Training with no altitude

I come from a mountaineering background, so I have quite a bit of experience with altitude.  I primarily run trails now and currently train with someone who won a 100 mile ultra at moderate altitude last year despite training at low altitude.  Depending on where we run in the S.F. Bay area, we are training anywhere from a few hundred feet, up to 3,000 feet tops.  Probably 90% is below 1500 feet, which has no effect on acclimatization for altitude.

"fairly significant elevation" is a very vague description.  There is a huge difference between running at 6,000 and 14,000 feet.  Regardless, you should avoid strenuous exercise on your first day at altitude.  Most of your acclimatization occurs in the first 72 hours, so my friend's decision to arrive at altitude 4 days before her ultra was a wise one.  Her race topped out at just a bit over 9,000 feet and she amazed her competition by winning after coming from sea level, when many of them lived and trained at altitude. 

I've run at 9,000 feet, after a week at over 6,000 feet (around Mexico City), and felt like I was running at sea level.  On the other hand, running at over 13,000 feet (with 3 or 4 days at altitude) gave me a monster headache and felt like running in molasses.  More important then the altitude you train at, is the altitude you sleep at. 

Ideally, you'd spend the first night at about 7,500 feet (plus or minus 1000), then take your first day a bit easy, perhaps with an easy hike up to 9,000.  You gradually increase your altitude and activity level.  Sleep a bit higher too.  But, if you have a race in a few days, you keep it really light (you're tapering) drive up higher and walk around and look at the views etc.  We can't always have it ideally, but if I was doing an Ultra in Colorado, where I peaked out at 14,000, I'd want to spend half my taper at altitude~~i.e. turn it into a vacation with the race near the end.

We used to drive 5 to 6 hours from sea level to 8 or 9,000 on Friday nights, throw our bags on the ground around midnight.  Then get up at first light, drive to the trailhead and start a long hard approach hike up to 10 to 12,000 feet in the Sierra.  The next day we would climb, sometimes to 14,000 feet.  Then we'd pack out.  Much of the approach/retreat hiking was cross country including scree, talus and boulder fields etc. carrying packs and climbing gear.  Hard work and we weren't acclimated. 

Some of us would get sick as dogs.  Often, they were the fittest.  Interestingly, younger, stronger and fitter guys seem to do worse with altitude.  Several psychological factors probably play the major roll here:  Lack of experience, feeling they are invincible, expecting to accomplish at altitude what they can at low elevation, showing off etc etc.

We used to use a drug called diamox.  It was originally meant to lower intraocular pressure, but was found to aid in altitude sickness.  I believe there is another drug used now, but I've been out of the game.  Do a google on it.

Do take altitude very seriously.  Overtaxing yourself at even a low 14,000 feet can result in death.  A number of decades ago, a renouned mountaineer passed away (I don't remember whether it was from Cerebral edema) while sleeping on top of Mt. Raineer, which is just a wee bit over 14K.  Usually you aren't in danger of serious death or incapacitation until you are much higher (18K and up).  You can't be sure how you will react.  I've had experiences with myself or friends, where one of us got sick as a dog at a very low altitude (7 to 9,ooo feet), although they'd never had the problem before and didn't have it after.  You are taxing yourself seriously with mountain sports and altitude can be the nail in your coffin, not just a reason to puke on your boots (I did that many times).

I personally believe a huge part of altitude sickness is due to dehydration.  Remember, the air is dry (despite all those snow clad vistas) and you are not only rapidly losing water from sweat, but you are breathing much harder and blowing out all kinds of moisture.  Many times, I've lost 10 to 12 lbs on 2 or 3 day climbing trips, despite trying to stay hydrated (hard when you are at work with a time limit).  I always gained all the weight back within 5 days after the climb, so I know it was virtually all water loss. 

Also, be aware that the sun is brutal at altitude, especially if your path takes you across snow fields.  A lot of the headache associated with mountain sickness is probably due to glare and sun exposure.

When you race at altitude, you quite literally "aren't in Kansas anymore".  Definitely lower the bar until you have more experience with how you'll react.  Prepare by arriving early, using plenty of sunblock and becoming doubly obsessive with hydration.