Medicine Nobel Prize 2019

The secret of altitude training

Oxygen is the elixir of life. Our body reacts to a reduced supply of oxygen (hypoxia) in a complex manner. The positive effect on the body has long been known in top-classsport. Athletes make use of this as part of high-altitude training in the mountains. This not only increases the
number of red blood cells in the blood. The effects that are
triggered are much more profound.

In 2019, the two US researchers William Kaelin and Gregg Semenza as well as the Briton Peter Ratcliffe received the
Nobel Prize for Medicine for researching the molecular
mechanisms of hypoxia (“The secret of altitude training”
World Genetics-Medicine-Nobel-Prize-for-the-Secret-of-Height-Training.html).

However, you don’t have to travel to the mountains for several weeks to take advantage of the positive effects of altitude training. With the help of special training and therapy devices, you can take advantage of the positive effects of a controlled and optimized hypoxia-hyperoxia on Mallorca at sea level.

Altitude training by the sea

Who is hypoxia therapy suitable for?

Hypoxia therapy can be used as a sports medicine “training therapy” in healthy athletes to improve performance or to treat patients with specific problems.

A large number of orthopedic patients show physical symptoms without an acute injury or illness. Many of these complaints result from a changed lifestyle

  • Lack of exercise
  • High stress
  • hyperglycemic diet (too many carbohydrates)
  • Environmental toxins

Exercise and training therapy (jogging, cycling, swimming …) can help improve physical fitness and cellular functions. However, due to complaints, illnesses or other limitations, this cannot be implemented for every patient and you get into a vicious circle. This is the approach for hypoxia therapy, in which cellular processes are trained and improved, as is also the case with altitude training.


  • Chronified pain syndrome (e.g. after herniated discs, operations …)
  • Stress and muscle tension
  • Rheumatic diseases
  • Sports medicine training / performance enhancement
  • Diseases with mitochondrial dysfunction
  • Disorders of the autonomic nervous system

Therapy goals

  • Relief from pain
  • Improvement of the ability to move and exercise
  • Reduction of the vegetative derailment
  • Increase in mitochondrial performance

Mode of action

Hypoxie Erläuterung TOM

Hypoxia therapy is a conservative, non-invasive therapy method in which different oxygen concentrations are applied as a physical stimulus in order to achieve a change in metabolism at the cellular level and an increase in ATP energy production in the mitochondria. With the improved metabolic situation and increased ATP production, the body is able to optimize repair mechanisms, better withstand physical stress situations, improve vegetative regulation and consequently achieve a reduction in pain and a reduction in immune activation. This means that hypoxia therapy is not only a useful tool for the orthopedic
surgeon, but can also be a useful supplement to therapy in many other specialist areas.

Practical implementation

Hypoxia training should be repeated at the beginning, especially for untrained people. For a positive effect, 10-15 sessions should be carried out within 4-6 weeks. This becomes understandable if you imagine that you can’t run a marathon after jogging once. The effects of hypoxia therapy at the cellular level once started last for about 3-6 months. It is recommended to repeat the therapy every 3-6 months or to carry out a session every 2-4 weeks after the therapy has been completed to maintain the therapy. Depending on the desired effect, one session every 2-4 weeks is sufficient, especially for trained people.

Each session lasts about 40 minutes and comprises four to six phases of hypoxia, each followed by a phase of normoxia or hyperxia. The intensity of the hypoxia depends on the patient’s state of health and the individual hypoxia tolerance, which is determined beforehand in a hypoxia test.

During the therapy session, the vital parameters (peripheral oxygen saturation, heart rate, heart rate variability and minute ventilation (optional)) are continuously monitored and recorded.

> During therapy, patients are usually very relaxed and sometimes they also fall asleep briefly. During this time, the cells and mitochondria go through several oscillations of oxygen partial pressure changes. In contrast to various physical training units, hypoxia training is neither strenuous nor does it pose a risk to the patient. The effect is comparable to individually dosed physical training, but the cellular and systemic effects are more pronounced in hypoxia training.

Hypoxie-Therapie TOM
Hypoxietherapie TOM

Costs and reimbursement

As a rule, the German private health insurances reimburse the costs for hypoxia therapy. Accordingly, the billing takes place in accordance with the German fee schedule for doctors based on the following clauses (GOÄ 646 Hypoxietest, GOÄ 505 Respiratory Treatment, GOÄ 602
Oximetric Examination, GOÄ 602 Oxymetric Examination, GOÄ 638 Punctual Arterial / Vein Pulse Recording, GOÄ A652 Entry Test, Computer-Aided Analysis de HRV of the autonomic nervous system)

Whether the cost of hypoxia therapy is covered by your Spanish or international insurance company depends on your tariff and the individual insurance company. A single treatment consists of various individual services that are billed individually in accordance with the German GOÄ.

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