Continuing the discussion, we focus on cellular and metabolic adaptations, including increased capillary density, higher myoglobin concentrations, and more efficient mitochondrial function. We also explore genetic adaptations in high-altitude populations like Tibetans, Andeans, and Ethiopians, as well as how chronic hypoxia suppresses immune function. Finally, we discuss altitude training, highlighting the benefits of the “Live High, Train Low” method for endurance athletes.