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Re-ordering Autoimmune Disorders

Updated: May 10

How can ice baths ameliorate such a wide range of chronic, degenerative, incurable diseases?


It takes more than an ice bath to scare former Navy SEAL Justin Hoagland. Discharged from the military with multiple sclerosis, Hoagland was confined to a wheelchair until he started a regular practice of ice baths.


Summary

  • Increasing evidence suggests that immunopathologies like Type 1 diabetes and multiple sclerosis originate in Vitamin D insufficiencies early in life, while the immune system is still developing.

  • Cold exposure seems to compensate for a lack of Vitamin D by boosting immune system function.

  • Certain autoimmune disorders that were once thought to be permanent and degenerative, like Hashimoto's thyroiditis, can in fact be reversed or ameliorated by cold plunge therapy.


Cold Exposure Activates the Immune System

Vitamin D, Immune System Function, & Cold Exposure

When I wrote Can Ice Bath Prevent Illness? it was at the earliest stages of the COVID lockdowns, when it physicians were re-discovering the relationship between Vitamin D and immune system strength. For example, it's long been understood that the seasonality in influenza infections is not due to colder temperatures in the winter, but rather due to Vitamin D insufficiency that impairs immune system function.


Fortunately, in the northern winters winter when there is less sunshine to stimulate Vitamin D production in the skin, there is usually ample opportunity to compensate with cold stimulation. Because ice baths typically boost blood markers of immune system function (Straat et al. 2022) short-term acute cold exposure might substitute for lack of sunshine, as far as immune function goes. For example, when a group of researchers in the Czech Republic exposed young men to several minutes in a 14C cold bath over a period of six weeks, they measured increased markers of immune function in their bloodstream (Janský et al. 1996). While the water wasn't very cold (by the standards of experienced ice bathers) the researchers noticed increases in immune strength over time -- suggesting that the effects of the cold plunge were longer-lasting than a simple acute cold shock response.


Cold exposure can help compensate for a lack of Vitamin D by charging up immune system function. That means people living in extreme latitudes who don't get enough sunshine during the winter might nevertheless avoid serious immune impairment by adding cold plunge therapy to their winter regimen.

Autoimmune Disorders

There are times when the immune system does more harm than good. That is, when the body's own immune system begins attacking healthy cells, the result is called an autoimmune disorder. As medical science learns more about immune system complexities, more previously inexplicable diseases are now understood as originating in disorders of the immune system including:


  • Type 1 diabetes,

  • Hashimoto's thyroiditis,

  • Allergies,

  • Rheumatoid arthritis,

  • Amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease),

  • Multiple sclerosis,

  • Fibromyalgia,

  • Parkinson's.


Type 1 Diabetes

My introduction to life-threatening autoimmune disorders was my son's diagnosis with Type 1 diabetes when he was just six years old. I wrote about how his diagnosis was revealed in Ice Bath for Fast Keto and how dangerous it was for him to be an undiagnosed diabetic.


In Type 1 diabetes, the immune system turns against the islet cells in pancreas that make insulin. For some reason that has never been fully explained, these islet cells are gradually destroyed by the body's own immune system until they are completely gone.


They never come back.


In some cases, replacement islet cells have been transplanted into Type 1 diabetics to temporarily reversed the condition. For awhile, they will make insulin, as if the transplant was a cure for diabetes. However, the immune system will eventually find them and destroy the replacement cells, too so that the diabetes comes back.


Type 1 diabetes meant that my son would rely on nearly constant blood glucose monitoring and regular injections of human insulin produced by genetically modified bacteria. At the time, the improvement of his condition was so dramatic and so rapid that I was grateful his condition was manageable, if not curable and we had no trouble adjusting to adopt a regular routine of blood glucose management for him.


What I never really admitted was the terrible feelings of guilt and shame that came for me as a result of his diagnosis. As his Father, I will never get over the feeling that I had failed in my job to protect him from harm. I know this feeling is not logical. There is no doctor in the world that would tell me that his diabetes could possibly be my fault. But there's no doctor in the world that can change my feelings about it, either.


On some deep biological level that defies scientific explanation, I remain convinced that my young son's diagnosis of Type 1 diabetes must somehow be because I did something wrong.

I think it's human nature for me to feel that if I hadn't done something wrong, my son never would have suffered. That sort of feeling is probably why human beings have historically become superstitious about events that are entirely out of their control, and there must be some evolutionary biology reason for it to be so persistent and pervasive.


I can tell you that for me, the worst feeling wasn't the fact that I had been giving him orange juice to drink in the days leading up to his diagnosis. Although orange juice is a terrible thing to give an undiagnosed diabetic, and unhealthy for everyone at any time, I was only doing what my Mother did for me when I was sick as a child and I though maybe the Vitamin C would do him some good.


The worst feeling for me was finding out years later that Type 1 diabetes is associated with a deficiency of Vitamin D in the first year of life. Just one month before my son's diagnosis, the results of a decades-long longitudinal study of mothers and children in Finland was finally published (Hyppönen et al. 2001). It showed that Vitamin D supplementation during pregnancy and the first year of infancy was associated with a significantly reduced rate of Type 1 diabetes later in life.


The study was unknown to me until I read an article about it years later in an old Reader's Digest magazine I found in the waiting room at the dentist, but as soon as I read it, I knew it felt right.


My sun was born in late October, when my wife and I lived up in the mountains in upstate New York. It was cold out that winter, of course. I remember thinking how great it would be to walk out on my deck and through my yard with him cradled naked on my shirtless chest on those sunny winter days when the snow is dry and cold and crackles under my boots. I remember thinking how it would feel good to have that sunshine on my face and light up his back and little behind.


Of course I never did it. I was too worried about him catching a cold. I didn't know a dang thing about health or metabolism or the immune system back then. I was just 30 years old and my head was still full of the lies about nutrition and health that I'd been taught as a kid,


So instead of going outside shirtless in the winter sun, I kept my son bundled up indoors and started him on Cheerios and apple juice when his teeth came in.


I was ignorant.


You might say, "There wasn't enough UVB radiation in the winter sun to stimulate any Vitamin D production in your skin, anyway!" and I know that's true. It's also not the point. Evolutionary biology prepared my son, just like it prepared me and all my ancestors before me, to compensate for the lack of UVB radiation in sunshine during the winter in the northern latitudes by responding to cold stimulation. My fears of him being too cold were way out of proportion, compared the potential benefit his nascent little immune system might have enjoyed from a short exposure.


Swedish researchers long ago established that infants are well-protected during brief periods of cold exposure by the activation of brown fat between their shoulder blades and around their clavicles (Rylander et al. 1972). Taking my son for a short walk around the yard on a sunny winter day would not have done him the least bit of harm, and it would have felt good for me. Additionally, had I started him with cod liver, eggs, and cheese for solid food instead of Cheerios, I might have boosted his metabolism instead of stressing it.


Most importantly, if I could have given my wife Vitamin D-rich foods to eat during the late stages of her pregnancy, and supplements while breastfeeding, I would have likely reduced the chances of my son's eventual development of Type 1 diabetes.

I've previously written a great deal about the relationship between cold exposure and insulin sensitivity. For example, in Reduce Blood Glucose I reported data from continuous glucose monitoring devices that showed a short ice bath could lower blood glucose numbers from elevated to nearly normal without injection of additional insulin. Moreover, in Ketosis & Ice Baths Reversed My Type 2 Diabetes, author AJ Kay described how she brought her HbA1c from over 7.2 down to normal by adopting a ketogenic diet and practicing ice baths. In How Cold Reverse Type 2 Diabetes I explained the scientific studies that explain her reversal.


But Type 1 diabetes cannot be reversed. It can only be managed. In this case it turns out that cold can reduce insulin demand in a Type 1 diabetic by improving insulin sensitivity. That explains why my son would require less insulin on the winter days when he would spend all day outside playing in the snow with his sister, compared to winter days filled with video games -- even though cold exposure cannot restore his insulin production.


Hashimoto's Thyroiditis

Since discovering the connection between Vitamin D insufficiency, cold exposure, and autoimmune function in Type 1 diabetes, I've noticed that an analogous connection exists in other autoimmune disorders. For example, Hashimoto's thyroiditis is an autoimmune disorder that is considered chronic, degenerative, and irreversible.


If Hashimoto's is incurable, then how did Dr Courtney Hunt and Morozko co-Founder Adrienne Jezick both reverse their Hashimoto's with cold plunge therapy?

I wrote about my interview with Dr. Hunt in The Cold Connection to Hashimoto's, where she explained that she combined improved light hygiene (sunlight exposure, especially at dawn), a ketogenic diet, and cold plunge therapy in her backyard pool in Scottsdale AZ. Although the temperatures in her pool weren't very cold, she stayed in for extended periods of time and she likely increased her brown fat to bring her thyroid under control.


By contrast, in How I Cured My Hashimoto's Jezick explained that her ice bath practice was in the freezing cold waters of her Morozko. After a year of daily ice baths, improvements in her diets and eliminating almost her medications, her blood work finally showed that "she had zero trace of autoimmune in her system."


Allergies

More than a year after reversing her allergies, Jezick discontinued her allergy medication, although still reacted to eggs. She would periodically re-expose herself to eggs, just to see if her allergic reaction persisted, and to her disappointment it did... until one day, it didn't.


Unlike Hashimoto's, allergies sometimes resolve on their own, without any particular interventions. It's possible that her ice bath practice and normalizing her Vitamin D levels had nothing to do with the resolution of Jezick's allergies. However, she's not the only case. Last year, I heard from a customer who said his allergies went away after he started an intense practice of ice baths.


I suffered from allergies that started 10 plus years ago. I didn't get tested until 12 March 2018. On that date I had a skin prick test which showed positive for four allergies: Mite DF, Mite DP, Ash and Cockroach. By far the dust mites were the allergies that caused me the most significant problems. On 22 December 2021, I went back to the allergist and had updated skin prick testing done. The test showed that all allergies had resolved. The doctor was surprised, so at the same visit he also did a blood draw to specifically test for dust mites since that was the allergy that caused me the most significant issues in the past. The IgE blood test also showed negative. The doctor's response was just to throw up his hands and say "sometimes they resolve." I'm not sure if that is helpful, but I keep a pretty close track of my health in terms of daily tracking of activity, sleep, nutrition, supplements, exercise, etc. and the only major change I had made in the several months prior to my negative test results was my ice bath deliberate cold exposure. - Steve F

My search of the scientific literature on cold exposure and allergies revealed zero studies indicating that cold could resolve allergies. Several studies on how cold could cause an allergic reaction called cold urticaria showed up instead. Although current advice for those suffering from severe cold allergy is to avoid cold exposure, the studies I found showed that exposure therapy – i.e., repetition of cold stimulation -- was effective for desensitizing patients and that's been the experience of several customers who have written to me about it.


Rheumatoid arthritis

One of the classic characteristics of an aberrant immune system response is inflammation. In rheumatoid arthritis, that inflammation causes pain and loss of mobility in the joints -- especially the hands.


Cold plunge therapy is already understood to be effective for reducing inflammation, and perhaps it shouldn't be surprising to learn that it helps alleviate arthritis pain. However, the benefits appear act at some deeper cause rooted in the immune system.


I first wrote about Erin Miller, RN recovery from rheumatoid arthritis in Cryotherapy for Chronic Medical Conditions. As a medical safety specialist in the intensive care unit, Miller's job requires her to carry equipment and open containers that strain her hands. She'd tried steroids, which helped alleviate the swelling, but her medical training convinced her that the long-term risks were unacceptable.


It was her boyfriend that convinced her to try cold plunge therapy. He works as a firefighter in central California, and had been doing thermal contrast therapy to help him recover from a job-related testicular injury that left him with low testosterone. He'd already read my article What Happened to My Testosterone... and pre-cooling his exercise with cold plunge has worked so well for him that he wanted Miller to try it, too.


When she finally tried cold plunge therapy, the pain of her arthritis went away immediately. She told me, "I had 100% pain reduction. When I woke up the next morning, for the first time in four or five years, I didn't have any pain in my hands."

What I found out later was that rheumatoid arthritis has been linked to Vitamin D insufficiency (Szodoray et al. 2008) -- just like other immunopathologies.


Amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease)

There is no scientific evidence that ALS is ameliorated by cold plunge therapy... yet. A ketogenic diet is known to improve the course of ALS in mouse models (Zhao et al. 2006) and the mechanisms likely relate to restoration of impaired mitochondrial function (Paoli et al. 2014). Recently, a 61 year-old man who adopted a time-restricted ketogenic diet improved on several measures of ALS including swallowing, fatigue, and quality of life (Phillips et al. 2024). This suggests that any therapy that increases ketone bodies and boosts mitochondrial function could benefit ALS patients (Cunha-Oliveira et al. 2024).


As I wrote in Ice Bath for Fast Ketosis, the quickest way to stimulate production of endogenous ketones is an ice bath. Moreover, ice baths may be the best therapy for mitochondria. For example, when mice were exposed to 72hr of cold air, the activation of their brown fat induced two processes relevant for improving mitochondrial function:


  1. mitophagy, which is the process by which your cells identify and destroy defective mitochondria, and

  2. mitobiogenesis, which is the process by which your cells make new mitochondria


Researchers found that exposure to cold resulted "both degradation of mature mitochondria by mitophagy and synthesis of new mitochondria that led to a net increase in the total amount of mitochondria" (Yau et al. 2021).


This type of research led one customer to persuade his father with ALS to try Morozko. The customer had already started precooling his workouts and raised his testosterone levels, so it made sense to him that his Dad may as well try it, too. He may be the first case study in the world to attempt cold plunge as a therapy for ALS, compared to the millions of people who did the "ice bucket challenge" on social media to raise awareness of ALS.


Multiple Sclerosis

Given that there is no cure for multiple sclerosis (MS), which is an autoimmune disorder impacting the central nervous system, and that treatment consists only of alleviating symptoms in exactly the way that cold plunge therapy has been shown to do, you might be surprised to discover that online resources published by the National MS Society makes no recommendation of cold therapy for management of the disease. They caution against overheating and provide a list of products intended to keep MS patients cool during the summer, but they never mention that cold plunge can be beneficial.


Fortunately, two Morozko customers have documented extensive experience with ice baths for managing their MS. In Cold Plunge for Multiple Sclerosis I told the story of former Navy SEAL Justin Hoagland's journey from wheelchair to athlete. And in Multiple Sclerosis Relief I talked about Julie Blew, who told me she in and out of her Morozko several times a day so she can stay able to run 10K road races despite her MS.


The mechanisms by which cold works for MS patients aren't described in the scientific literature, although we know it helps MS patients manage fatigue, muscle weakness, cognitive dysfunction, and loss of visual acuity. Probably, the benefits are derive from the same mitochondrial boost that might benefit ALS. For example, when four dozen MS patients were exposed to whole-body cryotherapy for 10 minutes at -110C (about -166F), researchers observed significant improvements in functional status and reductions in fatigue (Miller et al. 2016). An expanded study tested the effects of 20 sessions of whole-body cryotherapy on 74 MS patients in Poland. Compared to controls, they measured improvements in walking gait and other improvements in functional status (Radecka et al. 2021).


While the relationship between Vitamin D and MS is complex and difficult to decode, no such ambiguity exists with regard to cold plunge therapy. Both the science and the experience of patients is unequivocal -- cooling relieves MS patients of pain, improves motor control, extends endurance, and results in greater muscle output.


Fibromyalgia

The origins of fibromyalgia are largely unknown.  A complex interaction of metabolic, neuroendocrine, neuroinflammatory, and autoimmunological dysfunctions has been implicated.  There are no effective drug treatments and although the prevalence of Vitamin D insufficiency is more frequent in fibromyalgia than other autoimmune disorders, Vitamin D supplementation does little to alleviate the chronic pain that is the signature symptom.

 

Nevertheless, cold exposure engages all the related bodily dysfunctions.  Because cold is already renowned for its analgesic (pain-relieving) and anti-inflammatory effects, it would seem reasonable to expect that there are clinical trials investigating the potential benefits of cold exposure for fibromyalgia patients. 

 

There are. 

 

Researchers in Spain enrolled 60 fibromyalgia patients in a 7-week cryotherapy trial to test the effects of whole-body cold exposure on self-reported pain scores.  Because it’s not possible to create a “sham” treatment as a control group, the researchers cross-over two groups, which means that started half the patients in a cryo group for 3 weeks while monitoring the other half that were not getting cryo.  Then, they switched the groups to monitor changes.  Patients reported significant improvements in fibromyalgia-related-symptoms, including less pain and improved physical and emotional well-being, while undergoing cryotherapy (Rivera et al. 2018).

 

Those results are consistent with an earlier study in Italy that monitored 50 fibromyalgia patients while they underwent a prescribed course of 15 whole-body cryotherapy treatments over 3 weeks.  Compared to patients who did not undergo cryotherapy, the treatment group also reported improvements in subjective, self-reported pain scores (Bettoni et al. 2013).  They also agree with a more recent Italian that compared a group of fibromyalgia patients who incorporated ten sessions of cryotherapy into a two-week rehabilitation program with those patients who did not incorporate cryotherapy but kept all other aspects of the program the same.  Sure enough, those with cryo experiences reported lower pain scores than those without (Varallo et al. 2022). Finally, a German team tracked twenty-three fibromyalgia patients who underwent six sessions of whole-body cryotherapy and reported reduced pain scores.  They found that the clinical benefit of cold disappeared three months after discontinuing cryotherapy treatments (Klemm et al. 2021).

 

Despite the promising results of these clinical trials, cold therapy has yet to be adopted in the regular treatment of fibromyalgia.  That may be because many fibromyalgia patients report intolerance to cold.  To expose a patient who is already in debilitating, chronic pain to an environmental stressor that might exacerbate their principal symptom seems cruel – even inhumane.  Fibromyalgia patients typically report greater sensitivity to both hot and cold, with less tolerance for either temperature extreme. That likely explains why investigations of cold water stimulation for fibromyalgia have been limited to ice cubes or cooling plates that impact only small patches of skin, or at most the cold pressor test.  These consistently show increased cold sensitivity among fibromyalgia patients, compared to controls.

 

Nevertheless, fibromyalgia patients who have been brave enough to attempt whole-body cold-water immersion have reported improvement in symptoms, including pain relief.  In his book, Chill: The Cold Water Swim Cure, Dr. Mark Harper explains the paradox: 

 

On the surface, it may seem that getting into cold water for pain and symptom relief is contradictory.  It’s like treating pain with pain.  When we look at it more closely, however, it isn’t illogical at all.  First, the pain from cold water swimming is reframed as beneficial—participants know that it has been shown to be an effective intervention and their own experience of swimming is that it fosters the feel of well-being and hopefully, symptom relief.  Until someone tries it, though, this doesn’t seem self-evident… . While it is painful getting into cold water, you feel so good for the rest of the day.  Being able to get in and out of the water and overcoming the initial discomfort develops resilience.  This reduces sensitivity to a threat, and many medical professionals now say this sensitivity contributes to pain. - Mark Harper, MD, PhD Chill: The Cold Water Swim Cure (2022)

Dr. Harper describes three case studies of fibromyalgia patients in the United Kingdom who use successfully use cold water swimming to relieve their pain.  Whether these results are generalizable to others with fibromyalgia is uncertain.  


Parkinson's

There is no cure for Parkinson’s.  It is a chronic, progressive, neurodegenerative disorder characterized by the premature death of dopaminergic neurons that result gradual loss of motor function.  Historically, treatment has been able to do little more than alleviate some symptoms, although research is increasingly  focusing on novel methods for slowing progression.


Actor Michael J Fox is among the most famous Parkinson's patients. If you see him in a recent media appearance, you can't help but notice the characteristic posture, tremors, and loss of motor function that typifies Parkinson's disease.


Because Parkinson's involves dysfunction in the dopamine receptor system, administration of L-dopa can provide temporary relief from symptoms. However, over the longer term the salubratory effects of the exogenous dopamine wear off, and symptoms return.


What's not yet clear is whether the endogenous dopamine boost provided by the ice bath will provide longer-lasting relief than a drug. I wrote about studies that measured a 3x boost in dopamine resulting from cold plunge in Cold Plunge Romance. In that article, I explained how being in the ice bath together creates all the neurochemistry of lust, romance, and bonding in a romantic relationship and I used the experience that AJ Kay and I shared as an example.


However, when it comes to Parkinson's it's not the vasopressin, or oxytocin, or norepinephrine that is of interest. It's the dopamine.


So far, I've heard a two cases of Parkinson's patients benefiting from cold plunge therapy. One is a patient under the supervision of Stefan Hartman, PA at the Iron Direct Primary Care medical practice in Florida and the other is a customer in Arizona. Both report that they experience relief from symptoms of Parkinson's that lasts for hours after an ice bath -- as we might expect. The difficulty is in ascertaining the longer-term effects. Nonetheless, both have expressed a desire to minimize their drug treatment, instead preferring what they call a more natural approach.


Prevention, Therapy, or Cure?

Although autoimmune disorders may be rooted in Vitamin D insufficiencies, they variety of symptoms, emergence, progression, reversibility suggest complex etiologies that will resist simplification. Nonetheless, cold plunge therapy confers benefits across the full range of immunopathologies. The pattern suggests that human beings evolved to compensate for a lack of Vitamin D during winter at extreme latitudes by instead stimulating their immune function with cold exposure.


Medical research has yet to fully explore the potential of cold plunge therapy as a remedy for the myriad of disease states that seem to originate from dysregulated immune function. In some cases, such as Hashimoto's, rheumatoid arthritis, multiple sclerosis, and fibromyalgia, the evidence for therapeutic benefit seems overwhelming. For allergies, ALS, and Parkinson's, and the effects are more uncertain, while for Type 1 diabetes the benefits are measureable but might seem marginal. Nevertheless, aside from the usual Contraindications, there are none of the undesirable side effects associated with the drug treatments that are incapable or curing or reversing these diseases anyway.


The biggest obstacle to wider adoption of cold plunge therapy for the treatment of autoimmune disorders may be the misconception that the benefit are too good to be true.


References

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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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