The use of cold plunge therapies and saunas have become ubiquitous across social media, and increasingly prevalent in spas and wellness centers. Used separately, or in tandem, both forms of therapies are incredibly beneficial to human physiology, but is there a specific protocol to follow to ensure the best possible results when using hot and cold therapies together?
What is the optimal way to use hot and cold therapies? Which should go first? Are there any dangers or risks associated with combining hot and cold therapies? Should the combination of therapies be avoided all together? What time of day should hot cold therapies be done?
Continue reading to find out what experts and medical professionals are saying about combining the cold plunge and sauna therapy to optimize health benefits and safety.
Benefits of Combining Cold Plunges With Sauna Therapy
- Weight loss
- Improved immunity
- White fat cells to brown fat
- Reduced inflammation
- Better circulation
- Muscle recovery
- Stress reduction
- Improved discipline
- Hormetic effect
- Glowing skin
Both sauna therapy and cold plunge therapies offer many crossover benefits, and one might wonder why do both instead of just one or the other? The basic hormetic effect of intentional positive stress on the body are present with exercise, sauna use, and cold therapy. While it is true that many of the benefits that sauna therapy purports can be found in cold therapy as well, there are a few major differences. By combining both types of treatments in a safe manner the benefits become exponential.
A significant benefit that sauna use offers that is not found in cold therapy is fairly obvious: Sweating or perspiring. The act of sweating in order to regulate internal body temperature activates the cardiovascular system in very unique ways that mimics some of the benefits of cardiovascular exercise. (3)
Furthermore, sweating is beneficial because it capitalizes on the largest organ of the human body, the epidermis, to detoxify the body from harmful pathogens and substances. The obvious lack of sweating in cold therapy means that the use of cold plunges does not detoxify the body, even though it is helpful in many other ways.
The second important distinguishing feature is that saunas do not convert white fat into brown fat at the same rate as cold therapy (This process is important as brown fat has up to five times as many mitochondria compared to white fat cells) (4). Although, it is true that the use of near infrared light and color light therapy are necessary for photobiomodulation: The positive altering of mitochondrial metabolism, the use of an infrared sauna with red color light does not initiate mitochondrial biogenesis, even though it enhances mitochondrial function
The chart below very briefly indicates health benefits that are shared between infrared saunas, traditional saunas, and cold therapies, as well as their differences.
Comparison Chart:
| Health Benefits | Infrared Saunas | Traditional Saunas | Cold plunge |
| HSP Production | Yes | Yes | Yes |
| Improves Immunity | Yes | Yes | Yes |
| Hormesis | Yes | Yes | Yes |
| Increased Circulation | Yes | Yes | Yes |
| Detoxification | Yes | Yes | No |
| Mitochondrial Biogenesis | No | No | Yes |
| Photobiomodulation | Yes | No | No |
| White to Brown Fat | No | No | Yes |
| Cardiovascular Workout | Yes | Yes | No |
| Collagen Production | Yes | No | No |
| Improves Sleep | Yes | Yes | Yes |
Norepinephrine & Converting White Fat to Brown Fat Exclusively Through Cold Therapy
For many individuals it may seem much more desirable to just use saunas and skip cold therapies altogether. While one can get just as many health benefits from sauna therapies as cold therapy, and probably more, cold plunge therapy offers one very specific and important health benefit that is not easily attained in any other modality.
What the cold plunge is able to do that the sauna is not is its ability to convert white fat to brown fat. You are probably wondering why this matters for humans, as the thought of white versus brown meat seems more suitable to a thanksgiving meal…but keep reading.
Dr Susanna Soeberg of Denmark is an expert in the field of contrast therapy and she comments the following:
“Brown fat, a type of healthy fat stored around the spine that acts as our body’s temperature regulator, boosts metabolism and can even aid blood-sugar response and weight control. The more we expose ourselves to the cold, the more brown fat cells we have. So it’s a case of use it or lose it.” (5)
The release of Norepinephrine in response to cold is made in the adrenal glands, as well as the central nervous system, and is both a hormone as well as a neurotransmitter. Moreover, it is the release of norepinephrine that is responsible for the conversion of white fat into brown fat. This is important because the conversion process that activates brown fat is linked to mitochondrial biogenesis. Mitochondria are the energy plants of each individual cell, and scientists now understand that brown fat has at least five times as many mitochondria compared to white fat, and the only way to activate brown fat and therefore mitochondrial biogenesis is through the release of norepinephrine as a direct causation from cold exposure. (3)
Given that it is only through cold exposure that norepinephrine is released, even if sauna use is part of your regular daily routine it is definitely worth considering the addition of a cold plunge or even just a cold shower. So, what is the best type of cold exposure?
What Type of Cold Therapies Are Available Today: Cold Plunge, Ice Baths, Cold Showers, and Cryotherapy
There are a variety of cold exposure modalities from cold showers, ice baths, cold plunge pools, and cryotherapy. Many cultures around the world have intuitively used contrast therapy to improve health, but now there are many more accessible types of cold exposures available even if you do not live in a nordic climate.
As of yet, cryotherapy does not have nearly as much research or data available to properly quantify its long term effects on human physiology, so for the sake of this article, the focus is on cold plunges (33-65 degrees Fahrenheit), cold showers, and ice baths.
Ice Baths have been found in locker rooms of varsity and professional sports teams for decades, and anyone who has spent any time competing as an athlete or in physical therapy knows how gruesome it can be to dip into an ice bath. They’ll also understand how powerful the effects are on muscle recovery.
With years of research available now, we understand that it is very specifically the increase of mitochondrial biogenesis that creates such positive effects from ice baths for athletes and anyone recovering from injury. Naturally, the anti-inflammatory effects of cold therapy also aid tremendously in reducing pain in the joints and muscles.
According to neuroscientist Dr. Andrew Huberman of Stanford University, access to a cold shower is the minimum requirement for cold therapy and can go a long way to improving an individual’s health. An ice bath may be more effective than a cold shower, and is also more financially accessible than a cold plunge tank, which can run upwards of $10 0000 USD.(1) As research continues to evolve in the field of contrast therapy, more data may be revealed surrounding cryotherapy, however for now, what you can easily access from your home is all you need to reap the benefits of cold therapy.
Is It Better To Use a Sauna First or Cold Plunge First?
The overwhelming consensus among experts is that it is best to end with cold therapy after your sauna. (1) In order to fully benefit from cold exposure it is important that after the cold plunge you allow thermoregulation to happen naturally within the body to release norepinephrine, and therefore benefit from the increase in mitochondrial biogenesis. (1) If possible, avoid towel drying and truly allow for thermogenesis to occur!
While it is possible to engage in cold therapy before your sauna, you will benefit more from the effects of the cold plunge after the sauna is used. Another significant factor that may dictate how one uses contrast therapy is time of day dependent as well as the total amount of time spent in cold exposure.
What Time of day Should You Cold Plunge and/or Sauna?
Body temperature increases are associated with states of wakefulness, whereas body temperature decreases tend to induce sleepy states. Naturally, it is best to engage in cold plunge treatments earlier in the day to help induce states of alert wakefulness and focus. (1)
The ability to ‘fall’ asleep is associated with internal body temperatures decreasing. To help encourage this temperature change it is best to sauna before bed to help induce a deeper sleep.
Of course, a sauna at any time of the day is better than no sauna at all. However, in terms of combining cold therapy with sauna therapy a basic rule of thumb to follow: Sauna to sleep and cold plunge to wake-up!
How Much Time is Needed in a Cold Plunge Per Week Versus Time Spent in the Sauna?
Experts’ opinions vary in recommendations for how much time is enough time spent in a sauna to truly benefit from the heat exposure, but more or less a minimum of 3-4 times per week for 20 minutes is required to optimize the benefit of sauna use. Whereas it turns out that much less time is needed in a cold plunge to benefit from white to brown fat conversion, which may be quite a relief for those who are cold resistant!
After careful analysis of the data, Dr. Huberman has discovered that in order to get the benefits of norepinephrine release (and therefore more mitochondrial biogenesis) an individual only needs to be exposed to cold therapy for a total of 11 minutes a week. (1) It is safe to spend more time than this in cold exposure, however, for anyone who has a busy schedule, 11 minutes a week is all you need to benefit from cold therapy.
Potential Risks and Contraindications of Using Hot and Cold Therapies In Conjunction
Sauna use is not for everyone and certainly cold plunges are not advisable for anyone suffering from specific health concerns. Exposure to cold directly after sauna use may induce states of shock in some individuals.
Before beginning any new physical activity or healthcare protocol it is best to consult with a healthcare professional beforehand. Pregnant women, children, and the elderly should take special precautions when engaging in contrast therapy, or either sauna or cold plunge use on their own.
For more direct and elaborate information on combination therapies of cold plunge use with sauna therapy you can visit the websites of these PhD experts in the field:
Dr. Rhonda Patrick( www.foundmyfitness.com)
Dr. Susanna Soeberg (https://www.soeberginstitute.com/
Dr. Andrew Huberman (https://hubermanlab.com/)
Sources Cited:
- https://hubermanlab.com/the-science-and-use-of-cold-exposure-for-health-and-performance/
- https://michaelkummer.com/health/ice-bath-and-sauna/
- https://www.youtube.com/watch?v=XaLd5w6zF7A
- https://drchatterjee.com/the-new-science-of-cold-exposure-reduce-stress-boost-immunity-increase-resilience-with-dr-susanna-soberg/
- https://www.soeberginstitute.com/
- https://www.youtube.com/watch?v=5udactTA5IY&list=PLwAWbIQiqJ0D2gn5UJBPSOzvLROyqSl7f
