Table of Contents

• What is Cold Therapy?
• Health Benefits of Cold Therapy for Hashimoto’s
• Caveats, Risks, and Cautions with Cold Therapy and Hashimoto’s
• How to Get Started with Cold Therapy for Hashimoto’s

If you have hypothyroidism, you might often feel cold already and the idea of being in an ice bath can scare you. I was scared, too, but once I discovered the immense benefits of cold exposure, I had to give it a try. Now, it’s one of my favorite tools in my health toolbox and I’ll share with you why.

What is Cold Therapy?

Cold therapy refers to any usage of cold temperature to improve health or provide relief [1,2]. These include:

• Cryotherapy, which refers to ultra-cooling chambers that cool you down to -200 to -300oF (-129 to -184 oC)
• Cold water immersion, which includes ice baths and cold plunges into water, typically colder than 59oF (15 oC)
• Simply being in a cold place

When you jump in, you might feel the initial cold and shivers. However, once you get past the first few seconds, it starts to feel exhilarating and you can grow to like it.

Keep in mind that responses to cold therapy can be highly individual. And while it’s highly beneficial, there are risks especially when you have Hashimoto’s and other medical conditions. So, be sure to consult with your doctor and weigh the risk with the benefits before starting.

Health Benefits of Cold Therapy for Hashimoto’s

1) Promotes a balanced inflammatory response

Inflammation is a key factor in Hashimoto’s [3]. Specifically, your immune system is off-balance and overreacts to your thyroid. 

Cold therapy helps promote a balanced inflammatory response and shuts down many of these autoimmune key players, such as:

• C-reactive protein, an important inflammation marker [4,5]
• IL-6 and IL-17A, which are other inflammatory proteins that can contribute to autoimmunity when they’re elevated [6,7]

At the same time, cold therapy helps increase your natural inflammation-balancing proteins such as IL-1ra (interleukin-1 receptor antagonist) and regulatory T cells, which promote immune balance [8].

Lower inflammation means fewer inflammatory symptoms, so you may feel less joint and bodily discomfort [9]. 

2) Improves mitochondrial function and thus energy

Mitochondria produce cellular energy in most of your cells. Your thyroid hormones stimulate your metabolism partly by telling your mitochondria to produce energy [10].

Most Hashimoto’s patients have both low thyroid and dysfunctional mitochondria due to the inflammation. The mitochondrial dysfunction also produces oxidative stress, which further causes more inflammation and mitochondrial dysfunction. 

This is a vicious cycle that can manifest as lingering fatigue and other symptoms (like pain, cramps, and slow reflexes), even with normal thyroid labs [11]. Dysfunctional mitochondria also make it harder to lose weight and increases other health risks [12].

Cold exposure, like exercise, can stimulate mitochondrial growth to meet your cells’ increased demand for energy [13]. 

In animals, long-term cold exposure [14–17]:

• Boosted their mitochondrial activity
• Boosted their antioxidant production and improved their cells’ own self-defense against free radicals
• Increased mitophagy, or the breakdown of mitochondria to reuse parts and build new ones

3) Boosts mood, energy, stress resilience, and mental clarity

Most people will feel some exhilaration and enhancement of their mood with cold exposure. This is because cold increases noradrenaline and endorphins in your brain [18]. 

Noradrenaline is a chemical signal that regulates arousal, attention, cognitive function, and stress reactions, as well as boosting mood [18,19]. This is why many people report feeling more energized and focused after cold exposure.

Endorphins are the feel-good hormone released after you get a good workout. You can also release endorphins with a 1 – 3 minute cold plunge [18].

Last but not least, cold exposure is a small stressor that’s not big enough to kill you but makes you stronger (hormesis). A cold splash, even just on your neck, cheek, and forearm, also appears to reduce the stress your nervous system perceives [20].

4) Boost metabolism and fat loss

When you’re cold, your body needs to expend more calories to keep you warm. This is a legitimate way to create a caloric deficit if you want to lose weight. It does make you hungrier, though, so you’ll still need to watch your overall caloric intake.

In response to the cold, your body produces more brown fat cells, which are better at producing heat to keep you warm. These fat cells are brown because they’re full of mitochondria, which produce energy as heat [21]. Having more of these fat cells may make it easier to lose weight  [21,22].

Most people nowadays don’t have a lot of brown fat because they don’t purposely expose themselves to the cold. Hypothyroidism can also further reduce your brown fat, since you need thyroid hormones to produce brown fat. Also, brown fat has enzymes that turn your inactive thyroid hormone (T4) into active ones (T3) [23]. That means if you’re taking a T4 medication like levothyroxine, having more brown fat can make the medication work better.

Cold exposure also stimulates your brain to release more thyrotropin-releasing hormone (TRH). TRH usually stimulates thyroid-stimulating hormone (TSH), which tells your thyroid to produce thyroid hormones (T4). Aside from this, TRH also stimulates body heat regardless of your thyroid hormone levels, overall helping you burn more calories to stay warm [24,25].

5) Promotes metabolic and heart health

Many hypothyroid and Hashimoto’s patients have elevated cardiovascular risks, such as high cholesterol and poor blood sugar control. 

Cold exposure and shivering can bring sugar and fatty acids from the blood into muscle and brown fat cells to be used as fuel to stay warm. This helps improve blood sugar control, even in healthy people [26]. Also, through brown fat activation, cold exposure appears to promote healthy cholesterol levels [21].

6) May help with cold tolerance

Cold intolerance and feeling cold all the time are hallmark symptoms of hypothyroidism. While you may want to bundle up, cold therapy actually makes you warmer in the long run.

When you’re exposed to cold therapy on a regular basis, your body produces more brown fats. Also, your muscles and brown fat become better at producing heat and converting your inactive thyroid hormone (T4) into active ones (T3) [27]. Overall, the net effect of cold therapy is that it can reduce cold intolerance in the long run.

Caveats, Risks, and Cautions with Cold Therapy and Hashimoto’s

Increases hunger

Cold water immersion, especially after physical activity, can make you really really hungry [28]. This could be because it reduces leptin, one of the hormones that make you feel full [29]. 

Possibly, your body wants you to eat more and have enough energy and fat to stay warm for future cold exposures. So, if you want to use cold exposure to lose weight, you may still need to track your calories so as not to overeat. Also, if the hunger is too much, it might be a good idea to try less cold water or submerge in the water for shorter periods.

May inhibit muscle gain

Muscle building works by stressing your muscles and creating some inflammation inside your muscle cells [30,31]. Then, your immune system comes in to heal the damaged muscles and makes them bigger and better adapted to exercise [32]. 

Cold exposure can reduce post-exercise muscle soreness and allows people to go back to training faster. However, it also blocks this very inflammatory process you need to grow your muscles [33,34]. 

It doesn’t mean that you can’t benefit from both muscle building and cold therapy. You just need to avoid a cold dip within 4 hours after your workout, or only do the cold dips on days that you don’t train [35,36]. Currently, there is no study that looks at whether dipping before exercise impacts your results, but it likely doesn’t.

Hypothermia

Hypothermia is when your body gets dangerously cold, below 95°F (35ºC). Hypothermia can cause a loss of consciousness, heart attack, and death. In most adults, the possibility of hypothermia does not arise for at least 30 minutes when immersed in ice-cold water [34]. A typical cold water immersion session lasts between 3 to 5 minutes. However, if you have hypothyroidism, you should start with an even shorter time, and monitor your temperature and symptoms.

Drowning

Drowning is a risk, particularly if you submerge your head under water or have an uncontrollably fast breathing rate (hyperventilation) in stressful situations [34]. The risk of drowning is also worse in larger bodies of water, such as a pool or a lake. An accidental slip can also cause someone to hit their head and lose consciousness, which is why you need to take certain precautions.

Increased risk of cold burns with worse circulation

You may have a higher risk of frostbite or cold exposure burns with poor circulation due to conditions like Hashimoto’s.

Contraindications

Don’t do cold therapy if you have:

• Cold-triggered conditions like asthma or skin issues like Raynauds and rashes (cold urticaria) [34,37]
• Open wounds
• Pre-existing heart conditions, like irregular heartbeats or congestive heart failure
• Conditions with very poor circulation, such as diabetes or peripheral artery disease

Make sure you have an emergency plan

Brief cold water immersions should be done while another adult can monitor and come to help you, especially if it’s you’re just starting out. This is also a great opportunity to make friends and emotionally support one another. 

Common sense goes a long way, such as:

• Doing a cold plunge away from electronic devices and outlets
• Keeping sharp objects away (in case a slip occurs)
• Making sure you have a non-slip surface to step onto when getting in and out
• A working phone should be within arms reach (away from the water) in case you need to call for help

How to Get Started with Cold Therapy for Hashimoto’s

You can combine cold therapy with a few breathing techniques before, during, and after your ice bath sessions. For ladies with Hashimoto’s, I recommend starting very low and slow just as I would recommend for starting an exercise routine. Most manufacturers recommend starting at 55 – 60oF (12.7ºC – 15.5ºC). I’d say start at 70 oF (21.1ºC) for 30 seconds, work up to 1 min, and then 1.5 minutes over 2 weeks. Observe how you feel the days after, then start making it cooler and longer. It should generally make you feel better. If you feel too much stress on your body, such as extreme fatigue, then it may be time to ease up or stop.

Do you feel intimidated by exactly how long and how often to do cold therapy in order to obtain these benefits, especially in the long-term? It may surprise you, but even in experienced healthy swimmers, just 11 minutes of cold immersion per week, divided into 2 to 3 sessions, is all it took to get health benefits [38,39].

First, consistency is key for getting the most benefits from your cold therapy, so it’s a good idea to pick up an ice bath. Here are a few options I recommend:

1. Ice Barrel, which is a very easy-to-use insulated bucket. 
2. Cryospring Cold Plunges, which can double as both cold and hot tubs. It has a system to circulate, filter, and sanitize the water with ozone. Use code: thyroidstrong5 for 5% off
3. For a more portable and affordable option, consider Nurecover. You can use the coupon code EMILY92880 for 15% off the Nurecover.

Thyroid Strong is a comprehensive self-care program that includes exercise, nutrition, and all angles you need to know to thrive despite Hashimoto’s. Aside from my optimized exercise program, there are also 20 hours of bonus content with experts and doctors diving deep into these root contributors of Hashimoto’s along with tools such as cold therapy. Join the Thyroid Strong community today and take control of your health.

References