Cryotherapy 101: What it Is and How it Works

May 24, 2018

Proponents of cryotherapy claim it can help with weight loss, pain relief, and boosting athletic performance and energy levels.

But before you stand in a freezing chamber for a few minutes, you may want to know whether it really promotes health or is just another wellness trend. Here’s your primer on cryotherapy and what the science has to say about this popular wellness treatment.

What is cryotherapy and how does It work?

Cryotherapy is the use of extreme cold exposure as a medical treatment. “Whole-body cryotherapy” (WBC) is usually delivered via cold water bath or cold air exposure. The type of cryotherapy that has been popularized more recently refers to the delivery of liquid nitrogen-infused air on the skin while standing inside a chamber from the neck down. The length of time and temperature will vary based on the desired effect, but most often lasts for about 2-3 minutes.

The main effect of cold exposure is increased levels of norepinephrine (also known as noradrenaline) in the body, and this has a wide range of beneficial downstream effects . Serotonin and norepinephrine reuptake inhibitors (SNRI’s) like Wellbutrin for example, are a class of medications used to treat depression, ADHD, and tobacco addiction. They, too, work by increasing levels of norepinephrine.

No pain, no gain?

Cryotherapy is a hormetic stressor. Hormetic stressors improve body function when delivered in small doses, but harm the body in larger doses. The idea that what doesn’t kill you makes you stronger, is partially true, and small doses can actually be used to our benefit. In addition to cryotherapy, other examples of hormetic stressors are intermittent fasting , exercise, sauna or hot exposure, and arguably even strong emotion.

As humans in the modern era, we have associated success and luxury with a certain level of convenience and comfort. As scientific research and public interest about health and wellness grow, we are discovering that this desire for comfort and convenience is largely what has taken us away from human nature, and can be deleterious to our health. This applies to everything from “convenience foods” that we consume, to transportation which keeps us from walking, to thermostats that create a consistent 75 degrees indoors, to social media decreasing real human interaction, and the overuse of anti-depressants. Most of these time-saving commodities have been revered as improvements because they help us meet the high (and unrealistic) demands of the modern world; it would be quite inconvenient to hunt for and cook our lunch, and then make that 1 pm meeting.

Although modernization has been immensely helpful for the human race in a multitude of ways, we are also starting to take a step back and see which parts of this comfort-driven way of living is actually causing us harm. Because of the contrast between our modern lifestyles and that of our ancestors and DNA programming, there is now a culture of biohacking which attempts to replicate ancestral stressors in our modern world, and the growing popularity of cryotherapy is a great example of this.

Top 5 health benefits of cryotherapy.

Here are some of the possible benefits that cold exposure therapy offers:

1. Brain health

Expression of genes involved in lipid metabolism and cold shock proteins are increased under cold exposure. Most notably, the cold shock protein RBM3 (RNA binding protein), has been shown to protect the connections between neurons, which protects the brain from damage. In rat studies, activation of RBM3 by cold-exposure decreased brain damage and dysfunction in both the short and long term.

2. Pain-relief

The increase in norepinephrine is not only helpful for neurological and cognitive function, but it also seems to decrease inflammation by lowering TNF alpha levels. Since inflammation worsens every chronic illness and pain, a reduction in it would promote healing. A randomized control trial has shown whole body cryotherapy to decrease arthritis-related pain.

3. Anti-inflammatory

Although cold exposure and increased levels of norepinephrine decreases inflammation by suppressing some parts of the immune system , it can actually increase production of other immune cells like NK (natural killer) cells. NK cells are important as they help us to fight pathogens like viruses and bacteria, and also aid in killing cancer cells.

4. Fat burning

Cold exposure and norepinephrine have also been linked to increased production of brown fat in humans. Brown fat is called such due to the increased number of mitochondria that these fat cells contain that give it a brownish color. Mitochondria are the energy-producing units within our cells, and therefore having more of them will not only allow you to produce more energy but also use more energy, therefore creating a faster metabolism .

This increase in metabolism is the mechanism by which many cryo proponents tout to be at play in its fat-burning or slimming effects. One can also extrapolate that one 3 minute cryo-session at temperatures below -250 deg F could cause one to burn 500-800 calories.

5. Antioxidant effect

Whole body cryotherapy has been shown to increase antioxidant activity via increased glutathione activity when used for 3 minutes daily, for at least 10 days, at temperatures between -200 to -284 deg F.

Water or air cold therapy?

In comparing air-delivered cold therapy versus cold water therapy, the same effective increase in norepinephrine was seen in a study on 10 women who were exposed to either 20 seconds of 0-2 deg C water versus 2 minutes of -110 deg C air, 3 times per week for 12 weeks. This 2-3x increase in norepinephrine followed the cold exposure throughout the treatment period, showing no build-up of tolerance per say.

If you want to create a similar experience at home, you can try an ice bath. It’s not quite the same effect but may have similar benefits.

What should I know before I try cryotherapy?

I figured I had to experience cryotherapy for myself in order to best inform others about it. Here’s my first-hand cryotherapy experience.

I first went to QuickCryo , a high-end, spa-like suite. John Hoekman, founder and CEO, opened it up after he suffered multiple injuries to his neck, shoulder, and back, and used daily over the counter pain medication for years. Since using daily cryotherapy, he no longer requires pain medications.

Before entering the cryotherapy chamber, you are given gloves, socks, and boots. The cryotherapy session lasted only 2.5-3 minutes. The temperature dropped to -278 deg F. About halfway through, I started to feel my thighs burning and tingling, and I got the urge to start moving around. Luckily, the assistant stays with you to chat and play music. You can feel the norepinephrine surging through you as the air gets colder. After the session, I had a heightened sense of alertness, boosted mood, and the muscle aches that I had felt before the session were gone.

The following week, I visited CryoVigor . The founder and CEO, Kathy Butters, told me that she got into cryotherapy when it helped get rid of her neck pain, insomnia , and fatigue . In this session, I was at -266 deg F for 3 min. Again, my skin began to burn about halfway through, and afterwards, there was a sense of mental clarity and relief of muscle soreness.

Overall, my first two cryo-experiences were fantastic. I would recommend it as an adjunct therapy to anyone in pain or suffering from an inflammatory condition.

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How to get the most out of cryotherapy.

Cryotherapy has been shown to potentially help with pain, brain function, mental health, fat loss, muscle recovery time, and have antioxidant effects. Although it can be helpful for many people, there are certain people that should be weary of trying it, namely, those with active and uncontrolled heart disease, severe vascular disorders, or pregnant women.

Now that drug overdoses are the leading cause of death of Americans under 50, and more than 115 people die of an opioid overdose every day, we need to come up with natural and benign solutions to deal with chronic pain. Cryotherapy could certainly be one of them.

Talk to your doctor about whether you should try cryotherapy. With a doctor’s letter of medical necessity, it’s possible to be covered by your FSA or HSA account. Along with an anti-inflammatory diet, exercise program, stress management, and optimal sleep, this could take you closer to your health goals.

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