For thousands of years, Tibetan women have lived at extreme altitudes on the Tibetan Plateau, where the air is thin and oxygen is scarce. Over time, they’ve developed unique adaptations that allow them to thrive in this environment, according to new research from Case Western Reserve University.
The study, led by Professor Cynthia Beall, looks at how these women’s bodies have evolved to deal with the challenges of living at altitudes as high as 14,000 feet. The research highlights their ability to deliver oxygen more efficiently, which helps them survive and reproduce in this harsh environment.

Surviving in Thin Air

Living at high altitudes, where oxygen levels are significantly lower than at sea level, poses major difficulties for human survival. However, for more than 10,000 years, Tibetan women have managed not only to live but to build communities and raise families in these conditions. Beall’s study, published in Proceedings of the National Academy of Sciences, uncovers the physiological traits that have enabled these women to adapt to life with such little oxygen.

The Science Behind Their Adaptations

Beall’s team studied 417 women between the ages of 46 and 86 living in Upper Mustang, Nepal. Their goal was to understand how these women’s bodies manage oxygen intake and distribution, especially since this affects their ability to reproduce. The study found that those with higher oxygen saturation levels were more successful at having children. The key seems to be a balance in hemoglobin levels—enough to transport oxygen effectively, but not so much that it thickens the blood and strains the heart.

An Ancient Genetic Advantage

One of the most important findings is the role of the EPAS1 gene, a genetic trait passed down from ancient Denisovans. This gene, which helps regulate oxygen levels in the blood, is unique to the population living on the Tibetan Plateau and plays a critical role in their ability to adapt to high-altitude life. These adaptations have been crucial in allowing Tibetan women to not just survive, but to thrive, in an environment that would be extremely challenging for most people.