Montero · Comprehensive Physiology 2018 · narrative review · n=?

Regulation of Red Blood Cell Volume with Exercise Training.

Cited 102 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative physiological review without systematic search methodology

PubMed 30549016 · doi:10.1002/cphy.c180004 · record verified 2026-08-27

What was done

Narrative review synthesizing the physiological mechanisms regulating red blood cell volume (RBCV) expansion following acute and chronic endurance training. The abstract outlines physiological models, including the "critmeter" theory and endocrine responses (angiotensin II, vasopressin, catecholamines, cortisol), without reporting a systematic search protocol or sample sizes.

What was found

The review notes that endurance champions may have 40% higher RBCV than controls, and regular training increases RBCV by up to 10% after months of exercise in healthy individuals. Initial training sessions induce plasma volume expansion, causing transient hemodilution that stimulates renal erythropoietin (EPO) production via juxtamedullary oxygen sensors. Acute exercise also transiently elevates angiotensin II, vasopressin, catecholamines, and cortisol, which promote EPO production and bone marrow red blood cell release alongside bone marrow hyperplasia.

Why it matters

Synthesizes the hormonal and hematological feedback mechanisms that drive red blood cell volume expansion and subsequent improvements in maximal oxygen uptake following endurance training.

Limits

The abstract describes a narrative review without original clinical trial data, systematic search parameters, or study counts. No statistical precision (such as confidence intervals) or heterogeneity metrics are reported.

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