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Cryotherapy for Chronic Medical Conditions

Updated: May 5

Medicine is warming up to ice baths



Summary

  • Modern medicine seems to have discarded the ancient wisdom of cold therapies in favor of pharmaceuticals.

  • Polish researchers conducting clinical trials proving the efficacy of cryotherapy for treatment of chronic illness may be reversing the modern trend by supporting more traditional ways with new data.

  • Case studies in cold plunge therapy support its use for treatment of brain injury, mental health disorders, metabolic & cardiovascular disorders, multiple sclerosis, and chronic inflammation such as rheumatoid arthritis.


Cold Therapy in Ancient & Modern Medicine

The salubrious effects of cold therapy have been understood for centuries. For example, a team of researchers based primarily in the United Kingdom recently wrote that "the beneficial effects of cold-water immersion (CWI) on

human physiology dates as far back as 3500BC" and that ancient Greek physicians such as Hippocrates prescribed cold water therapies for medicinal purposes and analgesic benefits (Allan et al. 2022).


Unfortunately, as drug development has became more sophisticated, physicians have increasingly departed from the ancient wisdom of cold therapy in favor of pharmaceuticals. For example, cold water immersion has been a traditional remedy for the treatment or rescue of newborns with hypoxic brain injury. The story of entrepreneur and philanthropist Jon Huntsman, Sr. (1937-2018) is particularly dramatic. In his autobiography Barefoot to Billionaire (Huntsman 2014) he describes how a midwife in Blackfoot Idaho used cold and warm water contrast treatment to bring him to life after he failed to start breathing at birth.


She had my Father hold me under the cold-water spigot, and then under the hot one, and to keep doing it... cold, hot, cold, hot, cold, hot. He and the midwife repeated the routine for several minutes until, barely perceptible, my tiny (newborn) mouth opened and closed -- just once. - Jon Huntsman, Sr.

What's remarkable is that Huntsman not only survived extended oxygen starvation as a newborn, but his brain recovered so well that he became a super successful businessman and donated more than a billion dollars to charitable causes including cancer research.


Jackson et al. (2024) describes the myriad pathways by which mild hypothermia "produces potent neuroprotection" by stimulating the production of fibroblast growth factor 21 (FGF-21) and brain-derived neurotrophic factor (BDNF) for brain growth and function. Moreover, an international team of researchers funded by the US National Institute of Health (NIH) reviewed the extensive literature on therapeutic hypothermia and concluded "Evidence shows that artificially lowering body and brain temperature can significantly reduce the deleterious effects of brain injury in both newborns and adults" (Ma et al. 2012).


There is now overwhelming clinical and experimental evidence that mild to moderate postasphyxial cerebral cooling is associated with long-term improved survival without disability. - Gunn et al. 2017

The wisdom of therapeutic hypothermia for neonatal asphyxia was abandoned in the 1980's (Kochanek et al. 2009). Now, infants with hypoxic brain injury can be treated with Viagra instead of cold water immersion (Wintermark et al. 2024).


However, medical science may be taking an increasing interest in re-discovering what was once widely understood. New review articles have appeared in the last several years that both summarize existing scientific knowledge and suggest promising new pathways for research. The recent contributions of Polish researchers are especially helpful. For example, Tabisz et al. (2023) describe the medical benefits of deliberate cold exposure in several areas of chronic illness including mental health disorders, metabolic & cardiovascular disorders, and chronic inflammation.


Could it be that the best work on cold therapy is coming from eastern European countries that once languished under Soviet rule because they avoided capture by American pharmaceutical corporations?


Cold Benefits Mental Health & Mood

Most of the research related to nervous system benefits has been focused on whole-body cryotherapy (WBC). Here, several studies demonstrate improvements in cognitive function. For example, 21 patients suffering from mild cognitive impairment experienced lasting improvements in memory after WBC (Rymaszewska et al. 2021). Other studies have obtained similar results with regard to memory and also measured improvements in learning ability and attentional control (Senczyszyn et al. 2021). In addition to cognitive benefits, improvements in mood and sleep have been attributed to WBC. For example, Rymaszewska et al. (2008) demonstrated a decrease in the severity of depression and anxiety, while Tabisz' review cites other studies that noticed improved sleep and quality of life.


These studies are borne out by the experiences of Latvian product designer Edgar Treimanis. Suffering from a long-lasting major depression, Treimanis sought to drown himself in the warm water of his bathtub, only to be interrupted during his attempt by his brother. The next day, determined to escape his family's notice during his next attempt, he resolved to run down to the beach and drown himself in the Baltic Sea.


But when Treimanis waded into the cold Baltic waters, the shock to his nervous system jolted him out of his depression. His Father, having followed him to the beach, caught up to him, dove in after his son and they embraced in the water. Together, they went home to rewarm and promised each other that they would swim every day.


Since then, Treimanis has wanted to live. What's more, he's continued his practice of cold water therapy, won an award for one of his product designs and stayed out of the funk that drove him to attempt suicide.


Treimanis' case is not unique. In Depression Cured by Cold Plunge I wrote about scientifically supervised cases of severe depression that resisted drugs and talk therapy, but responded well to winter swimming. As with Treimanis, these patients resolved their depression and were able to discontinue taking medications. That may be because the cold is more effective than drugs for modulating neurochemistry. In addition to the dopamine and norepinephrine boost provided by the cold plunge, new research has revealed that lower skin temperatures can stimulate production of oxytocin and motivate stronger social connections (Fischer et al. 2024).


Cold Benefits Metabolism & Cardiovascular Health

The metabolic benefits of cold plunge therapy have already been well documented. For example, in Ice Baths for Mitochondrial Therapy I wrote about the use of cold water for reversing insulin resistance and stimulating mitobiogenesis -- the production of new mitochondria. But what I didn't write about was the effect of cold on markers of cardiovascular disease and the improvement in blood lipid profiles that can be expected from a regular cold practice.


When a team of Polish researchers used exercise and whole-body cryotherapy with 30 adult obese subjects, they measured decreases in cardiovascular risk factors including triglyceride levels and an increase in HDL (i.e., good) cholesterol -- without changes in body mass index or percent body fat (Lubkowska et al. 2015).


This remarkable finding suggests that even in the absence of weight loss, cold therapy can create metabolic and cardiovascular improvements that reduce markers of ageing and mortality. Moreover, other studies corroborate these findings, and add that cold therapy will remodel body fat by reducing dangerous visceral (belly) fat (Pilch et al. 2022). As I first wrote in How To Increase Brown Fat? Ice Bath, a regular program of cold therapy can even reduce the liver fat that is characteristic of deadly non-alcoholic fatty liver disease (Wibmer et al. 2021).


Cold Therapy Reverses Chronic Inflammation

It seems that every athlete, trainer, or physical therapist is already familiar with the use of cryotherapies for reducing the acute inflammation that accompanies injury or overuse. However, few people understand the potential for a regular cold plunge practice to alleviate symptoms of chronic inflammation.


One important blood marker of chronic inflammation is called c-reactive protein (CRP). Elevated CRP is a clinical indication of rheumatoid arthritis (RA) and associated with increased risk of heart attack. Consequently, some physicians monitor CRP levels in their patients to detect possible heart disease.


When 25 patients with rheumatoid arthritis were enrolled in a study to investigate the potential of whole-body cryotherapy (WBC) to alleviate pain and increase mobility compared to a control group undergoing physical therapy, researchers in Warsaw, Poland observed improvements in both groups. However, only the cold therapy group experienced a reduction in C-reactive Protein (Sadura-Sieklucka et al. 2019).


Rheumatoid Arthritis

These results are similar to an earlier study that enrolled more than a dozen RA patients in a 4-week program of daily WBC for 2-3 min at -140 to -160C. Although they didn't measure CRP, these researchers discovered a significant reduction in histamine levels in the cold-treated group (Wojtecka-Lukasik et al. 2010). Given that RA is an auto-immune disorder, and elevated histamines are associated with immune system irregularities, this study suggests that cold therapy may reduce chronic inflammation by reversing immune system dysfunction.


The experience of Erin Miller is emblematic of the way in which cold therapy can benefit RA patients. Miller is a registered nurse who works as a medication safety specialist in a California hospital. She exercises regularly and eats healthy, but she also suffers from such severe RA pain that is sometimes used to interfere with her ability to perform her medical duties.


She resisted taking steroids and pain medications, because her expert training in medication safety informed her of the adverse side effects that long-term use of these medications can cause.


When she discovered cold plunge therapy, her rheumatoid arthritis (RA) symptoms disappeared. After just 2-3 minutes of full-body cold water immersion "for the first time in 4-5 years, I woke up and didn't have any pain in my hands."


Multiple Sclerosis

I've written previously on the life-changing potential of cold plunge therapy for multiple sclerosis, another autoimmune disorder. For example, in Cold Plunge for Multiple Sclerosis I chronicled the experiences of former Navy SEAL Justin Hoagland, who was bound to a wheelchair by his debilitating symptoms of MS until he started a regular practice of ice baths. And in Multiple Sclerosis Relief I related the story of Jule Blew, who considers her ice bath her "best friend" because of how it allows her to practice yoga and compete in long-distance running races. Their experiences are consistent with a study that showed significant reduction in self-reported fatigue among MS patients who participated in a clinical trial of WBC (Miller et al. 2016). Moreover, cooling therapy studies show a dose-dependent relationship, meaning that more cooling generally results in greater benefit (NASA 2003).


What the Tabisz' review adds is that one mechanism by which MS patients obtain relief is likely a reduction in neuroinflammation (Tabisz et al. 2023). That finding reinforces the view that cold therapy benefits the brain and can be used to treat disorders of the central nervous system.


The Future of Cold Plunge Therapy

One of the downsides of social media is that it can reward bad behavior with clicks. That is, social media pays content creators for engagement -- not truth. Moreover, according to a 2023 report the healthcare/pharmaceutical industry is the fifth-largest spender on digital advertising in the United States -- ahead of automobiles, entertainment, and travel. This combination of incentives amplifies hyperbolic, science-flavored criticism of personal experiences, case studies, and clinical trials conducted outside the protection of pharmaceutical funding.


As the popularity of ice baths has exploded, so has a cacophony of critics ridiculing people who post about the benefits they've received from cold plunge therapy and lampooning the scientists who have published studies in support of those experiences. Nonetheless, knowledge is more persistent than clicks.


Increasingly, a credible scientific community is forming around cold plunge and related metabolic therapies. Aside from celebrity science communicator Prof. Andrew Huberman (Stanford University), others like insulin expert Prof. Ben Bikman (Brigham Young University) and metabolic mental health psychiatrist Dr. Chris Palmer (Harvard University) are helping advance the leading edge of metabolic science in both the laboratory and the media. Part of our mission at Morozko is to connect our audience to these credible sources of scientific knowledge that helps sort out the helpful from the hyperbole.


References

  • Allan R, Malone J, Alexander J, Vorajee S, Ihsan M, Gregson W, Kwiecien S, Mawhinney C. Cold for centuries: a brief history of cryotherapies to improve health, injury and post-exercise recovery. European journal of applied physiology. 2022 May;122(5):1153-62.

  • Fischer S, Nägeli K, Cardone D, Filippini C, Merla A, Ehlert U. Emerging effects of temperature on human cognition, affect, and behaviour. Biological Psychology. 2024 Apr 8:108791.

  • Gunn AJ, Laptook AR, Robertson NJ, Barks JD, Thoresen M, Wassink G, Bennet L. Therapeutic hypothermia translates from ancient history in to practice. Pediatric research. 2017 Jan;81(1):202-9.

  • Huntsman J. Barefoot to Billionaire: Reflections on a Life's Work and a Promise to Cure Cancer. Abrams; 2014 Oct 1.

  • Kochanek PM, Fink EL, Bell MJ, Bayir H, Clark RS. Therapeutic hypothermia: applications in pediatric cardiac arrest. Journal of Neurotrauma. 2009 Mar 1;26(3):421-7.

  • Jackson TC, Herrmann JR, Fink EL, Au AK, Kochanek PM. Harnessing the promise of the cold stress response for acute brain injury and critical illness in infants and children. Pediatric Critical Care Medicine. 2024 Mar 1;25(3):259-70.

  • Lubkowska A, Dudzińska W, Bryczkowska I, Dołęgowska B. Body composition, lipid profile, adipokine concentration, and antioxidant capacity changes during interventions to treat overweight with exercise programme and whole-body cryostimulation. Oxidative medicine and cellular longevity. 2015 Oct;2015.

  • Ma H, Sinha B, Pandya RS, Lin N, Popp AJ, Li J, Yao J, Wang X. Therapeutic hypothermia as a neuroprotective strategy in neonatal hypoxic-ischemic brain injury and traumatic brain injury. Current molecular medicine. 2012 Dec 1;12(10):1282-96.

  • Miller E, Kostka J, Włodarczyk T, Dugué B. Whole‐body cryostimulation (cryotherapy) provides benefits for fatigue and functional status in multiple sclerosis patients. A case–control study. Acta Neurologica Scandinavica. 2016 Dec;134(6):420-6.

  • NASA/MS Cooling Study Group. A randomized controlled study of the acute and chronic effects of cooling therapy for MS. Neurology. 2003 Jun 24;60(12):1955-60.

  • Pilch W, Piotrowska A, Wyrostek J, Czerwińska-Ledwig O, Ziemann E, Antosiewicz J, Zasada M, Kulesa-Mrowiecka M, Żychowska M. Different changes in adipokines, lipid profile, and TNF-alpha levels between 10 and 20 whole body cryostimulation sessions in individuals with I and II degrees of obesity. Biomedicines. 2022 Jan 26;10(2):269.

  • Rymaszewska J, Ramsey D, Chładzińska-Kiejna S. Whole-body cryotherapy as adjunct treatment of depressive and anxiety disorders. Archivum immunologiae et therapiae experimentalis. 2008 Feb;56:63-8.

  • Rymaszewska J, Lion KM, Stańczykiewicz B, Rymaszewska JE, Trypka E, Pawlik-Sobecka L, Kokot I, Płaczkowska S, Zabłocka A, Szcześniak D. The improvement of cognitive deficits after whole-body cryotherapy–A randomised controlled trial. Experimental Gerontology. 2021 Apr 1;146:111237.

  • Sadura-Sieklucka T, Sołtysiuk B, Karlicka A, Sokołowska B, Kontny E, Księżopolska-Orłowska K. Effects of whole body cryotherapy in patients with rheumatoid arthritis considering immune parameters. Reumatologia/Rheumatology. 2019 Dec 31;57(6):320-5.

  • Senczyszyn A, Wallner R, Szczesniak DM, Łuc M, Rymaszewska J. The effectiveness of computerized cognitive training combined with whole body cryotherapy in improving cognitive functions in older adults. A case control study. Frontiers in psychiatry. 2021 Jun 25;12:649066.

  • Tabisz H, Modlinska A, Kujawski S, Słomko J, Zalewski P. Whole-body cryotherapy as a treatment for chronic medical conditions?. British Medical Bulletin. 2023 Jun;146(1):43-72.

  • Wibmer AG, Becher T, Eljalby M, Crane A, Andrieu PC, Jiang CS, Vaughan R, Schöder H, Cohen P. Brown adipose tissue is associated with healthier body fat distribution and metabolic benefits independent of regional adiposity. Cell Reports Medicine. 2021 Jul 20;2(7).

  • Wintermark P, Lapointe A, Steinhorn R, Rampakakis E, Burhenne J, Meid AD, Bajraktari-Sylejmani G, Khairy M, Altit G, Adamo MT, Poccia A. Feasibility and Safety of Sildenafil to Repair Brain Injury Secondary to Birth Asphyxia (SANE-01): A Randomized, Double-blind, Placebo-controlled Phase Ib Clinical Trial. The Journal of Pediatrics. 2024 Mar 1;266:113879.

  • Wojtecka-Lukasik E, Ksiezopolska-Orlowska K, Gaszewska E, Krasowicz-Towalska O, Rzodkiewicz P, Maslinska D, Szukiewicz D, Maslinski S. Cryotherapy decreases histamine levels in the blood of patients with rheumatoid arthritis. Inflammation research. 2010 Mar;59:253-5.


 

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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