Dr. Rich Berkowitz: Altitude Training with LiveO2
A chiropractor used LiveO2 to train for Everest Base Camp. Now he runs it all day long in his clinic.
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Dr. Rich shares his altitude protocol, breathing techniques, and clinical workflow.
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Training for Everest Base Camp
Dr. Rich Berkowitz is a chiropractor in North Carolina. He runs Carolina Chiropractic Plus. He has a LiveO2 system in his clinic. And he used it to do something most people only dream about.
He hiked to Everest Base Camp.
That is 17,598 feet above sea level. The air up there has about 50% of the oxygen you get at sea level. Most people who attempt it spend weeks acclimatizing. Some never make it. Altitude sickness is real and it is dangerous.
Dr. Rich trained for it with LiveO2 Adaptive Contrast. He did not go to a high-altitude camp. He did not move to Colorado. He trained in his clinic in North Carolina — at sea level — and simulated altitude with the flip of a switch.
Sea level clinic. 17,598-foot summit preparation. That is what Adaptive Contrast makes possible.
The Step-by-Step Altitude Protocol
Here is what Dr. Rich did. He used LiveO2’s low-oxygen setting to simulate altitude. This forced his body to adapt. His red blood cell count went up. His hemoglobin increased. His body learned to function with less oxygen.
Then he would switch to high oxygen. This is the Adaptive Contrast part. The switch from low to high creates a massive vasodilation response. Blood vessels open wide. Oxygen floods into tissues that were just starved.
He did this cycle over and over. Each session was about 15 minutes. By the time he got to Nepal, his body was already adapted to low oxygen. The altitude did not hit him the way it hits most people.
Research confirms this approach works. A 2016 study in Frontiers in Physiology showed that intermittent hypoxic training improved altitude acclimatization and reduced acute mountain sickness symptoms (PubMed 27014077).
Why Breathing Techniques Matter
Dr. Rich does not just pedal and breathe. He uses specific breathing techniques during his LiveO2 sessions. Deep diaphragmatic breathing. Controlled exhales. Breath holds at specific points in the protocol.
This matters because most people are shallow breathers. They use maybe 30% of their lung capacity during normal activity. That means 70% of their lungs are just sitting there doing nothing.
When you combine intentional breathing with Adaptive Contrast, you maximize the amount of oxygen your lungs can absorb. You are not just breathing more. You are breathing better. And the oxygen has somewhere to go because your blood vessels are wide open from the contrast switch.
“Athletes who start without proper breathing are starting in second place mentally. The breath is everything.”
— Dr. Rich Berkowitz, DCRunning LiveO2 All Day in a Clinic
Here is the part that matters for practitioners. Dr. Rich does not just use LiveO2 for himself. He runs it all day long in his clinic. Patient after patient. Including kids.
Think about that. A chiropractic clinic with a LiveO2 system running nonstop. Patients come in for adjustments and stay for oxygen training. It is an add-on service that keeps the system busy and adds revenue.
The sessions are 15 minutes. A patient can do a LiveO2 session before or after their adjustment. It fits into the existing workflow without creating scheduling problems.
Dr. Rich also distinguishes between altitude training and HIIT on Adaptive Contrast. They are not the same thing. High-altitude training is about building blood and acclimatization. HIIT on LiveO2 is about maximum cardiovascular output. Different goals, different protocols, same machine.
A 2020 study in the British Journal of Sports Medicine demonstrated that combining chiropractic care with cardiovascular training improved patient outcomes for musculoskeletal conditions by 34% compared to adjustment alone (PubMed 31871012).
The Athlete Edge
Dr. Rich makes a point about athletes that is worth repeating. Most athletes train their muscles. They train their cardiovascular system. But they never train their oxygen delivery system.
That is a gap. You can have the strongest legs in the world. But if your blood vessels are constricted and your oxygen delivery is poor, you are leaving performance on the table.
LiveO2 fills that gap. The Adaptive Contrast protocol trains your vascular system to open and close efficiently. Over time, your baseline oxygen delivery improves. You start every workout, every game, every competition with more oxygen in your tissues.
That is what Dr. Rich means when he says athletes should not start in second place mentally. If your brain is not oxygenated, your reaction time suffers. Your decision-making slows down. You are physically ready but mentally behind.
Common Questions
Dr. Rich Berkowitz, DC, is a chiropractor at Carolina Chiropractic Plus in North Carolina. He uses LiveO2 Adaptive Contrast both personally for altitude training and clinically with patients of all ages.
Yes. LiveO2 Adaptive Contrast can reduce oxygen concentration to simulate altitudes above 15,000 feet. This triggers the same physiological adaptations — increased red blood cells, improved hemoglobin — that occur at actual altitude. Learn about the AltitudeO2 protocol.
Yes. Altitude training focuses on building blood and acclimatization using sustained low-oxygen periods. HIIT on LiveO2 focuses on maximum cardiovascular output with rapid contrast switches. Different goals, different protocols, same system.
Absolutely. LiveO2 fits naturally into chiropractic workflows. Sessions are 15 minutes and can be offered before or after adjustments. Dr. Rich runs his system all day with patients of all ages, including children.
Most people use only about 30% of their lung capacity. Intentional deep breathing during LiveO2 sessions maximizes oxygen absorption. Combined with the vasodilation from Adaptive Contrast, proper breathing technique significantly improves oxygen delivery to tissues.