Breath Retention + Pranayama: the Performance-Enhancing Effects (EPO, Stem Cells, Nitric Oxide + More!)

Breath Retention + Pranayama: the Performance-Enhancing Effects (EPO, Stem Cells, Nitric Oxide + More!)

In This Article

Superhuman Effect of Breath Retention

Who would think it possible that a simple breathing practice could induce your body to produce regenerative stem cells, nitric oxide (the Nobel Prize-winning “panacea molecule”), and EPO (the performance-enhancing molecule that carried Lance Armstrong to seven Tour de France victories)?! Modern science backing these ancient breathing techniques is in.

Breathing techniques employed in Ayurveda are called pranayama. Prana means life force and ayama means to extend, control or to expand, suggesting pranayama techniques are designed to expand life force.1

Considered the key component of pranayama by many experts, (getting much attention lately in the scientific community) is breath control in the form of breath retention or kumbhaka.

Why Pranayama?

According to the Laws of Manu and the Hatha Yoga Pradipika, pranayama alone that would be sufficient to overcome desires of the mind and sense organs.4

Pranayama is a time tested tool for improving physical health, while helping the student to gain control of the mind and senses (as opposed to them having control over the student). With practice, the student begins to feel unattached to the needs of the mind and senses, allowing for a more fulfilling inner focus in life, rather than only being satisfied by outer stimulation.

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4 Parts of Pranayama1

  1. Inhale (puraka)
  2. Exhale (rechaka)
  3. Breath retention on inhale (antah kumbhaka)
  4. Breath retention on exhale (bahih kumbhaka)

Note: There is also an advanced stage of pranayama called kevala kumbhaka, a spontaneous breath retention during meditation.1

Research on pranayama with kumbhaka suggests regular practice can change and improve brainwave function and calm down fight-or-flight responses (sympathetic nervous system), while boosting rest-and-digest responses (parasympathetic nervous system). Pranayama has been found to support healthy pulmonary function, blood sugar, heart health, and blood pressure, while improving cerebral vascular circulation.1

Science of Breath Retention / Kumbhaka

Benefits of brief intermittent hypoxia (breath retention) were studied in the USSR some fifty years ago, when they were cut off from the rest of the world. When the USSR broke apart, research on intermittent hypoxia that confirmed Ayurveda’s research and practice of pranayama with retentions started to trickle out.

Russian scientists have used several techniques to produce hypoxia, including:2

  1. Hypobaric chambers
  2. High-altitude training. Quick ascent to high altitudes for short durations.
  3. Normobaric hypoxic gas mixtures, where low oxygen gas mixtures are delivered.

Brief intermittent hypoxia training or breathing techniques produce a molecule called hypoxia inducible factor 1 (HIF-1),2 responsible for what some call superhuman effects.

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Benefits of Hypoxia / HIF-1

  1. Hypoxia has been shown to increase hemoglobin levels through formation of erythropoietin (EPO).2 EPO was made famous when Lance Armstrong was caught doping his blood with EPO and was stripped of his six Tour De France victories. Yes, science suggests intermittent hypoxia from breath retention can boost EPO and enhance athletic performance.2
  2. Hypoxia boosts stem cell production. This was discovered when scientists measured stem cells in fetal circulation. The embryo in a mother’s womb breathes in a very low partial pressure of oxygen, about equal to that on Mount Everest. This hypoxic environment is so important for multiplication and growth of stem cells. After birth, when oxygen levels rise, stem cell production declines and future stem cell production is restricted to various locations in the body, such as bone marrow. Researchers suggest stem cells from bone marrow migrate to various tissues, and such migration may be facilitated by even a few minutes of hypoxia every day.2
  3. Hypoxia supports formation of growth factors, such as vascular endothelial growth factor (VEGF), which leads to formation of new blood vessels (angiogenesis). With heart patients, this can lead to formation of coronary collateral circulation.2
  4. Hypoxia induces the enzyme nitric oxide synthase (NOS), whose role is to produce nitric oxide.3 Nitric oxide (which, incidentally, is produced during nose breathing, but not mouth breathing) is perhaps the body’s most potent defense against damage of oxidative stress (free radicals).2 Nitric oxide contributes to dilatation of coronary arteries when needed. It is also involved in the quick vasodilatation required for erection of the penis, and intermittent hypoxia can be an effective treatment for erectile dysfunction.2
  5. Hypoxia has been shown to increase resistance of tissues to various insults and injuries, including radiation and aging.2
  6. Hypoxia has been shown to protect and repair damaged DNA by inducing production of a transcription factor called p53, called Guardian of the Genome.2

Starting Breath Retention Pranayama Practices

This practice requires knowledge of a pranayama technique called bhastrika. If you’re not familiar, please watch my instructional video.

Practice One

Note:  Before staring any breathing exercise or pranayama with breath retention, it is important to check you’re your primary healthcare provider to make sure such a practice is safe for you.

The first practice starts with 10 breaths of bhastrika, followed by a comfortable breath retention after the inhale. This completes one round. Complete three rounds daily.

  • Bhastrika: 10 breaths
  • Follow with comfortable breath retention after inhale
Note: Breath retention should be comfortable without any strain. As soon as there is an urge to breathe, take a breath and start your next round of 10 bhastrika breaths.

The second practice can be started after two weeks of successfully completing the first practice without any discomfort or complications.

Practice Two

This practice is the same as the first, except that following the inhale breath retention, you perform another 10 bhastrika breaths, followed by a breath retention after the last exhale. Perform three rounds daily. Do three rounds of this practice, totaling 60 bhastrika breaths and six comfortable breath holds.

  • Bhastrika 10 breaths
  • Follow with comfortable breath retention after inhale
  • Bhastrika 10 Breaths
  • Follow with comfortable breath retention after exhale
Note: Stop at any point if you feel dizzy or light-headed. Breath retention should be comfortable without any strain. As soon as you feel the urge to breathe, take a breath.

Have you experimented with breath retention, aka kumbhaka? What have you noticed?

This article originally appeared in Elephant Journal.

Thank you for visiting, where we publish cutting-edge health information combining Ayurvedic wisdom and modern science. If you are enjoying our free content, please visit our Ayurvedic Shop on your way out and share your favorite articles and videos with your friends and family.

Dr. John


  4. Swami Kuvalayananda, Pranayama. The Sky Foundation, 1931, 1966, 1978. Pg. VI

11 thoughts on “Breath Retention + Pranayama: the Performance-Enhancing Effects (EPO, Stem Cells, Nitric Oxide + More!)”

  1. Hello, Thank you so much Dr. D for your wonderful articles and videos. You are a great source of knowledge and inspiration, I learn a lot from you!
    Can this practice help lower high blood pressure? Thanks Raquel

    • Hi Helena,

      The breath hold lasts as long as is comfortable for you.

      “Breath retention should be comfortable without any strain. As soon as there is an urge to breathe, take a breath and start your next round of 10 bhastrika breaths.”

      LifeSpa Staff

  2. Thank you for sharing all of the fascinating research. I have been reading B.K.S. Iyengar’s book, “Light On Yoga”. The pranayama technique on breath retention is explained in detail as well. Taking in a breath, holding it and very slowly releasing it so that oxygen is absorbed into the cells of the body. I would like to master Bandha and Kriya. It states the effects are tones the abdominal organs, increases the gastric fire and eliminates toxins in the digestive tract. Do you have any thoughts on it? Also I enjoyed the article on the thyroid. I have celiac disease I haven’t eaten gluten in 15 years. Before I realized what it was I would break out in cluster blisters that where extremely painful. I thought it was affecting the nervous system. After reading your article it was due to my lymphatic system being sluggish as well as a compromised parasympathetic nervous system. I blew out my adrenals. My job is stressful working long shifts sitting for 18 hours a day. I have incorporated skin brushing and rhythmic breathing into my work day. By the time I arrive home I am still stressed out. Only eat two meals a day and attempt to eat meals containing foods to promote digestive fire. I hoping it will be enough to keep disease at bay as I enter to old age. I have never smoked or used drugs. Only drink wine occasionally. Any thoughts? Thank you for educating me.

    • Hi Letha,

      Dr. John says that is it Best to have a teacher for bandhas.

      He also suggested the following articles for you:

      This entire category of articles:

      And the following eBooks:

      He also mentioned that you may benefit from reading his book Eat Wheat to help with your digestion further:

      Hope this helps!

      LifeSpa Staff

      • I am so grateful for all the information given. I performed both bhastrika and Kapalabhati-pranayama. The kapalabhati -pranayama had the most interesting/beneficial effect for me. It felt as if it cooled my inner body from my head down through my chest as I breathed in. Then as I pushed the air out with the abdominal muscles it did in fact massage the heart and once again cooled the body with a great tingling effect. The stress that I hold in my chest around the heart was eliminated for a period of time. I performed this periodically throughout the workday. The only issue I had was by the end of my shift I was still thoroughly exhausted and my heart was racing when I arrived home. You probably figured out I work in the medical field. I have incorporated the following into my wellness plan. Kitchari cleanse on work days along with time restricted eating, breathing techniques:kapalabhati-pranayama and alternate nostril breathing, skin brushing for moving lymph for long hours of sitting and standing, hydration. I am going to try journaling to get through fasting. My field of study is in Cardiology I can see the harmful affects of the job all around me. I began my job weighing 120 lbs I currently weigh 170 lbs that weight gain is over 5 years! Jaw-dropping right?! My doctor is furious with me! I explained I don’t know what I am doing wrong she connected me with a nutritionist and the nutritionist did not tell me how to eat, when to it, or explain the true science of nutrition. Ayurveda does! I am feeling better and starting to lose a pound a day. I apologize for the long text. If you cannot reply I understand. Sincerely grateful.

        • I purchased the lymph cleanse kit and received the several podcast with it. I am extremely impressed. I started this thinking I knew something about diet and wellness. I was so in the dark about all of it. Dr. Douillard described EVERYTHING I have been experiencing in a very professional manner. Explained exactly how to fix it. It was as if he was sitting in my livingroom! I have been on the cleanse three days. Such a valuable purchase! By the way I took notes on every podcast! Thank you!

  3. Dear Dr. Douillard,
    For three years I have been doing a breath-holding sport – Underwater Rugby. So my ears perked up when I heard about this breath-retention technique, which I will begin doing, and report to you the results.
    We never have communicated, but you took my pulse 30 years ago at a meditation retreat and I have been happy to see your progress (from a distance) all these years. My wife Linda follows your advice as well. Here’s wishing you all the Best!!

  4. Not a fan of Lance Armstrong but he was a super-talent with or without drugs. Besides there were a high number of cyclists drugging at the time (actually across the history of cycling but that’s another story) but didn’t draw attention to themselves b/c they didn’t do well akin to Barry Bonds. How many pro baseball players actually use PEDs but no one cares because they are not standouts.


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