Why are red blood cell counts often higher in people who live at high altitudes?
People who live at high altitudes often have higher red blood cell counts as a physiological response to the lower atmospheric pressure and reduced oxygen tension found at those elevations.12
This process is regulated by the hormone erythropoietin, which is produced primarily in the kidneys. When the body detects a decrease in the oxygen transported by the blood, it triggers an increase in erythropoietin production. This hormone travels to the bone marrow, where it accelerates the production of red blood cells. By increasing the number of circulating red blood cells, the body enhances its capacity to transport oxygen to the tissues, helping to offset the scarcity of oxygen in the environment. This mechanism is reversible; if a person moves to a sea level environment, the production of erythropoietin is suppressed, and the red blood cell count gradually declines to normal levels.132