A group of trekkers have written to ask if they should take "Alti-Vit" in preparation for their trip to Mt Everest Base Camp.
Here's my reply...
Alti-Vit - A bottle of forty capsules cost £29.99
"Alti-Vit has been around for almost a decade. In the UK it's marketed by "The Altitude Centre", a London-based company that specialises in hypoxic training. According to the manufacturers, Alti-Vit contains,
"The highest quality ingredients that are known to assist performance and acclimatisation"
So what is the evidence to support these claims? Well, it all boils down to one study that appeared in the British Journal Of Sports Medicine (BJSM) in 2013.
From the outset its worth saying that the details of the study are sketchy. Seven young men were asked to take two short courses of tablets - placebo and Alti-Vit. Following each course, the men were placed in a hypoxic chamber (15% oxygen - equivalent to 2400m) and told to cycle 16km as quickly as possible. A number of measurements were taken however its not clear at what points these were taken.
Two results stand out. The time taken to complete 16km was shorter (30 vs 31 mins) and the AMS Lake Louise Score was lower (0.4 vs 3.0) whilst taking Alti-Vit. This led the authors to conclude, "The current study found 24 hour supplementation of Alti-Vit improved exercise performance at altitude and reduced the incidence and severity of AMS".
Now, it's clear that there are a number of problems with this study*. Rather than go through them all let's focus upon the conclusions. A one minute improvement in the time to pedal 16km in 15% oxygen doesn't mean a lot to trekkers or mountaineers heading to high altitude. This is especially the case since other measurements such as rating of perceived exertion (RPE), heart rate and oxygen consumption were largely unchanged. But of more concern is the conclusion that Alti-Vit had an impact upon AMS. The incidence of AMS at 2400m is normally very low. The incidence of AMS following 30 minutes of exposure to 2400m should be almost 0. What was reported as AMS in this study was probably something else - a hangover, an episode of gastroenteritis or more likely the headache, nausea and dizziness of exercising harder.
As someone who's edited medical journals for more than a decade I've seen this a lot! Researchers get caught up in their data and make over ambitious claims. Normally, these errors are politely pointed out and the authors tone down their conclusions. But today I'm going to put politeness to one side and state clearly that studies like this give science a bad name. This study was published as an abstract in a "pay to publish" journal. It did not go through the scrutiny of a peer review process and therefore this study is little more than an advertisement for Alti-Vit. What makes matters worse is that there is no declaration of interest. Were the researchers given a free supply of Alti-Vit and access to the facilities at "The Altitude Centre" to complete their study? If so, the pressure to publish a "positive" study must have been enormous. Did "The Altitude Centre" pay for it's publication? Was there support for further studies too? We just don't know.
I mention all this because the taking of Alti-Vit has important consequences. The cost is not inconsiderable. If it's used as recommended, those heading to high altitude will pay more than £60 for a single course. Alti-Vit has 12 active ingredients. Therefore there are real dangers of side effects and interactions with other drugs. But most importantly there is the message that the manufacturers of Alti-Vit are sending out. Despite the absence of any trustworthy evidence, users are led to believe that Alti-Vit offers them protection from the effects of altitude. This may lead trekkers and mountaineers to adopt dangerous ascent profiles, or worse, ignore the symptoms of high altitude diseases and put their lives at risk.
My advice is to avoid Alti-Vit. Travel light. Ascend slowly and most of all, enjoy yourselves!"
*"Sensationalised headlines", "conflict of interests", "sample size too small" and "unreplicable results" - just some of the flaws found in the Alti-Vit study