As we move from low altitude to high altitude, the air starts getting thinner and thinner. The partial pressure of oxygen starts decreasing with increasing altitude. Now, since the partial pressure of oxygen is less in our lungs, the binding of oxygen to haemoglobin in RBCs also decreases. As a result, there is decreased oxygen supply to the tissues thereby starving them of oxygen. This situation leads to the release of the hormone erythropoietin from the kidneys, which stimulates the bone marrow to increase the production of RBCs. Related Theory Oxygen is carried in the blood in two forms: (i) dissolved in plasma and RBC water (about 2% of the total) and (ii) reversibly bound to haemoglobin (about 98% of the total). The haemoglobin molecule has four binding sites for oxygen molecules: the iron atoms in the four heme groups. Thus, each Hb tetramer can bind four oxygen molecules.