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Cold Plunge Therapy for Optimal Health

Updated: Feb 1

Max Gulhane, MD - Regenerative Health Podcast


  • Seager's understanding of metabolic health began in 2001, when his 6-year-old son was diagnosed with diabetes. He spent more than twenty years keeping scrupulous records on diet, exercise, and metabolism to monitor his son's insulin. But Seager found that despite all he was learning about his son's health, he had neglected his own.

  • At age 52, obese and middle-aged, Seager's blood labs showed an elevated prostate specific antigen (PSA) indicating an inflamed prostate and an increased risk of cancer.

  • Determined to avoid biopsy and allopathic interventions, Seager chose to reduce his prostate inflammation using a ketogenic diet and daily ice baths. It worked. His PSA dropped to less than 1, and a surprising thing happen to his testosterone -- it jumped almost 400 points.

  • Seager had accidentally rediscovered that doing light exercise after cold stimulation will provide a natural boost to testosterone and luteinizing hormone in men. When Joe Rogan cited Seager's writing on his Joe Rogan Experience podcast in Dec 2022, men all over the world began to replicate Seager's results.

  • This conversation between Dr. Max Gulhane and Thomas P Seager, PhD summarizes how cold plunge therapy is an essential element in regenerative health.

Why are there so many different terms for cold water exposure?

It seems that every author invents their own terms. For example:

  • Andrew Huberman, PhD uses the term "deliberate cold exposure," to help distinguish accidental, or chronic cold exposure (which can be harmful) from intentional cold exposure for therapeutic purposes.

  • Ben Greenfield uses the term "cold thermogenesis" to describe the state of the body during cold water eposure. It includes both shivering and non-shivering thermogenesis. In my article Should I Shiver in the Ice Bath? I described the advantages of both promoting or suppressing your shiver response.

  • Joe Rogan favors the term "cold plunge," and Wim Hof often refers to an "ice bath."

  • Technically, "cryotherapy" is any deliberate use of cold exposure to promote healing or enhance performance. Although cryotherapy is most closely associated with frigid chambers of super cold air, it cold also be applied to other cold therapies, whether whole or partial body, or by cold water, ice pack, or gel pack.

  • I now prefer the term "cold plunge therapy" because that's my area of expertise. You'll still hear me sometimes use the terms "deliberate cold exposure" and "cold thermogenesis," even though those terms are a little broader than cold plunge therapy.

What is vasoconstriction?

In my article Are You Getting Enough Vasoconstriction?, I described the process by which the body shuts down circulation to cold limbs to reduce heat losses and defend the core body temperature. In a phenomenon called afterdrop, core body temperature can keep dropping even during rewarming after the ice bath, because the restoration of circulation to cold limbs will cool blood before it returns to the body core.

What is brown fat?

Unlike white fat, which stores excess food energy, brown fat is packed with mitochondria for converting stored fat into heat in a process called non-shivering thermogenesis. Most adults in western, industrialized countries don't get enough cold exposure to maintain their brown fat. By age 45, fewer than 5% of Americans who got PET scans during cancer screening had any detectable brown fat at all. Without brown fat, the body can eventually experience metabolic and cognitive disorders -- because brown fat is not just for thermogenesis. It is also an essential secretory organ. In my article How To Increase Brown Fat? Ice Bath, I explained that it takes 7-10 days of regular cold plunge therapy to recruit new brown fat and acclimated your body to the cold.

How do mitochondria modulate ageing?

Mitochondria are organelles that exist inside the body's cells to accelerate the conversion of food energy into the energy that drives exercise, growth, wound repair, thermogenesis, and all the essential processes of life. Because life is an energetic process, mitochondrial health is essential to life. Poor mitochondrial function is associated with the diseases of ageing. By contrast, robust mitochondria are associated with the vigor of youth. In my article Ice Baths for Mitochondrial Therapy, I described how the best way to stimulate the process of generating new mitochondria, called mitobiogenesis, is cold plunge therapy. Mitochondrial damage is associated with insulin resistance, and increased risk of Type 2 diabetes, cardio-vascular disease, cancer, Alzheimer's dementia and every leading cause of death from chronic illness in the United States.

Will an ice bath help me lose weight?

Cold plunge therapy will clear glucose from the bloodstream and stimulate fat burning. It will correct metabolic disorders, remodel your body composition in ways that reduces deadly visceral fat and increase benign subcutaneous fat. However, cold plunge therapy alone is insufficient to stimulate weight loss because the night after cold exposure, the metabolism slows down to compensate for the additional calorie burn during the ice bath. In Calories & Cold Exposure, I wrote about the what's wrong with the calories-in-calories-out (CICO) hypothesis and the relationship between cold exposure and body fat.

What about cortisol?

The data on cortisol and ice baths is confusing, because some datasets show that cortisol goes up during cold plunge therapy, and some shows that it goes down. It may be that an ice bath modulates cortisol. That is, it may reduce high levels and boost low levels. In this video, I reviewed several journal articles that published that data.

Can ice baths cure cancer?

No one knows what will work for any particular patient's cancer, and nothing in my podcasts or articles constitutes medical advice. All I can tell you is what other people have experienced, and what the scientific studies say. I've written several articles about these, like Cryotherapy for Cancer that describes the mechanisms by which cold exposure starves cancer cells of glucose and inhibits tumor growth. Moreover, I've written about Thomas Seyfried, PhD experiments that showed ketones also inhibit tumor growth. Because an Ice Ice Bath is Fast Keto, cold plunge therapy may be an powerful adjunctive to conventional cancer treatments. Finally, in Cold Shock Protein for Cancer, I described a new study from the University of Rochester that should cold water stimulates production of a protein that is effective for repairing defects in DNA.

Nonetheless, more inspiring than the scientific studies are likely the personal experiences. For example, in Cancer vs Cold Water Therapy and Mitochondria, Cold, Recovery from Cancer I described Dean Hall's amazing remission after swimming the entire more than 180 miles of the cold Willamette River in Oregon. Although his doctor told him that his immune system was so weakened by his leukemia that so much as setting foot in the public pool would kill him, Dean spent 3 weeks swimming the river in an effort to inspire other cancer patients. When he reported for screening after his swim, all traces of his leukemia were gone.

What's more, when author AJ Kay was diagnosed with an inoperable liver tumor in 2018, she chose to adopt a ketogenic diet, ice baths, and hot yoga. A follow up scan showed that her liver tumor shrunk and she hasn't been back to the hospital since.

How to do cold plunge therapy?

For starting out, the rule of thumb for cold plunge therapy is:

Go cold enough to gasp, long enough to shiver.

After cold acclimation, the body will activate brown fat for cold thermogenesis to defend core body temperature without shivering. Water temperatures in the upper 40's Fahrenheit are sufficient for metabolic benefits. However, in my article Set Your Ice Bath to a Temperature That Frightens You I wrote about how colder temperatures confer a psychological challenge that leads to a euphoric feeling of accomplishment.

There are Contraindications to Cold Plunge, including hypertension. And there are precautionary protocols to keep in mind that I described in Dangers of Deliberate Cold Exposure.

Many people get started with Cold Showers vs Ice Baths and it's likely that cold showers impart the same metabolic benefits that an ice bath will. However, a study in Finland showed that partial body (shower) has a different physiological effect than whole body (bath). For example, a cold shower activates the gasp reflex without the dive reflex. As a consequence, cold showers will speed heart rate, whereas an ice bath will slow it down.

That probably explains why cold showers make me angry, and ice baths relax me.


About the Author

Thomas P Seager, PhD is an Associate Professor in the School of Sustainable Engineering at Arizona State University. Seager co-founded the Morozko Forge ice bath company and is an expert in the use of ice baths for building metabolic and psychological resilience.

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