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Writer's pictureThomas P Seager, PhD

Do Ice Baths Really Work?

Updated: Sep 9

Seager answers critics of cold plunge on the Mark Bell Power Project Podcast



Summary

  • When Mark Bell and Nsima Inyang saw popular critics of cold plunge therapy saying an "ice bath was the dumbest thing you can do," and "I would never recommend a cold plunge to my patient," they invited Morozko CEO Thomas P Seager, PhD to their podcast to stoke some ice bath controversy.

  • Seager criticized one popular social media influencer for misrepresenting the science of body temperature, as well as a popular medical doctor for failing to move beyond his rote medical school training.

  • As cold plunge therapy gains popularity, it's normal for people to question whether the mental health, metabolic, athletic, hormone balancing, and cancer-fighting benefits are real. Nevertheless, both clinical trials and personal case studies support Seager's view that a regular ice bath practice is essential for maintaining mitochondrial health, slowing aging, extending health span, and improving brain health.


Does Cold Plunge Promote Weight Loss?

Although Gary Brecka says that "there is nothing better than a cold plunge for burning fat," he neglects to mention that compensatory metabolic mechanisms reduce core body temperature at night, allowing your body to rebuild the fat stores that were used up in the cold. For example, I'm almost 6ft tall and I used to weigh almost 250lbs. When I quit alcohol and ultra-processed foods, and increased my exercise, I dropped below 190lb -- but that was all before started ice baths. It's been several years since I lost all that weight and now I've done probably 2000 ice baths, and I'm back up to 215lbs.


Ice baths do not promote extreme weight loss.


I wish they did, because if I could post the before/after pics of my own body saying "I was fat, then I did ice baths and now I'm ripped like Mark Bell!" then I'd be a millionaire by now. But the body just doesn't work like that.


The fact is that cold plunge therapy will remodel your body composition in healthy ways, but it won't cause you to lose more than about 5-6 pounds. In Calories and Cold Exposure I explained some of the limitations of the calories-in-calories-out (CICO) hypothesis, and how your thoughts can be more important to body composition than the quality of calories you eat. But to really understand how whole-body cold water immersion will change the fat in your body from unhealthy visceral (belly) fat to healthier subcutaneous, you really have to read How To Increase Brown Fat? Ice Bath.


However, a regular ice bath practice will remodel body composition. That is, it will reduce dangerous visceral fat that surround body organs and promote more subcutaneous fat -- the type of fat that is just below the skin that helps defend core body temperature. Moreover, cold exposure will Build Brown Fat, which is associated with leaner overall body composition, improved metabolic health, and likely leads to longer healthspan. Just don't be tricked by changes in your InBody Scan body fat measurements after starting an ice bath practice. Electrical impedance body scanners aren't calibrated for people with brown fat, and may fool you into thinking that you have higher body fat than you really do.


Why is Morozko so cold? Do we really need ice?

Although the metabolic benefits of cold plunge therapy are available at higher temperatures, Morozko was invented to make ice because some of the mental benefits only kick in when your anxiety does. That's why I wrote Set Your Ice Bath to a Temperature That Frightens You.


Since then, I've conducted more than a dozen of interviews with high performers and elite athletes from the National Football League (NFL), Major League baseball (MLB), and the Pro Golf Association (PGA). They all tell me that the mental benefits of the ice bath are of paramount importance to them -- even though metabolic and injury recovery benefits are also important. You can read more in Ice Bath Benefits for Athletes.


According to Stanford Professor Andrew Huberman, the mental benefits to colder temperatures might reside in a portion of the brain called the anterior midcingulate cortex that might harbor the will to live. When doing things that a person hates to do, this part of the brain grows as presumably does the willpower of the individual. So, Huberman says, "we can build this area (of the brain) up" only by doing those things we don't want to do.

If you love the ice bath, guess what? Your anterior midcingulate cortex did not grow. But if you hate the cold water, then the anterior midcingulate cortex gets bigger. - Andrew Huberman, PhD (2023)

Can an ice bath prevent prostate cancer?

In Cold Therapy for Cancer I wrote about four mechanisms by which a regular practice of will inhibit tumor growth and may help heal from cancer.


  1. Preferential uptake of blood glucose into brown fat to starve tumor cells,

  2. Production of endogenous ketones to slow cancer growth,

  3. Stimulation of mitogenesis to improve mitochondrial function, and

  4. Repair defects in nucleic DNA.


There are now several documented case studies of people who have either shrunk inoperable tumors or eliminated cancer from their bodies altogether after adopting a regular program of cold plunge therapy. However, I'm not one of them.


I started doing ice baths in earnest because I a routine lab test revealed elevated levels of prostate specific antigen (PSA), which is a blood marker that is associated with prostate cancer, but not indicative of it. That is, the usual course of treatment for an man in his early 50's with an elevated PSA is a prostate exam and biopsy. The problem is that the biopsy itself creates iatrogenic health risks, including deadly infection and false positives leading to unnecessary prostatectomy and its side effects, including incontinence and erectile dysfunction.


For me, the usual course of treatment sounds worse than the disease. As I told Mark and Nsima, I has just separated from my wife and I was afraid of living the rest of my life without sexual performance than I was of death. So I resolved to practice ice baths and ketosis to to reduce my PSA, instead of have a biopsy.


It worked, and I wrote about the techniques I used in The Prostate Protocol.


What's more, my testosterone jumped from about 750 ng/dL to almost 1200. I wrote about it in What Happened to My Testosterone... and Joe Rogan quoted me on a podcast he did with David Goggins. Since then, I've been getting direct messages from men all over the world who tell me that they've adopted my precooling protocol and experienced a big boost in their testosterone, too.


There's just one problem. Most medical doctors still believe that testosterone will promote prostate cancer -- even though this isn't true. For example, I have a friend who had his prostate removed. His doctor insisted on testosterone blockers (sometimes called anti-androgens) because he believed that high levels of testosterone might somehow promote cancer cell growth.


However, as I wrote in Testosterone for Prostate Health, just the opposite is true. High levels of testosterone protects against prostate cancer, which means that men who are prescribed anti-androgens are making their risk of cancer worse, not better.


Do cold showers have the same benefits as an ice bath?

Cold showers will activate brown fat and confer metabolic benefits, but a study from the University of Oulu in Finland comparing partial body cold immersion with whole body found significant differences in the nervous system benefits. As I wrote in Cold Showers vs Ice Baths, partial body cold stimulation will increase heart rate by activating the fight-or-flight sympathetic nervous system response. So will an whole body ice bath. However, after about 30 seconds in the ice bath, when you've gotten past the gasp reflex and regained control of your breathing, the dive reflex takes over and heart rate goes back down.


The cold shower will never activate the dive reflex the way an ice bath will.


There are other differences, including the electrical grounding benefit of the ice bath and the hydrodynamic effect of floating in the water, but activation of the mammalian dive reflex that accompanies whole body immersion is the principal additional benefit of cold plunge compared with cold shower.


Why don't more medical doctors prescribe ice baths?

Mark and Nsima played a clip from the Howie Mandel podcast in which Dr. Mike said he "Medically I would never recommend to a patient, ever in my life, to go do a cold plunge."


They asked me to respond.


In retrospect, I think I was too kind to Dr. Mike. At the time, all I said was "Dr. Mike never had a class in medical school that taught him about ice baths. Because I'm a researcher, I create new knowledge and we can't really blame Dr. Mike for not prescribing the things he knows nothing about, because he's a practitioner."


What bothers me about Dr. Mike is that he also said "there's no evidence to say it really does anything valuable," and that's a lie. I've got nearly 600 scientific citations in my Uncommon Cold book that document the benefits of cold plunge. What's more, the idea that Dr. Mike relies on "evidence" to support his medical practice is dubious. For example, one podcast viewer pointed out that Dr. Mike promoted the experimental mRNA COVID vaccine on social media -- despite the fact that there was no evidence that it would provide any benefit whatsoever. Maybe he's changed his views now, but at the time anyone who bothered to read the first Pfizer trials of the vaccine would have discovered that more people died in the vaccinated group than in the unvaccinated.


In fact, there are medical doctors who prescribe cold plunge therapy. Dr. Courtney Hunt in Scottsdale AZ is one, and so is Dr. Kirk Parsley in Austin TX. They do it because they see the benefits in their own bodies as well as in their patients, despite the fact that they know they'll be criticized by their colleagues like Dr. Mike. There's tremendous financial and professional pressure on medical doctors to conform to the expectations of the pharmaceutical companies.


Tenured university professors are also subject to financial incentives, but they aren't as intense. For example, it was Professor Ben Bikman who taught me that metformin was damaging to mitochondria. While metformin is a blockbuster, profit-making drug prescribed to Type 2 diabetics to help them control blood sugars, Bikman pointed me to a study that showed it would cancel out the mitochondrial benefits of exercise. When I suggested to a friend with Type 2 diabetes that he discontinue his metformin, sure enough his blood glucose levels improved.


It makes me angry when social media entertainers distort the data or lie about the science. One of the worst offenders is the Carnivore Aurelius account, who seems to be repulsed by the idea of being uncomfortable for two whole minutes. When a video she or he posted about ice baths being the "dumbest thing you can do," went viral, my readers asked me to respond. My biggest objection was the deliberate misrepresentation of a population study of body temperature over time that made it seem like lower body temperature was a bad thing, when in fact the authors of the study represented it like it was a good thing.


Will ice baths support mental health?

In Depression Cured by Cold Plunge Therapy, I cited cases of patients who resolved major depression with cold plunge after failing to respond to drugs and traditional talk therapy. There are likely several reasons for it:


  • The neurochemistry of the cold plunge breaks the negative feedback loop of low energy and low mood.

  • When plunging in a group, the social connections support mental health.

  • The grounding benefits that come from a natural body of water, or a Morozko, support positive emotions.

  • Sometimes, cold plunging is accompanied by getting out in Nature and increased sunlight, both of which support mental health.


However, one of the most important mechanisms by which cold plunge therapy supports mental health is by boosting metabolism in the brain. Dr. Chris Palmer has probably done more than anyone to popularize understanding of the relationship between metabolism and mental health, and Palmer appeared on the Mark Bell Power Podcast just one month before me. In his view, the brain cannot do the difficult work of emotional regulation without the metabolic energy necessary to support it. When the mitochondria are damaged by too many carbohydrates (without a break), the brain suffers and mental disorders can result. Ultimately, the mitochondrial damage can be so extensive that it results in dementia. In Brown Fat & Brain Health I wrote about how seed oils and sugar promoted my mother's Alzheimer's.


In Ice Baths for Mitochondrial Therapy I wrote about the mechanisms by which the cold will stimulate apoptosis of damaged mitochondria and mitobiogenesis to create new, healthy mitochondria. And if you're interested in the ketogenic diet, you might want to read Ice Baths for Fast Keto, in which I document how an ice bath will stimulate endogenous ketone production -- even after eating too much Thanksgiving pumpkin pie. The most important lesson to remember is that anything that supports mitochondria will also support brain health and mood.


What about ice baths and stress? Or PTSD?

There is no doubt that an ice bath is a stressful experience -- which can be a good thing. For example, in Hormesis & Hypertension I wrote about how the ice bath can ultimately improve blood flow and reduce blood pressure. However, hypertension (high blood pressure) is also a contraindication to ice baths because the temporary stress of the ice bath could causes a serious acute event if it's too much for the body all at once.


Post-traumatic Stress Disorder (PTSD) can be like that. The stress of the ice bath can confer benefits that help manage the emotional flashbacks of PTSD in the long term -- as long as the short-term effects are so serious that they cause some long-lasting damage. Because a cold plunge will activate the sympathetic nervous system -- i.e., the fight-or-flight response -- it can cause the re-experiencing of unresolved negative emotions that may deepen trauma rather than help resolve it.


In Ice Bath & Trauma I wrote about the origins of the term "PTSD" and the relationship between stress and trauma. The critical component is control.


When a person feels that they are in control of their stressful situation, they no longer experience the stress as trauma. That's why human beings, and other mammals, are programmed with a compulsion to reenact their traumatic events from a position of control so that they can figure out what went wrong in the experience and how to fix it in case they should ever find themselves confronted with it again. For this reason, I always advocate for self-direction in cold plunge therapy. There can be no coercion without diminishing the accomplishment.


You cannot bully someone into mental health.

However, there is also a physiological aspect to cold plunge therapy for resolution of trauma. In Q: Should I Shiver? I talked about Peter Levine, PhD and his experience with somatic healing, in which trembling in his patients (and himself) either protected against or resolved PTSD. My own experience has been that shivering in the ice bath will help release the anxieties, fears, and negative emotions that I might be carrying after an argument, an accusation, or a setback. On those days, I might start shivering after just ten seconds in my Morozko, not for thermogenesis, but for psychological relief.


What about penis shrinkage?

An ice bath is one of the best things a man can do for his sexual health. In Ice Bath for Erectile Dysfunction, I wrote about the essential role that mitochondria play in producing the energy necessary for nitric oxide production, vasodilation, and blood flow to the penis. Because an erection depends on good mitochondrial health, erectile dysfunction is now considered one of the earliest clinical markers of insulin resistance in a man.


Despite the fact that cold water can cause the testicles to retreat up into the body, my experience has been that (in the right company) an ice bath does not present an obstacle to sexual arousal or an erection. In fact, for women it may have an aphrodisiac effect by boosting her testosterone immediately. Although men need to exercise after the ice bath to get a testosterone boost, in women about three-quarters of their total testosterone is produced in the skin, adrenal glands, and fat -- all of which are activated by the cold water. That may be why men and women who participated in a Czech Army study reported a significant boost in sexual satisfaction after undertaking a program of regular cold water swimming.

Can athletes use ice bath to improve their performance?

One of the most popular misconceptions about ice baths for sports performance is that ice baths after exercise will speed recovery. Just the opposite is true. In Precool Your Exercise I wrote about the benefits of doing your ice bath prior to your workout. Readers have messaged me to report gains of 25-30% in peak muscle power output, which is consistent with the research I've previously cited.


However, in Cold Plunge for Competition I cataloged the three types of benefits available to athletes like the San Francisco 49ers when preparing for the Super Bowl. They are mental, metabolic, and injury recovery. I also described some advice to avoid too much mitochondrial stress close to the big game.


How can an ice bath possibly help thyroid function?

There are several case studies, including Dr. Courtney Hunt, of people who have reversed their Hashimoto's thyroiditis by adopting a regular practice cold plunge therapy. In Cold Cure for Hashimoto's I described the mechanisms by which brown fat regulates thyroid function. For example, activation of brown fat will convert inactive forms of thyroid hormone to more active forms.


When the adult human body goes too long without cold, it can lose all its brown fat. Without brown fat to modulate thyroid function, thyroid disorders seem inevitable. Thus, it is not just the thyroid that regulates human metabolism, but the thyroid in cooperation with brown fat. By restoring brown fat to the body, cold plunge therapy can also restore healthy thyroid function.


Does green light really stop headaches?

I started a company called MyGreen Lamp to deliver powerful narrowband LED green light to the eyes for the relief of migraine pain. Studies at Harvard and University of Arizona have demonstrated the efficacy of green light for pain relief. I wrote about it in an article called Green Light Relieves Headache Pain.


After we recorded this podcast episode, I sent the Power Project podcast producer Andrew Zaragoza a green light to use for his headaches. He tried it once and wrote to me:


This green light is amazing. I had a headache and it escalated to a 9. I threw on the MyGreen Goggles assuming nothing and I came out with a manageable level 4. I couldn't believe it. I've used it three times since it arrived, Once even just for a few seconds before I had to leave and I was amazed. - Andrew Zaragoza, Podcast Producer Mark Bell Power Project

Andrew's results have been replicated by dozens of others. The MyGreen Lantern and MyGreen Goggles can relive the pain of migraine, sinus, post-concussion, and stress headaches. However, there are two types of headaches that it can't seem to touch: 1) hangovers, and 2) high estrogen headaches.


Getting Started in Cold Plunge Therapy

For professionals considering incorporating cold therapy into their wellness programs, these tips might help you


  • Start Small. Begin with shorter exposures at warmer temperatures, gradually decreasing temperature over time. It is never necessary to extend a cold plunge for longer than 4-5 minutes, except when showing off. (Sometimes I like to show off).

  • Focus on Breathing and Mindset. The mental aspect of cold therapy is crucial. Proper breathing techniques and a positive mindset can significantly enhance the experience and benefits.

  • Listen to Your Body. There is no optimal time or temperature that applies to every body. A good rule of thumb when starting out is "Go cold enough to gasp, long enough to shiver."

  • Learn to Recognize Contraindications and Adverse Reactions. In the Dangers of Deliberate Cold Exposure (Ice Bath Safety) I summarized some of the risks and described the precautionary protocols that minimize them. Furthermore, in Contraindications to Cold Plunging I listed some of the reasons for caution, including hypertension (high blood pressure). Finally, in Don't Cold Overdose, I wrote about what to do when you overdo it with your ice bath.


 

About the Authors

Mark Bell is a powerlifter and founder of the Super Training Gym in Sacramento CA. With his brother Chris and Mike Bell, he starred in the 2008 documentary Bigger Stronger Faster that examined the abuse of steroids in competitive sports. He an Nsmia Inyang host the Mark Bell Power Podcast, which is produced by Andrew Zaragoza. 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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