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Serving up health and fitness insights (daily, of course) with a side of irreverence.
19 Jun

Cold Water Therapy

WaterfallYou’re in the middle of a nice, hot shower, feeling your muscles relax, the day’s tension (or night’s sleepiness) melt away. As you bask in the quiet moment of repose, suddenly your body gets a startling jolt. After a second of disoriented shock, you realize something has happened to the hot water. Did someone start the washer? Is the water heater going berserk? Your hopes of relaxation now dashed, your stress level through the roof, you finish only the most obligatory rinsing and step out of the shower cursing, muttering and shivering as you reach for your towel.

But does a cold shower need to ruin the day? Can they actually be more than a nuisance, but a legitimate health therapy as some say? We thought we’d do some digging to explore the notion MDA reader Alex recently put forth: “The way Grok kept himself clean sure wasn’t with sustained periods of temperature controlled hot water. Maybe we shouldn’t either.” The results we found were very intriguing (and encouraging) indeed.

The underlying premise of cold water therapy is that briefly and somewhat regularly exposing the body to certain kinds of natural stresses (like cold water) can enhance health. Promoters of cold water therapy say that it can boost immune function, decrease inflammation and pain, and increase blood flow. Some argue that a shower setting is suitable, while others say some level of immersion is necessary for real benefit. What does the research say? Here’s what we found.

The benefits of cold water therapy appear to depend on the subject’s adaptation over time. In other words, regular polar dips seem to enhance long term health, but a single cold burst in the shower won’t offer much beyond a good wake-up jolt. The power of cold water therapy, it seems, is in the habituation itself.

In studies comparing regular winter swimmers with subjects not adapted to cold immersion, winter swimmers showed an ability “to survive a significantly greater temperature gradient between body and environment than non-cold-adapted subjects.” Their advantage over the non-adapted subjects was a modification of the “sensory functions of hypothalamic thermoregulatory centres to lower heat loss and produce less heat during cold exposure.” The researchers concluded that regular winter swimmers show “metabolic, hypothermic and insulative” kinds of adaptation to cold temperatures.


Cold showers, research shows, can help this habituation process, but only water at 10 degrees Celsius (as opposed to 15 degrees C) made a difference. Habituation also seems to be somewhat long-term. In a British study, subjects’ responses showed that habituation to cold water lasted 7-14 months as measured by respiration and heart rate.

Some of the specific benefits? A German study examined oxidative stress associated with ice-bathing in regular winter swimmers and found these swimmers showed an “adaptive response” through enhanced “antioxidative defense” as measured by several blood markers.

Other research highlighting cold water’s effect on immunity shows an increase in both the number and activity of peripheral cytotoxic T lymphocytes in those regularly exposed to cold therapies.

Full body cold water immersion and cryotherapy (cold air chamber) also resulted in a sustained increase in norepinephrine, which substantiates the long-term pain relief touted by cold therapy promoters. Exposure to cold also increases metabolic rate.

Finally, the benefits of cold water therapy show promise for those with chronic fatigue syndrome, chronic heart failure, and some (non-lymphoid) types of cancers.

Ice Plunge

So, are you intrigued yet? Though the jury may still be out on some of the findings related to specific medical conditions, healthy individuals seem to have much to gain from the cold. It’s all about upregulating our systems, taxing them in a healthy, natural way like intermittent fasting. While the findings don’t suggest people should, in the name of health, give up hot showers altogether (who would give them up even if they did!) Alex may have a legitimate point after all. We will be keeping our eyes and ears open for new research around cold water therapy for future posts.

Some specific suggestions based on the findings? Very cold showers appear to be beneficial for the purpose of habituation, but we’d recommend alternating them occasionally with immersion when you can. Those of you in Northern climates might have more fun and social occasions (e.g. New Year’s polar dips) for such an exercise, but we can all spare the water heater for a day now and then for a nice cold dip in the old tub.

Thoughts? Questions? Fun stories of your own polar hydro-adventures? We’d love to hear your take.

GoGap, Mario Sepulveda, freezelight Flickr Photos (CC)

Further Reading:

Is Intermittent Fasting Healthy?

Hot To: Intermittent Fasting

What is The Primal Blueprint?

Drink Less Water?

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You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. I live in AZ and was running a lot throughout the winter. I was very sore and started doing 10 min dips in my cold pool. I noticed much less soreness- ! 4 months had passed without a cool dip (hot here). I just swam ALcatraz without a wetsuit. My AZ companion froze in a wetsuit, I found it refreshing! I think my cold immersions helped prep me for the swim. Interesting that the adaption to the cool lasts that long.

    sarah williams wrote on August 7th, 2010
  2. I can’t help but wonder if there may be some benefit that Navy SEAL candidates get from all the exposure to cold water that allows them to push there bodies to seemingly superhuman levels for months on end.

    Chad Cilli wrote on August 12th, 2010
  3. Brian wrote on December 13th, 2010
  4. I recently used the hot and cold shower treatment during a recent bout of flu and I can say that it really works. After the bath I spent a very peaceful night when on previous days I had been coughing throughout the night. For more on these treatments visit

    Samuel Phiri wrote on February 20th, 2011
    • I agree. When I lived in Canada for many years, I would catch a cold and flu every now and then. Did not use cold water therapy then. A year ago I have moved to Middle East and at the same time started cold water therapy – water is not that cold here from the tap so I put a 2 gallon bucket into my fridge and let it cool overnight. After a hot shower I would just pour it quickly over my head feeling the rush – a form of mini immersion. Doing this every weekend (2 days a week) and have not been sick once for a year with anything. Even though there is no cold in Middle East, the A/C in the car and the buildings can get you in addition to alternating from hot outside to cold inside. Fridge cold water helped me this way, there is no other way for me to immerse in cold water, all swimming pools are hot outside. There was a Russian fellow last century, don’t know his name, who used this bucket cold water therapy to stay healthy and was even tortured by authorities to check his claims and became famous in Russia….that’s how I have heard of this and started doing it…

      Stan wrote on July 28th, 2014
  5. Who would give up warm water… Well me and yes it is by choice, I’ve found that the benfits of cold water are so great that I have cancelled out any warm water entirely. I will likely never deviate from this, unless I have a really really good reason;) Oh I also live in New England year round.

    Conor wrote on March 11th, 2011
  6. I have always liked the ocean in the winter. As kids I would ditch school and go bodysurfing for hours in January. As i got older i moved away from bodysurfing and cold water. A few years back I was filming some outrigger canoe races and found myself swimming in some pretty cold water Off Avila beach for up to 40 min at one swim. I do not like wetsuits at all so this was with just a patagonia shirt and short and my trusty Churchil fins. The point is Man did I feel alive. I cannot talk about the science of it but I know and knew that the cold water is good for me. Now I just need to part from the comfort and get wet.

    Andy wrote on March 30th, 2011
  7. I love cold showers, especially in winter.

    Cold showers are amazing, I time myself for 4 minutes and the first 20 s really hurts, especially when it’s winter but the next 3 minutes are… liberating (the only word that seems fitting)

    When you emerge the warmth the towel offers is a little reward and when your hair dries, in my case for once it actually has volume. Yeah my hair is usually a straw mess which sticks to my scalpt, but cold water gives it volume and a shine (it liberates it! hahah). After the shower I go outside in the sun to let it dry naturally.

    Brandon wrote on April 17th, 2011
  8. This article really spoke to me. I never have liked hot water; I take showers in I guess you would call- “room temperature” water. And hot tubs are just so uncomfortable for me. It’s a very interesting topic that I’ll definitely do more research on. This site inspires me so much– keep up the good work!

    Sami wrote on April 18th, 2011
  9. For anybody still interested, I take 1-2 cold showers per day (hot for about 1 minute to open pores, cool for 1 min, then gradually colder for about 4 minutes until BAM… coldest setting for about 7 minutes).

    I have noticed a few worthy changes:
    -increased energy levels (no doubt about this)
    -improved sleep, skin, immune system, and sex drive
    -potentially increased metabolism, though not as definitive as the above benefits

    TIPS: do things in the shower such as… brush your teeth, recite a speech, do basic maths, calf raises… ANYTHING to get your mind off the cold, but brandon is right, it’s incredibly liberating.

    MattG wrote on May 12th, 2011
    • I like the sound of this protocol – but what about movement during the shower? Do you stay in one position or keep alternating between back and front? Because that can be excruciating, but perhaps more beneficial.

      Patrick3000 wrote on January 7th, 2012
      • I take cold showers 4 or 5 times a week. My tap water from the well is 55-57F after I let it run a while. I start with the feet for a few seconds, then I spray the legs then the trunk in front, then I do the face. I make a point to hold the spray on my forehead until it hurts. That takes about a minute. The trigeminal nerve is what sends you into the dive reflex from what I have read. Then I start cooling off the back shoulders and legs. I rotate the spray around various places to get maximum cooling effect. After having done this for a few weeks, the water temp is not feeling cold at all. I could stay in all day I think at 55F. I usually limit my time to around 10 minutes. After the treatment I check my chest skin temperature and find it is usually 60F or so, where as it started at 90F. I know my metabolism is working harder, I’m converting the white fat tissue to brown tissue which you can feel becoming softer. The result is better weight loss rate, body composition changes are good and recovery from exercise is faster. Oh, and I am sleeping MUCH better.

        A few weeks ago my family went to the shores of Lake Michigan for my 64th birthday wish and I swam for 20 minutes in 49F temperature lake water. I loved it and was not cold in any way. No one else could stand to get in the water past ankle deep. Clearly we are wired to adapt to the cold.

        Eric wrote on June 8th, 2012
  10. I used to habitually take cold showers consistently over a period of about 2 1/2 years (incl. ice cold showers in the winter time in north-central European climates), but I can’t remember feeling a huge difference in health – on the other hand, my lifestyle wasn’t as much in line with “Mark’s teachings” as it is today.

    I don’t think I’ll go back to cold showers in the morning (never really felt like I fully adapted to those), however, nowadays I’d even enjoy cold showers after a workout during daytime/night, when the body’s fully warmed up.

    As far as surfing goes, even here in SoCal, I’d prefer wearing a wet suit most of the time, since the symptoms of hypothermia (at least for me) become apparent real quick when you’re not wearing a wet suit.

    Uberdoc wrote on May 16th, 2011
  11. I have been using Cold water therapy for the past 1year, it feels great.

    CHIBEKA wrote on July 11th, 2011
  12. Interesting Article. I find it especially interesting that you said that repeated exposure to cold temperatures allowed the subjects to better control their thermogenics, I have read other studies that seem to indicate that they may do this through encouraging your body to produce BAT (brown adipose tissue) or brown fat instead of WAT (white adipose tissue) or white fat. Brown Fat is supposed to be more thermogenically active and easier to burn to regulate body temperature under periods of stress (exercise, cold, etc.) Just thought I would share, it certainly seems to fit with your article, and when I read things that seem to fit with my pre-existing knowledge, just reinforces the validity of the information in my mind.

    Greg wrote on August 5th, 2011
  13. Let’s see, cold showers… Oh! It helps decrease an active libido too right?

    Seriously, I spent some time in Mexico on vacation this Spring and pampered myself to a daily massage at the Hotel. After each massage, they had me switch between the sauna and a COLD bath. Wow! Very invigorating and I definitely felt better than the usual post massage experience here in the US.

    The mention of cold water therapy in T-Cell Lymphoma cases/prevention is interesting to me as my Mother-in-Law just survived it last year.

    Marc Richter wrote on October 3rd, 2011
  14. As the weather has been getting cooler and wetter, I have taken to running indoors on the tredmill. The swimming pool is no longer heated (60 F) but we have had the hot tub on (104 F). After my run, I immediately plunge into a cold pool and while bracing at first can easily endure 10 minutes of gentle lengths followed by a plunge in the hot tub. I do this hot/cold dip back and forth a couple of times. The contrast and sensation is amazing. Almost a silky feeling. I feel so refreshed and do not suffer the excessive muscle pain after an workout.
    It feels great.

    Nancy wrote on October 5th, 2011
  15. Hey m from India over here during winter its not so cold but for our country people it is…
    I stay in a Joint Family through out my childhood m seeing ma Uncle taking bath in cold water use to ask him always y he bath with cold water always even during the winter & i was told tat is very gud to bath with cold water – mainly u do not feel cold.
    From past 4 yrs. now i have been bathing in cold water in due to this now m becoming strong internally i do not feel cold in winter…
    Now i have gone through many sights one of which i have mentioned it is very healthy taking cold bath / ice bath / ishnan.

    Siddharth wrote on December 12th, 2011
  16. Hi,

    In Shia Islam, we have teachings where it is recommended to rinse your feet with cold water after a shower.

    Napoleon Hill, in his books, also mentions cold rinsing after showers for better health.

    Naveen Hussain wrote on December 29th, 2011
  17. Thanks for the article Mark.

    This is something new to me, I have CFS too and was interested to read the comments aboutit being a potential treatment.

    It’s defintiely something I’m going to be experimenting with.

    I always loved hot showers, the hotter the better, even if sometimes they did make me more fatigued, as did hot baths.

    I tried my first full cold shower this morning striaght after reading this, not sure of the temperature but at first it was torture but i was surprised how quickly i got used to it, instead o ice cold it began to feel just slightly cold and i was able to stand under it for longer without jumping around like a sissy.

    Scott wrote on December 31st, 2011
  18. After reading about the benefits of cold showers, I started taking them regularly two weeks ago and I am now totally addicted to them. I prefer to start cold and stay under the cold water (approximately 50F) for 5-8 min. I feel totally invigorated afterwards.

    I have a question though for the other cold water afficionados on this forum. When you feel a bit “under the weather,” is your experience that cold showers help, or do they put undue strain on your body?

    Nathan wrote on January 28th, 2012
    • I have been doing this now for several years and I am soon to be 68. I start with a very hot shower while I shave then turn it all the way cold for several minutes. I do this day in and day out and may even take a cold shower later in the day. It even invigorates me if I seem to be a bit under the weather. If you still seem to experience some cold or flue symptoms try inhaling Hydrogen peroxide mist through the mouth. I emptied out a nasal mister and give myself about ten pumps while breathing in deeply.

      Roger wrote on January 30th, 2012
  19. wow, awesome blog post. Really Cool.

    Mckenzie Eckard wrote on February 7th, 2012
  20. Cold exposure can help with fat loss as well. Cold exposure has been shown to cause brown adipose tissue (brown fat or BAT) to burn white fat to produce heat (via thermogenesis). Also, cold exposure has been shown to cause the body to produce additional brown adipose tissue. One efficient way to take advantage of this is to exercise by swimming in cool water. Water is very thermo-conductive.

    If you want to learn more, search Google for brown adipose tissue and cold exposure.

    John Garnett wrote on February 7th, 2012
  21. Love the cold water. My husband and I swim as many days a week as our schedule allows, never less than 3. We check the temperature once or twice a month, so far February has been 5 to 5.6 degrees celsius. People say we are crazy to jump in the ocean with just our bathing suits and mask and snorkel [love to see all the amazing sea creatures and plants as the seasons change], but I can’t imagine not swimming. Too much to say about it here but we love it. People always ask me what I do at 44 to be so healthy, happy and youthful….jump in the ocean and if I’m lucky that day, swim with the seals.

    Teresa wrote on February 13th, 2012
  22. All this and no mention of the great Victorian cold water therapists of Britain. Nor of Professor Vijay Kakkar (The Chelsea Thrombosis Research Institute), who did much systematic research and specifically promoted ‘Thermo-Regulatory Hydrotherapy’ for CFS in the late 80’s… and introduced the idea of brown (adipose) fat storage so perhaps answering the above question
    Lots of benefits… partic. heart and circulation, blood thinning, lymphocytes tc. but adapative effect is controleld by consistent and fairly measured increase in full immersion at reducing temps and increasing times (down to about 15C, quite warm when 3 months into it :)

    Turning to cold at the end of a shower, does stimualte the circulation, great for muscles, relaxing whole body afterwards and in the morning, removing residual back-pain if run down spine… however, the shower/sprinkiling effect is ‘disturbing’ and actually much more shocking and upsetting than the feet, lower body and then full immesrion in a proper bath of cold water. That is without doubt the far better way to do it… in fact, cold showering can put people off, it can be so disturbing being ‘splashed’ with cold water. There is a proper way of doing T-R-H-T… worth checking out, feet first spash (hence that runni g through the shallows) then sit for a few minutes then lie back and immerse up to neck.. keep moving and use a thermomenetre and a clock. Warm drink and carbs soon after… NEVER warm shower or warm bath after, let the body warm itself. Never exercise ctrongly after, always before if required. Shivering can be strong, to start with (first month or so) Hey it’s natural!
    Quite a lot of research into thermal adaption exists.. one major effect is on the hypothalamaus, the body’s thermostat.
    I’ll try to upload the original European Newspaper Articles by Prof. Vijay Kakkar (Thrombosis Research Institute)

    Harry Mann wrote on March 12th, 2012
  23. OK, found alink to a fairly extensive synopsis Of Vijay Kakkar’s 1993 articles on TRHT

    Harry Mann wrote on March 12th, 2012
  24. I am originally from Russia, known for its cold winters. I remember my grandma getting half naked in the backyard and rubbing her skin with snow. There are clubs of people doing regular cold dips in winter rivers, who call themselves “Walruses” (Morzhi).
    Just a question from the Russian CW though. Though we leave in a cold climate, people are obsessed about dressing warmly, avoiding drafts etc. I can imagine that a lot of women will scald the cold water practice because “it will negatively affect and cause inflamation in female organs”. What do you think about that?

    Pov wrote on March 15th, 2012

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