me (image below). I’m fascinated with breathing, but sometimes I need a paper like this to remind me how important it is to get this research out.

The Breathing Protocol

One hundred and twenty three type-2 diabetics participated in this study. Sixty were placed in the diaphragmatic breathing group, and 63 served as controls.

The participants were instructed to lie down, place one hand on their chest, one hand on their belly, and breathe deeply and slowly, only allowing the hand on their belly to move.

This protocol is almost identical to the Oxygen Advantage “Breathe Light Advanced” exercise.

They were asked to perform this procedure for 15-20 minutes, twice a day, for 3 months.

Breathing Improves Oxidative Stress and HbA1c

At the end of the 3 months, participants in the breathing group had significantly lowered their oxidative stress by increasing antioxidant levels.

Additionally, they decreased their HbA1c by 3%. Now, this isn’t 3% as in dropping from 9% down to 6% (like last week’s study). This was 3% of their original value. Not quite as significant, but still encouraging. And, remember the study from last week didn’t see major improvements in HbA1c until the 12 month follow-up.

In short, diaphragmatic breathing led to:

• Decreased oxidative stress

• Better blood sugars

In good breath,
Nick

P.S. Here’s the first page of my notes on this article. I was clearly excited the first time I read it too.

Only Breathing Principles Endure

The first time I heard that quote, I thought of Wim Hof. Although Wim’s charisma is what sets his method apart from others, the principles he teaches are timeless.

For example, in the classic book Science of Breath, the following advice is given to avoid catching a cold:

When chilled, breathe vigorously for a few minutes, and you will feel a glow all over your body. [1]

How about the Oxygen Advantage? Well, that originated with the Buteyko Method. And long before Buteyko, yogis were training themselves to “bottle up” as much CO2 as possible (my bold).

He had learned much about the basics of the transparent gas in medical school and quickly realized that yogic rituals worked to bottle it [CO2] up inside the body. The main technique of manipulation was pranayama… [2]

It is often said that history repeats itself. Breathing techniques are no exception. People relearn the same principles and add their own unique take on it. But the the principles remain.

That’s why for health and wellness, I focus on principles, not techniques. And from thousands of years of practice, and hundreds of years of research, the key principles are:

1. Breathe Through Your Nose (24/7) - Unless you’re an elite athlete, you should be breathing through your nose all the time. This is especially true during sleep.

2. Breathe Slowly - Almost every technique (and scientific study) has focused on breathing slowly, usually in the range of 4-6 breaths/min. Use any method you’d like to achieve this rate (equal inhale/exhale, extended exhale, box breathing, etc.).

3. Hold Your Breath - Breath holds have amazing benefits, doing everything from improving immune function to increasing blood flow to the brain.

I’ve jumped on almost every breathing bandwagon there is. And every time, I discover that there is no “cure all.” There are only principles. And when they are practiced with patience, persistence, and diligence, the true magic begins.

In good breath,
Nick

[1] Science of Breath

[2] The Science of Yoga