The Complete Guide to Using Cryotherapy to Reduce Inflammation
Cryotherapy involves literally chilling out in a -110°C room for three minutes while wearing as little as possible. Like many fun things in life, it sounds a little crazy, but the benefits may be huge.
For years, I’ve been hearing anecdotal stories about how whole-body cryotherapy improves mood, boosts energy, and generally makes you feel better. So I decided to get involved. Now I’ve done more than 150 sessions and am a cryotherapy convert.
In the article below, I’ll tell you how I came to decide to do cryotherapy, why you might want to try it yourself, and how to prepare.
Whole-body cryotherapy is kind of like a sauna — one that uses extremely cold temperatures, instead of heat. You spend 90 seconds to three minutes in an air temperature of less than −110°C (-166°F).
There is probably a cryotherapy center near you. I’m lucky because I live close to Alchemy Cryotherapy (about $50/session USD), and I’ve become such good friends with the owners that I practically live there. The session itself takes three minutes, but we often spend much longer talking all things biohacking, productivity-boosting and how to generally kick butt in life.
Why should you consider cryotherapy? With respect to its effect on athletic performance, it’s an active and debated subject of current research. For example, recent studies seem to show that cryotherapy probably isn’t a more effective recovery strategy for muscle or endurance athletics (based on blood work) than immersion in cold water.
There is, however, scientific evidence that whole-body cryotherapy can be helpful in relieving symptoms of chronic inflammation. This probably explains why it makes so many people feel better—whether they are athletes or not.
What is chronic inflammation?
Inflammation isn’t just what happens when you twist your ankle and it swells up. That’s acute inflammation: it’s easy to see, has an easily discernible cause, and has a noticeable lack of symptoms when it’s healed.
Chronic inflammation is a lot more slippery. Chronic inflammation can be caused by conditions like autoimmune disorders. It’s also linked to a range of health problems such as arthritis, obesity, digestive disorders, neurodegenerative conditions, some cancers, and many other issues.
The causes of chronic inflammation include stress, certain foods, the environment, and exposure to toxins—so it can be caused things you probably encounter every day.
If what you want in the way of evidence for cryotherapy is a clear, double-blind, peer-reviewed study with a high number of human participants with differing backgrounds, you’ll have to wait. That doesn’t exist for whole-body cryotherapy. Not yet, anyway. But there is enough research to say that the cold is doing something pretty special on a cellular level that is reducing inflammation.
Testing for chronic inflammation is not something most doctors immediately suggest. This might be due to the vague nature of symptoms caused by chronic inflammation, and the relative newness of the idea that it is involved with many chronic diseases. Yet it is something you can test for.
The two cheapest blood tests to give an indication of chronic inflammation are high-sensitivity C-reactive protein (hsCRP) and fibrinogen. More expensive (but more accurate) tests include serum protein electrophoresis (SPE), which shows concomitant hypoalbuminemia and polyclonal increase in all gamma globulins (polyclonal gammopathy). The gold standard of testing for inflammation is to check for pro-inflammatory cytokines like tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1beta), interleukin-6 (IL-6), and interleukin-8 (IL-8).
If you can find a doctor willing to run some tests, and you’re the type who wants some evidentiary proof of the changes in your inflammation markers, the above tests are the ones to go for.
Your doctor should be able to prescribe a high-sensitivity C-reactive protein test and walk you through the results. If you want or need to monitor it yourself, you can order a test for about $40. If the results you get indicate that you are at “high risk”, you should share them with a doctor.
I’m not a doctor, and I did not do this testing myself. When I was sick with depression a few years ago, I came to the conclusion through research and self-experimentation that my condition was most likely a result of two main factors: chronic inflammation and hormonal imbalances. Everything improved when I started to figure out ways to hack the inflammation in my body and brain. Cryotherapy was key.
Whole-body cryotherapy vs. other forms of cold therapy
One problem with the research that surrounds ‘cryotherapy’ is that it can refer to different things. The original use of the term ‘cryotherapy’ in science referred to the application of cold at the site of an injury. It has also referred to a type of cold therapy that involved full or partial submersion in ice-cold water.
It’s fairly widely accepted that the application of ice to the site of an injury reduces acute inflammation. Sports players have been doing this for years, and the application of cold on acute inflammation has been well-studied; the application of cold to an injury site reduced the inflammatory response.
There have been a few trials involving whole body cryotherapy that I discuss later, but we’re yet to see a large, randomized control study involving a range of participants of different ages and health statuses. From the limited studies we’ve seen (on professional athletes and those with arthritis) whole-body cryotherapy does seem to have health benefits.
The main two types of whole-body cryotherapy chambers around are electric whole-body walk-in chambers and liquid nitrogen open-faced tubes.
The electric walk-in chambers are better for a number of reasons, including the fact your whole body, including your head, are exposed to the cold. There are more risks associated with the liquid nitrogen chambers, including that the air you are exposed to may be unsafe to breathe. However, safety standards and precautions have improved since the early days. If a nitrogen chamber is your only option, it will still have benefits—just be sure to choose a reputable operator.
My experience and the advice in this article are limited to whole-body walk-in chambers.
How to prepare and what to expect
It’s normal to be nervous before your first session—you’re about to put your body into some serious cold shock, after all. There’s surprisingly little preparation required in order to reap the benefits.
In my experience, it’s important to make sure you’re not dehydrated, as this seems to make the session more difficult. Also, I don’t recommend doing cryotherapy directly after fasting for a few days. I tried this and I didn’t feel the usual benefits. My feeling was that I was probably putting my body under unnecessary pressure.
Aside from not being in a fasted state, anything else pretty goes for the days leading up to my cryotherapy sessions. Time of day hasn’t been an important factor for me; either first thing in the morning, end of the day, before a meal, or after a meal — I feel great with each.
The only time of day that I don’t do a session is immediately after training. It is definitely not recommended for directly after strength training. Your body is working to repair after a training session, and immediate extreme cold can halt the natural muscle building process, so try to give it a couple of hours before you introduce cold.
What’s involved in a session?
All of my cryotherapy sessions have been at Alchemy Cryotherapy, where they use the whole-body walk-in chamber. Here’s what happens there, and it’s pretty typical of what you can expect at other centers.
- You register and declare any medical concerns via an intake evaluation. Be logical here: you shouldn’t use a cryo chamber if you’re pregnant or have any serious medical issues—especially heart problems. Of course, if you’ve got any serious medical issues, it’s best to discuss the risks of cryotherapy with your doctor first.
- You strip down to your undies (or bathers, shorts and a singlet, or whatever you’re comfortable in — underwire bras are fine). Anything that conducts the cold has to be prepared: jewelry is removed, and any non-removable metal piercings need to be covered in tape. You can’t have wet hair when you go into the chamber—you need to make sure your body and clothes are dry.
- Put on the supplied mittens, earmuffs, socks, and shoes to protect parts of your body that could be quickly damaged by extreme cold.
- You’ll also get a fabric mask to make breathing more comfortable inside the chamber. It’s safe to breathe the air inside an electrically-cooled chamber, but because it’s so cold, it’s nicer to have a bit of a buffer before it hits your lungs. I take the earmuffs and mask off for the last 30 seconds of each session to enhance the experience, but recommend this only for seasoned cryo users.
- Your skin temperature is measured before you hit the chamber, so you can tell how much it drops.
- There’s a little pre-chamber to step into before the main event. That one is about -60°C (-76°F). You stay there for about 20 seconds before stepping into the actual cryo chamber.
- Then you go into the main cryo chamber. A standard session is three minutes at minus 110°C (-165°F). There’s a speaker inside the chamber that plays a song—often you can pick the music.
- Some people walk around (the chamber is about two meters wide, so there’s some space); others prefer to stand still. I like to stand still with my arms up to expose as much of my body to the cool air as possible.
- A staff member stands outside the chamber and watches you through the glass as well as on live video feed. You’re automatically told when you’re halfway through, but the staff member can talk to you as much as you need and can answer any questions you may have. (I wouldn’t recommend trying to hold a full conversation while you’re in the chamber, because you’ll likely be distracted by the cold.)
- When your three minutes is up, you return to the warmer pre-chamber for about ten seconds, then back into the real world.
- Your skin temperature is measured again to see the difference. The results vary; my skin temp is usually anywhere between two and ten degrees Celsius, but you immediately begin to warm up in the normal air.
- After your session, you’re encouraged to warm up either by walking a little or jumping on an exercise bike.
Then, you’re good to get on with the rest of your day.
How does it feel during the session?
The moment the cold air hits your exposed skin, there’s a sense of shock, but it’s not painful. Although you’re being exposed to extremely cold air, I don’t think the human body can easily distinguish between air temperature slightly or significantly below zero; they’re both cold!
Inside the chamber, it’s usually a little foggy—more so if it’s been a busy day and there have been a lot of people doing sessions before you, but you can always clearly see the door, window, and staff member outside.
There’s often a thin layer of what looks like snow on the carpeted floor, and you can usually see a round track of footprints around the edge of the room where others have walked.
I think everyone experiences cryotherapy a bit differently. I know some people dance around a fair bit in the chamber trying to keep warm. Others walk slowly in circles within the chamber to continually expose skin to “fresh” cold air.
I tried all different things in my early sessions: walking, dancing and standing still. As mentioned above, at the moment I’ve settled on calmly standing still with my arms raised for most of the session and removing my mask and earmuffs for the last thirty seconds. I think early on I wanted to move more, fearing that standing still would make my muscles lock up. I’m a lot calmer now, and I trust my body to handle the cold whatever I do inside the chamber.
For newer users, it can seem scary in the chamber, despite knowing the benefits. Your body naturally fights against the sudden cold, knowing that if you’re exposed to those conditions for too long it would be fatal. So there’s an internal conflict between the body’s natural instinct to get away from a physically stressful situation, and the brain’s conscious decision that this is a safe situation with health benefits.
I don’t shiver inside the chamber, and only occasionally will get slight goosebumps. I’ve never personally had the urge to do anything to try and warm up, perhaps because my mind knows why I’m there and I deliberately try to let my skin temperature drop. My breathing slows and gets more shallow, but overall there’s a feeling of calm and safety as I listen to the music — I know that three minutes will be over before I know it.
How do you feel after a session?
Your skin temperature is measured again as soon as you leave the chamber. My skin usually drops to between 2°C and 10°C (35°F and 50°F) and is flushed red until I warm up, which usually takes up to 15 minutes. Your core temperature doesn’t drop, so your internal organs are safe.
Cryotherapy causes a release of norepinephrine, a hormone and neurotransmitter involved in vigilance, attention, focus, and mood. Almost immediately after a session, I feel a combination of strength and calm. It’s a feeling of being able to achieve anything, while still being strangely relaxed.
Most people say they sleep well after cryotherapy. I didn’t really notice a difference to my sleep, but I always sleep fairly well.
I have noticed increases in strength if I hit the gym a few hours after a session. This could possibly be as a result of mitochondrial biogenesis brought on by the cold, but there could be a number of factors at play, so I can’t speculate too much at this stage.
How often should you hit the cryotherapy chamber?
There’s no scientific recommendation of the frequency of cryotherapy for reduction of inflammation. I’d say listen to your body and go as often as you can handle. I usually go both days of a weekend, but I’ve also tried more extreme regimens, such as daily for 20 days. This was a really good jump start to reset my body into a state of calm.
However, I would suggest trying to do your first few sessions within a couple of weeks, ideally with not more than a week in between, so that your body has a chance to learn what it’s about. I don’t have a scientific reason for this, but human nature seems to make it harder to do something the longer you put it off, and after your first session, you might feel a little nervous about putting yourself through it again. (I didn’t — I loved it from day one, but I did have a friend who built the second session up so much in his mind I don’t think he ever went.)
A study of elite kayakers found it took multiple whole-body cryotherapy sessions to see an increase in antioxidant activity. That’s not necessarily directly linked to inflammation, but pretty impressive all the same. A single session is beneficial; repeated exposure over time seems to be more so.
In a randomized control trial on patients with rheumatoid arthritis, three cryotherapy sessions of two to three minutes over the space of a week were found to significantly reduce pain. I also know of one person who does daily cryotherapy sessions for two weeks to effectively control arthritis pain for six months. (So, they followed a regimen of daily sessions for two weeks, then six months without a session.) While certainly not a randomized control study, it has changed this person’s life by controlling the inflammation associated with arthritis and thereby controlling their pain.
What if there isn’t a cryo chamber nearby?
Firstly, you could consider opening a center if you’re looking for a business idea! As research continues in this area, and with celebrities like Tony Robbins, Joe Rogan and Mark Wahlberg singing its praises, I expect the popularity of cryotherapy to continue to grow.
Installing one at home is prohibitively expensive for most people—up to $100k or more. But a lot of the cold shock benefits described in this article may be achieved through cold water submersion. As I mentioned earlier, much of the initial research around cold therapies was based on either localized cold treatment or participant’s response to ice baths.
I personally think ice baths are less convenient and effective than whole body cryotherapy, but it’s worth exploring the option if you can’t get yourself to a chamber.
Cryotherapy will remain a part of my life. I’ve spent thousands of dollars on treatment, but find it well worth the cost. Understanding the research to date can help reinforce your inclination to try cryotherapy, but nothing beats actually experiencing the benefits for yourself. If cryotherapy is something you’ve been considering, I’d wholehearted recommended it.