“Ladies and gentlemen, this is the maaain event of the evening…”
As Bruce Buffer began his famous introductions, TJ Dillashaw glanced across the octagon at his opponent, Henry Cejudo. TJ was aiming to become the fifth UFC fighter in history to simultaneously hold championship belts in two divisions. Everyone in the Barclays Center knew they could witness a historic moment that night. They didn’t know that TJ had already submitted a pre-fight drug test which would soon test positive for Erythropoietin, resulting in a two-year suspension.
Lance Armstrong, TJ Dillashaw, and Shane Mosley were all punished for doping with synthetic Erythropoietin (EPO). Why did they use synthetic EPO? The short answer: to elevate their cardiovascular capabilities and endurance to another level.
Synthetic EPO continues to be on the banned substance list for most athletic organizations, and it likely always will be, as it’s one of the most effective performance-enhancing substances. According to Jeff Novitzky, the UFC vice president of athlete health and performance, “It’s a very effective substance. On a scale of seriousness in anti-doping, it’s up near the top.”
Luckily, for athletes who don’t want to risk suspension or put synthetic substances in their body, you can increase your EPO levels naturally using breathwork.
What is EPO and Why Is It Beneficial for Combat Sports Athletes?
EPO is a glycoprotein hormone that stimulates production of oxygen-carrying red blood cells. In layman’s terms, EPO acts as a trigger telling your body to deliver more oxygen to your muscles.
For cyclists, like Lance Armstrong, EPO helps them to create energy aerobically for long periods of time by making sure their muscles receive enough oxygen.
For combat sports athletes, like TJ Dillashaw and Shane Mosley, they have more complex energy needs. EPO helps them maintain aerobic endurance, even in later rounds of a fight, which means they can push a faster pace on their opponent. EPO also helps them conserve anaerobic energy creation, meaning they can save it for key moments when they need extra power to finish a fight.
EPO Benefits:
- Improved endurance: More red blood cells means better oxygen delivery to muscles, allowing athletes to perform longer before fatigue sets in.
- Faster recovery: Enhanced oxygenation helps repair muscles and accelerates recovery post-training or competition.
- Enhanced VO₂ max: Higher EPO levels can directly contribute to a greater VO₂ max—a key metric for cardiovascular fitness and stamina.
- Efficient energy split: More time spent creating energy aerobically means athletes can save anaerobic energy creation for when they need extra power.
How Does EPO Work?
When your body detects low levels of oxygen (referred to as hypoxia), it naturally responds by releasing EPO. The EPO then stimulates the production of red blood cells. Red blood cells excel at carrying oxygen because they are high in a protein called hemoglobin, so more red blood cells means more oxygen delivery to your cells.
It takes 3-4 days for this process to occur, so you should plan ahead when training to increase EPO for a match or competition.
In order to release EPO, your body must reach an oxygen saturation (SpO2) level of 90% or less. As soon as your oxygen levels return to normal, EPO release slows down. In order to get meaningful benefits, we must repeatedly let our oxygen levels drop below 90% SpO2.
This can be done using breath hold training.
How to Increase EPO Using Breath Holds
A study by Robert de Bruijn at Mid Sweden University had participants practice 3 sets of 5 maximum breath holds. Before each breath hold, participants did one minute of hyperventilation-style breathing, which helped them to extend their breath hold time and reach lower oxygen levels. The results showed increases in EPO of up to 24%.
If you aren’t able to dedicate time to do that many rounds of training, you can likely get effective results with less volume. Patrick McKeown, the founder of Oxygen Advantage, recommends a protocol of 5 maximum breath holds a few times per week.
When performing breath holds, remember:
- Hold your breath after an exhale for better results
- Breath holds should NOT be performed completely to failure, only until you have a strong urge to breathe
- Breath hold times vary based on a lot of factors (sleep, stress, when you last ate), so don’t expect to reach the same breath hold time each session
Want a helpful follow-along tool? I recommend the Wim Hof Method app. Wim Hof breathing involves hyperventilation style breathing (similar to the Mid Sweden University study) followed by breath holds. You can customize the settings in the app in order to do 5+ rounds.
Want to take your performance on the mats to another level? Consider one-on-one breathwork coaching.