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Several clinical studies and meta-analyses have quantified the effects of EPO and high-altitude exposure on hemoglobin concentration and erythropoietic response, highlighting significant individual variability and the potential risks of excessive EPO use, such as increased hematocrit and cardiovascular complications, emphasizing the need for controlled usage and monitoring (Poszczyca et al., 2018

Vitamin B12 also helps prevent megaloblastic anemia, a blood condition that makes people tired and weak

Prolonged residency at high elevations correlates with increased susceptibility to pathological conditions such as chronic mountain sickness (excessive erythrocytosis), pulmonary hypertension, high-altitude heart disease, cognitive deficits, and metabolic dysfunction (Richalet et al., 2024