Are Cold Showers Good for You? The Beginner’s Guide to Cold Exposure - Dr. Michael Ruscio, DC

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Are Cold Showers Good for You? The Beginner’s Guide to Cold Exposure

Taking Cold Showers Is a Great Introduction to the Benefits of Cold Exposure Therapy

Key Takeaways:

  • Cold exposure therapy has numerous health benefits, including improved insulin sensitivity, brown fat activation, boosting metabolism, and regulating the immune system. 
  • Taking cold showers is a great way to dip your toe into cold therapy, since it’s easily accessible and something you already do on a regular basis.
  • You only need 30–90 seconds in a cold shower to experience benefits. 
  • Combining heat and cold therapy may compound their benefits, especially improving cardiovascular health. 
  • While cold therapy might not be for everyone, it has the potential to create significant improvements in your health.

The more I learn about cold exposure therapy and the myriad of benefits it can have for our health, the more I want to share it with everyone I know — including you! 

Now I know for many people cold therapy not only sounds a bit ridiculous, it also sounds daunting, or even downright unappealing. Are the benefits really worth the shock of cold water, or going outside in the cold with a few less protective layers in the winter? If you’ll give me just the next few minutes of your time to read this article, I’ll show you why cold exposure is not only worth it, it can also be easy — by simply turning your water from warm to cold at the end of your regular shower for 30 seconds. No cold plunge tanks or freezing lakes required!



Let’s answer the question “are cold showers good for you,” (short answer: yes!) and offer some practical advice on how to get started with cold exposure therapy

Benefits of Cold Showers

Regularly taking cold showers represents one way to achieve the health benefits associated with applying “good stress” to the body. Research has shown cold exposure therapy (also known as cold therapy and cold water therapy) can stimulate improvements in [1]:

  • Immunity, especially if you have a sensitive/overactive immune system
  • Mental health
  • Anxiety
  • Sleep quality
  • Energy
  • Body composition/weight loss
  • Thyroid health 
  • Inflammation response
  • Balanced stress hormones

Over time, cold exposure may result in [2, 3]:

  • Decreased cardiovascular health markers (ApoB/ApoA1 ratio, homocysteine)
  • Reduced inflammation 
  • Improved immune response
  • Reduced oxidative stress 
  • Increased antioxidants 
  • Balanced stress hormones (ACTH, cortisol)
  • Improved thyroid markers (T3, TSH)
  • Increased zinc levels
  • Increased norepinephrine
  • Increased insulin sensitivity

These are some serious benefits! The benefits listed here may also be amplified when combined with other lifestyle practices, such as heat exposure therapy (sauna, hot yoga, etc.), exercise, and breathwork like Wim Hof breathing [2, 4, 5]. 

How it Works

Exposing your body to cold air or water basically acts as a form of “good stress” for your body, leading to [6]:

  • Temporarily increased blood pressure
  • Increased heart rate
  • Hyperventilation
  • Vasoconstriction in the extremities
  • Vasodilation in the core

These effects mean you are intaking more oxygen due to hyperventilation, circulating that oxygen at a higher rate due to increased blood pressure and heart rate, and directing that oxygen towards your heart and other vital organs by constricting blood vessels in the extremities and opening them up wider in the core. 

Note: Although chronically high blood pressure and hyperventilation are bad for our health, inducing both in short bouts can be very supportive for the body.

Brown Fat Activation

Over time, cold exposure also activates brown adipose tissue (BAT), aka brown fat, a type of fat found mainly in your neck, shoulders, and around central organs of the body such as the pancreas, adrenals, and kidneys [7].

Brown fat has the ability to break down glucose (sugar) and white fat (what we think of as “belly fat” for example) in the body, and its purpose is to generate heat to keep you warm when you get cold, particularly around your central organs. Unlike white fat, we don’t have much brown fat, and we don’t want to get rid of it. If anything, we want to optimize the amount of brown fat we have to improve our metabolic rate and thermoregulation (body temperature control). 

As far as we can tell, only cold exposure therapy has the ability to consistently activate brown fat, stimulating metabolism and thermogenesis [3]. 

A 2022 literature review looked at studies that implemented protocols believed to induce brown fat activation in both healthy and unhealthy humans:

  • Cold exposure (10–20° C)
  • Moderate intensity exercise (3x/week)
  • High-intensity interval training (HIIT)
  • Capsaicin supplement
  • Mirabegron (pharmaceutical)

However, only cold exposure has shown consistent results for activating BAT, and the authors concluded there is “no evidence to date for a positive impact of exercise on brown fat activation in humans” [3].

While other good stressors like exercise and sauna have some of the same benefits as cold exposure therapy, brown fat activation isn’t one of them. Depending on your health goals, this may be one significant reason for you to incorporate cold showers into your routine. 

Can Anyone Do Cold Exposure Therapy?

Pregnant women should avoid cold exposure therapy due to possibly altering blood flow to the fetus, which can have significant health consequences [8]. Breastfeeding women should also avoid cold exposure therapy until we have more data on the effects of cold exposure for breastfeeding women. 

Those with heart conditions or other medical concerns should consult their provider prior to starting cold exposure therapy. 

That being said, what’s nice about the cold shower method is you can gradually adjust the cold temperature to your tolerance over time, making it less of a shock to your system than a cold plunge or ice bath. 

How to Start Cold Showers

Simply take a warm or hot shower as you normally would, and slowly turn the dial to cold at the end of your shower. You can start with simply a “cooler” temperature, enough that you notice the change but not shocking. As you get used to the cooler water temperature over time, you can gradually get colder until the water is properly cold. The warm-to-cold method may actually be more beneficial, as you are first increasing circulation throughout your extremities with heat, and then directing oxygenated blood to your internal organs and stimulating brown fat with cold. 

Technical Requirements for Cold Showers

How cold: As cold as you can stand, decreasing slowly over time if desired

How long: As little as 30 seconds, and up to 90 seconds

  • Note: Research shows that similar immune benefits occur at 30, 60, and 90 seconds of cold showers, meaning that more time isn’t necessarily better [1]. One 2021 study found that 11 minutes per week was enough to get the benefits of cold exposure, and recommended you split this up over at least 2-3 days [9]. 

How often: It’s up to you — the more important factor seems to be consistency in general. Whether you’re taking cold showers once a week or making it part of your daily routine, find a schedule that works for you. 

Combining Heat and Cold Therapy

Research is ongoing around the combined benefits of heat and cold therapy, but they seem to have synergistic benefits when combined. 

One review compared the effects of “heat stress” (Finnish sauna use) and cold water immersion on the body. Both were found to have many health benefits and are often alternated in Scandinavian culture. 

The authors hypothesized that the increased blood flow to the skin from sauna use and the rebound in peripheral blood flow after cold water exposure can augment each other to better benefit cardiovascular health (by stimulating the heart and cardiovascular system). However, there are no studies that have directly assessed this at this time [10].

Theoretically, this means that prior heat exposure (in any form) may enhance the movement of blood to the body’s core during cold exposure, thus increasing brown fat activation and the subsequent health effects. However, this has not been directly studied. 

Having experimented with both heat and cold exposure myself, I have found excellent benefits from both, including exercise recovery, boosting energy levels, and lowering inflammation in terms of less creaky joints and muscle soreness. 

And again, you don’t need a sauna and a cold plunge tank to try these two therapies. You can generate heat by exercising, sunbathing, working up a sweat in your garden — and then jump in your cold shower for 30–90 seconds. You could even do it a second time by turning up the warm water in your shower for a few minutes and then returning to cold again. The added benefit here is that you’ll probably look forward to that cold shower after all that hard work! 

Making Cold Exposure Part of Your Routine

The first step to trying cold exposure therapy (after you’ve been cleared by your provider to start) is to pick a schedule and decide to do it. Whether you do it at the end of every shower or a couple of times a week, put it in your calendar, put sticky notes on your bathroom wall to remind yourself, set alarms on your phone — whatever you need to do to make sure you remember to do it. 

It’s also a good idea to make a note in a journal or your notes app of the goals you’re looking to achieve. Is it increasing energy, improving immunity, weight loss, or all of the above? You can’t measure your goals without knowing what they are first. 

Now commit to cold showers (on whatever schedule you choose) for 30 days, for a minimum of 30 seconds at a time. You can go longer, but 30 days is a good ballpark number to see if you notice any benefits. Keep track of your goal outcomes as you go. Do you notice you don’t have as much of an afternoon slump anymore? Is your sleep better? Did you escape getting sick when everyone else around you caught the flu? It’s all worth noting.

Finally, decide if you’re going to continue the habit over the long term. If you do notice benefits at 30 days, you’ll likely see additional benefits with continued use. But if you don’t see any benefits, or you really hate the cold, then it’s okay to stop too. You tried, and there are plenty of other lifestyle practices you can use to support and enhance your health (and ones that don’t make you hate getting into the shower). 

If you try this cold shower experiment, I’d love to hear about your results! Leave a comment on one of my cold exposure YouTube videos and let me know how it goes. 

Are Cold Showers Right for You?

I know cold therapy can be one of the hardest practices for people to get on board with — I’m not going to say it isn’t challenging! But the benefits speak for themselves, and sometimes these difficult practices can be the tool that changes everything for our health and well-being, whether your goal is weight loss, energy enhancement, or putting an autoimmune disease into remission. 

If you want to see me break down multiple studies on cold exposure and its benefits, share some of my own lab results after doing cold exposure consistently, as well as discuss helpful tips for starting cold exposure therapy for yourself, check out this 12-minute video above. Send it to a friend who needs to hear about this!

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➕ References
  1. Buijze GA, Sierevelt IN, van der Heijden BCJM, Dijkgraaf MG, Frings-Dresen MHW. The effect of cold showering on health and work: A randomized controlled trial. PLoS ONE. 2016 Sep 15;11(9):e0161749. DOI: 10.1371/journal.pone.0161749. PMID: 27631616. PMCID: PMC5025014.
  2. Yoneshiro T, Wang Q, Tajima K, Matsushita M, Maki H, Igarashi K, et al. BCAA catabolism in brown fat controls energy homeostasis through SLC25A44. Nature. 2019 Aug 21;572(7771):614–9. DOI: 10.1038/s41586-019-1503-x. PMID: 31435015. PMCID: PMC6715529.
  3. Scheel AK, Espelage L, Chadt A. Many Ways to Rome: Exercise, Cold Exposure and Diet-Do They All Affect BAT Activation and WAT Browning in the Same Manner? Int J Mol Sci. 2022 Apr 26;23(9). DOI: 10.3390/ijms23094759. PMID: 35563150. PMCID: PMC9103087.
  4. Kox M, van Eijk LT, Zwaag J, van den Wildenberg J, Sweep FCGJ, van der Hoeven JG, et al. Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans. Proc Natl Acad Sci USA. 2014 May 20;111(20):7379–84. DOI: 10.1073/pnas.1322174111. PMID: 24799686. PMCID: PMC4034215.
  5. Zwaag J, Naaktgeboren R, van Herwaarden AE, Pickkers P, Kox M. The effects of cold exposure training and a breathing exercise on the inflammatory response in humans: A pilot study. Psychosom Med. 2022 May 1;84(4):457–67. DOI: 10.1097/PSY.0000000000001065. PMID: 35213875. PMCID: PMC9071023.
  6. Esperland D, de Weerd L, Mercer JB. Health effects of voluntary exposure to cold water – a continuing subject of debate. Int J Circumpolar Health. 2022 Dec;81(1):2111789. DOI: 10.1080/22423982.2022.2111789. PMID: 36137565. PMCID: PMC9518606.
  7. How brown fat improves metabolism | National Institutes of Health (NIH) [Internet]. [cited 2023 May 4]. Available from: https://www.nih.gov/news-events/nih-research-matters/how-brown-fat-improves-metabolism
  8. Khodadadi N, Dastoorpoor M, Khanjani N, Ghasemi A. Universal Thermal Climate Index (UTCI) and adverse pregnancy outcomes in Ahvaz, Iran. Reprod Health. 2022 Feb 2;19(1):33. DOI: 10.1186/s12978-022-01344-7. PMID: 35109854. PMCID: PMC8811963.
  9. Søberg S, Löfgren J, Philipsen FE, Jensen M, Hansen AE, Ahrens E, et al. Altered brown fat thermoregulation and enhanced cold-induced thermogenesis in young, healthy, winter-swimming men. Cell Rep Med. 2021 Oct 19;2(10):100408. DOI: 10.1016/j.xcrm.2021.100408. PMID: 34755128. PMCID: PMC8561167.
  10. Heinonen I, Laukkanen JA. Effects of heat and cold on health, with special reference to Finnish sauna bathing. Am J Physiol Regul Integr Comp Physiol. 2018 May 1;314(5):R629–38. DOI: 10.1152/ajpregu.00115.2017. PMID: 29351426.

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