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Scand J Med Sci Sports. 2017 Jul;27(7):704-713. doi: 10.1111/sms.12685. Epub 2016 Mar 31.

Live high, train low - influence on resting and post-exercise hepcidin levels.

Author information

Institute for Sport & Physical Activity Research, University of Bedfordshire, Bedford, UK.
School of Sport Science, Exercise & Health, University of Western Australia, Crawley, Western Australia, Australia.
Centre for Exercise & Sports Science Research, School of Exercise and Health Science, Edith Cowan University, Joondalup, Western Australia, Australia.
School of Psychology and Exercise Science, Murdoch University, Murdoch, Western Australia, Australia.
Department of Laboratory Medicine (TML 830), Radboud University Medical Centre, Nijmegen, The Netherlands.
6, Radboudumc, Geert Grooteplein 10 (TML 830), Nijmegen, The Netherlands.
Research Institute for Sport & Exercise, University of Canberra, Belconnen, Australian Capital Territory, Australia.
Department of Physiology, Australian Institute of Sport, Bruce, Australian Capital Territory, Australia.
Exercise Physiology Laboratory, Flinders University, Bedford Park, South Australia, Australia.


The post-exercise hepcidin response during prolonged (>2 weeks) hypoxic exposure is not well understood. We compared plasma hepcidin levels 3 h after exercise [6 × 1000 m at 90% of maximal aerobic running velocity (vVO2max )] performed in normoxia and normobaric hypoxia (3000 m simulate altitude) 1 week before, and during 14 days of normobaric hypoxia [196.2 ± 25.6 h (median: 200.8 h; range: 154.3-234.8 h) at 3000 m simulated altitude] in 10 well-trained distance runners (six males, four females). Venous blood was also analyzed for hepcidin after 2 days of normobaric hypoxia. Hemoglobin mass (Hbmass ) was measured via CO rebreathing 1 week before and after 14 days of hypoxia. Hepcidin was suppressed after 2 (Cohen's d = -2.3, 95% confidence interval: [-2.9, -1.6]) and 14 days of normobaric hypoxia (d = -1.6 [-2.6, -0.6]). Hepcidin increased from baseline, 3 h post-exercise in normoxia (d = 0.8 [0.2, 1.3]) and hypoxia (d = 0.6 [0.3, 1.0]), both before and after exposure (normoxia: d = 0.7 [0.3, 1.2]; hypoxia: d = 1.3 [0.4, 2.3]). In conclusion, 2 weeks of normobaric hypoxia suppressed resting hepcidin levels, but did not alter the post-exercise response in either normoxia or hypoxia, compared with the pre-exposure response.


Iron metabolism; altitude training; hypoxia; iron deficiency

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