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Altitude
From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history
Physical changes at high altitude after full acclimatization has been achieved include reduced production of lactate post-exercise,[1] increased tissue carbon dioxide, increased red blood cell mass, increased hematocrit, decreased plasma volume, a higher concentration of capillaries in skeletal muscles, increased myoglobin, increased mitochondria, increased aerobic enzyme concentration, increase in 2,3-Bisphosphoglyceric acid, hypoxic pulmonary vasoconstriction, and right ventricular hypertrophy.
The decreased lactate production at altitude is called the "lactate paradox."