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Mercola on "Intermittent Hypoxia"

I previously published a blog on altitude therapy vs. cold therapy, which is included below. Altitude therapy is "intermittent hypoxia." Here is what Mercola contributes to this discourse.

I would suggest that building the discipline of "holding your breath" is too unnatural to do regularly. That is why I use a flow restriction mask when not using my altitude/hypoxia system.

Here is the mask I use.

And you will fit right in with those who are afraid to die from a "virus" yet are willing to get an unproven toxin injected right into their body!


From the Mercola article...

The interview in his article features Dr. Arkadi Prokopov, a Russian integrative medicine physician who specializes in hypoxic training and mitochondrial medicine. Optimizing mitochondrial function is, of course, one of the most important strategies for optimizing cellular energy, so it’s at the core of almost everything you do to improve your health.

Prokopov graduated from Moscow Medical University in 1980. Most of his work has revolved around biomedical research, specifically research with professional divers. He did his postgraduate dissertation on improving stress resistance in deep-sea divers.

After a decade of doing these kinds of studies, Russia started cutting research funding, so he returned to medical practice, where he began to apply his knowledge of diving physiology and controlled intermittent hypoxia (low oxygen) to the treatment of diseases such as asthma, high blood pressure, chronic inflammation and chronic infections.

“I was always interested, what is the best application of oxygen treatment to stimulate nonspecific, nonspecific [general] stress resistance?” he says. “And from many, many studies, it became clear, paradoxically, that the most efficient intervention is intermittent hypoxic treatment.”

Intermittent Hypoxia Treatment

The scientific application of intermittent hypoxic treatment started in Russia in the late 1970s. Early research showed it was radioprotective. As explained by Prokopov, when you reduce the partial pressure of oxygen in tissues that are being radiated, there’s a significant protective effect on healthy tissues. Tumors are not protected, however, because they're already hypoxic, so they’re not affected by the small, physiological decrease of oxygen partial pressure.

Early pioneers also discovered that intermittent hypoxia takes place during embryonic development. So, in utero, there are significant variations of partial pressure of oxygen.

It was not clear what is the physiological purpose of these oscillations were, but now, decades later, “we understand that this is a powerful mechanism to control the quality of mitochondria,” Prokopov says. Intermittent hypoxia is also very common in other instances.

“For instance, when we have some physical activity, when we stress our muscles, when they are contracted, the circulation is blocked and the muscle experiences [mild] hypoxia. Then, during relaxation, blood delivery [resumes] and muscles become again [saturated with] oxygen and nutrients.

This is the universal mechanism that provides continuous repair and recovery of the mitochondria and other cellular structures. So why not use this natural mechanism for other purposes, like enhancing endurance in athletes? Now, this is very well known as altitude training. Thousands of athletes use altitude training.”

As Prokopov explains, intermittently holding your breath is one of the simplest ways to stimulate mitochondrial function through hypoxia.

A face mask can also be used to administer an intermittent flow of oxygen-depleted air. These machines are known as hypoxic generators. The latest models also include computerized biofeedback and allow for all sorts of protocols to be administered. I’ve been participating (involved?) in the development of such devices for the last two decades.

Basically, it cycles through the amount of oxygen you breathe, from the therapeutic low of 10% to 14%, to a high up to 21% to 34%.

Hypoxia and the Role of Carbon Dioxide

One of the mechanisms that helps explain the benefits of intermittent hypoxia training is that it raises your carbon dioxide (CO2) which, in turn, increases the efficiency of oxygen transport and metabolism. The hypoxia also relaxes your capillaries. In your brain, hypoxia increases blood perfusion up to 40%. This is a normal physiologic hypoxic response, and CO2 plays a significant role.

If you routinely overbreathe (breathe too deeply or too rapidly, or both), you end up with lower CO2 levels than are ideal. This kind of subclinical hyperventilation is frequently a learned response to stress, and needs to be unlearned — something we discuss in my interview with Peter Litchfield, which will be posted next week.

Interestingly, Prokopov claims that once people improve the quality of their mitochondria, they typically stop overbreathing automatically.

He explains:

“Because where do we get carbon dioxide from? From the mitochondria. It's an element metabolite, the byproduct of oxidative phosphorylation. And if the mitochondria are not active enough, they don't produce enough carbon dioxide.”

Normally, the urge to breathe is stimulated and regulated by a slight increase in CO2, which happens in any physical activity. But today, in stressful situations, we rarely switch on the "fight-or-flight" response that raves up metabolism and raises CO2 production. Instead, we have only a fast increase of CO2 removal by accelerated breathing, but without an increase of physical activity that would produce more CO2 and would compensate for its drop.

Add stress when you hyperventilate even more, which further reduces your CO2 level. Before you know it, you’re in a vicious doom loop that can send you to the emergency room.

One way to increase the amount of CO2, thereby breaking this loop, is to breathe into a paper bag. That can reduce many symptoms of over-breathing and hyperventilating in just a couple of minutes. A hypoxia generator can also be used. The drawback of these kinds of tools is that they only offer temporary relief.

“It’s just a symptomatic treatment if used only sporadically,” Prokopov says. “As soon as you stop it, you overbreathe again and you have the same problems. But if you regenerate your mitochondria and make them work more efficiently and more economically, it produces a much better level of endogenous carbon dioxide.

The normal partial pressure of carbon dioxide in blood plasma is from 35 to 45 torr, but most people are below 35. If mitochondria are functioning optimally, it automatically [resets the partial pressure of CO2], and we see a reduction or complete elimination of all problems connected to over-breathing.”


You may know that your crazy mad scientist sleeps in an altitude chamber. Right now, I have adapted to 13% oxygen, equivalent to 12,000 feet above sea level.

Why do such a thing? As a cyclist and a former cross-country skier, I was made aware of the concept of "Live High - Train Low." This method was perfected by the Scandinavians who put American cross country skiers to shame.

Back then, I assumed that living in a state of depleted oxygen increased red blood cell counts and hematocrit, leading to more oxygen through the blood. However, research indicates that spending time in a hypoxic environment also increases blood vessel density.

The Japanese now outlive Americans by 9 years. Part of the reason is their lifestyle promotes healthy blood vessels.

Here are some key findings published in this paper.

In one of the most comprehensive studies of its kind, researchers at the University of Colorado School of Medicine in partnership with the Harvard School of Global Health have found that people living at higher altitudes have a lower chance of dying from ischemic heart disease and tend to live longer than others.

"If living in a lower oxygen environment such as in our Colorado mountains helps reduce the risk of dying from heart disease it could help us develop new clinical treatments for those conditions," said Benjamin Honigman, MD, professor of Emergency Medicine at the CU School of Medicine and director of the Altitude Medicine Clinic.

"Lower oxygen levels turn on certain genes and we think those genes may change the way heart muscles function. They may also produce new blood vessels that create new highways for blood flow into the heart."

Another explanation, he said, could be that increased solar radiation at altitude helps the body better synthesize vitamin D which has also been shown to have beneficial effects on the heart and some kinds of cancer.

The study was recently published in the Journal of Epidemiology and Community Health.

Honigman, senior author of the study, along with researchers that included Robert Roach, PhD, director of the School of Medicine's Altitude Research Center, Deborah Thomas, PhD, a geographer at the University of Colorado Denver and Majid Ezzati of the Harvard School of Global Health, spent four years analyzing death certificates from every county in the U.S. They examined cause-of-death, socio-economic factors and other issues in their research.

They found that of the top 20 counties with the highest life expectancy, eleven for men and five for women were located in Colorado and Utah.


Here is my setup - messy bed and all. The "all" includes an oxygen sensor and a pulse oximeter. I also have an infrared light switch for when both sides of the tent are zippered.


Here is another of many studies on this topic.

Beside genetic and life-style characteristics environmental factors may profoundly influence mortality and life expectancy. The high altitude climate comprises a set of conditions bearing the potential of modifying morbidity and mortality of approximately 400 million people who are permanently residing at elevations above 1500 meters.

The available data indicate that residency at higher altitudes are associated with lower mortality from cardiovascular diseases, stroke and certain types of cancer. In contrast, mortality from COPD and probably also from lower respiratory tract infections is rather elevated. It may be argued that moderate altitudes are more protective than high or even very high altitudes. Whereas living at higher elevations may frequently protect from the development of diseases, it could adversely affect mortality when diseases progress.


This one was published in 2021.


Preclinical studies have disclosed complex signaling cascades whereby hypoxia bolsters myocardial resistance to ischemia and reperfusion. β-Adrenergic activity, moderate ROS formation and intracellular hypoxia mobilize CREB, Nrf2 and HIF-1 to activate their respective gene programs.

The myriad products of these genes augment anaerobic ATP production and membrane Ca2+ transport, suppress apoptosis, preserve mitochondrial integrity and confer powerful antioxidant and anti-inflammatory protection to blunt ischemia-reperfusion induced myocardial injury. Defining the extent to which these diverse mechanisms effect cardioprotection in humans is crucial to develop interventions harnessing these mechanisms to treat and prevent ischemic heart disease.


This is why I originally decided to sleep in a hypoxia tent. I have been wanting to do this for 30 years since I first admired the athletic prowess of the nordic skiers.


The effect of live high-train low on hemoglobin mass (Hbmass) and red cell volume (RCV) in elite endurance athletes is still controversial. We expected that Hb(mass) and RCV would increase, when using a presumably adequate hypoxic dose.

An altitude group (AG) of 10 Swiss national team orienteers (5 men and 5 women) lived at 2,500 m (18 h per day) and trained at 1,800 and 1,000 m above sea level for 24 days. Before and after altitude, Hbmass, RCV (carbon monoxide rebreathing method), blood, iron, and performance parameters were determined. Seven Swiss national team cross-country skiers (3 men and 4 women) served as "sea level" (500-1,600 m) control group (CG) for the changes in Hbmass and RCV.

The AG increased Hbmass (805+/-209 vs. 848+/-225 g; P<0.01) and RCV (2,353+/-611 vs. 2,470+/-653 ml; P<0.01), whereas there was no change for the CG (Hbmass: 849+/-197 vs. 858+/-205 g; RCV: 2,373+/-536 vs. 2,387+/-551 ml).

Serum erythropoietin (P<0.001), reticulocytes (P<0.001), transferrin (P<0.001), soluble transferrin receptor (P<0.05), and hematocrit (P<0.01) increased, whereas ferritin (P<0.05) decreased in the AG. (Ferritin reduced to accommodate a higher concentration of iron to create the higher amounts of hematocrit).

These changes were associated with an increased maximal oxygen uptake (3,515+/-837 vs. 3,660+/-770 ml/min; P<0.05) and improved 5,000-m running times (1,098+/-104 vs. 1,080+/-98 s; P<0.01) from pre- to postaltitude.

Living at 2,500 m and training at lower altitudes for 24 days increases Hbmass and RCV. These changes may contribute to enhance performance of elite endurance athletes.


I do cold therapy to bring blood to overworked muscles. However, I was always quite sure it did not permanently change physiological values as does hypoxic living. Many studies confirm this.

Regular exposure to a cold factor—cold water swimming or ice swimming and cold air—results in an increased tolerance to cold due to numerous adaptive mechanisms in humans. Due to the lack of scientific reports on the effects of extremely low outdoor temperatures on the functioning of the human circulatory system, the aim of this study was to evaluate complete blood count and biochemical blood indices in multiple Guinness world record holder Valerjan Romanovski, who was exposed to extremely cold environment from −5 °C to −37 °C for 50 days in Rovaniemi (a city in northern Finland).

Valerjan Romanovski proved that humans can function in extremely cold temperatures.

Blood from the subject was collected before and after the expedition. The subject was found to have abnormalities for the following blood indices:

  • testosterone increases by 60.14%,

  • RBC decreases by 4.01%, (wrong direction!)

  • HGB (hemoglobin) decreases by 3.47%, (wrong direction!)

  • WBC decreases by 21.53%,

  • neutrocytes decrease by 17.31%,

  • PDW increases by 5.31% (Platelet distribution width -wrong direction) Percentage changes in other complete blood count and biochemical indices were within standard limits. Long-term exposure of the subject (50 days) to extreme cold stress had no noticeable negative effect on daily functioning.

My message to Joe Rogan: Why freeze your ass off for little benefit when you can sleep in a cozy tent and derive great benefit?

Big Joe is NOT a scientist - and is just following a trend!


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Yeah, wearing a mask to fit in is a good idea but I would not want to give those people the satisfaction and say you were right and I was wrong. We need to educate, and not worry about blending in but I get it, very amusing. Holding your breath is not natural to do regularly and I agree. Same with breathing into a paper bag to promote C02, but wearing a mask is probably unnatural also. Any invention we do is probably unnatural to the human body. Not what God intended. Going back to the term "moderation" is key. Cannot get carried away with one intervention or another. Just like working out to build up strength… it is not…


Quote: "And you will fit right in with those who are afraid to die from a "virus" yet are willing to get an unproven toxin injected right into their body!"

😆 😆 😆 😉

Thanks for the laugh, Dr. Lewis, not only because it's contradicting and funny (in a way), but also because you gave me an idea of how to blend in with the "rest" of the folks in a more productive and efficient manner. I just hope you could also provide me an affiliate link with the product you endorsed so I can help with just a little bit. That product that you provided is also new to me I didn't know it existed as a workout…

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