Cryotherapy, the practice of brief whole-body exposure to intense cold in chambers or cold water, is promoted for faster recovery, better mood and a longer, healthier life. Evidence is uneven: added to usual care, it eases pain, arthritis activity and depressive symptoms; cold water eases post-exercise soreness. Cold water straight after strength training reduces gains in strength and muscle, and blood pressure rises during each exposure. Lifespan gains are unproven. (Full Review)

Protocol

Clinical chamber course

Ten sessions of 2–3 minutes at −110 to −160 °C

Over two weeks; six 3-minute sessions at −130 °C over 14 days for rheumatoid arthritis

Recovery immersion

Water at 11–15 °C for 11–15 minutes

After strenuous exercise; gave the largest soreness reduction

Weekly maintenance (popularized by Andrew Huberman)

About 11 minutes weekly in total

As 2–4 sessions of 1–5 minutes, uncomfortably cold but safe

Time to effect

Pain relief and mood

After 6–10 chamber sessions

Over two weeks

Muscle soreness

At 24 hours

Cold water after strenuous exercise; soreness eased up to 96 hours

Sickness absence

Over 90 days

After 30 days of 30–90 seconds of cold at the end of a daily hot shower

Benefits

High: Pain relief in rheumatic and chronic pain conditions; less post-exercise muscle soreness; faster recovery of muscle power after exercise; lower disease activity in inflammatory arthritis; fewer depressive symptoms as an add-on to treatment

Medium: Fewer sick days from work; improved cognitive scores in mild cognitive impairment; lower low-density lipoprotein cholesterol and fasting glucose

Low: Better insulin sensitivity; lower perceived stress; better sleep quality; better quality of life

Speculative: Longer lifespan; brown fat activation and higher energy expenditure; anti-inflammatory cytokine shift; alertness via catecholamines

Contraindications

Uncontrolled hypertension (sessions deferred at ≥160/100 mmHg)

Ischemic heart disease, decompensated heart failure, moderate-to-severe stenotic valve disease, pacemaker or implantable defibrillator, second- or third-degree heart block, or resting heart rate >110 beats per minute

Aortic root or ascending aorta dilatation ≥45 mm

Stroke within 12 months or pulmonary embolism within 6 months

Chronic migraine, epilepsy, glaucoma

Cold-related immune disorders such as cryoglobulinemia

Cold urticaria; Raynaud's syndrome

Peripheral artery disease beyond Fontaine stage I

Pregnancy; type 1 diabetes or uncontrolled type 2 diabetes

Severe anemia (hemoglobin ≤80 g/L) or platelets <50 ×10⁹/L

Chronic obstructive pulmonary disease stage III–IV, severe asthma, or chronic kidney disease stage III–IV

Malignant melanoma, active invasive cancer, or ongoing cancer therapy

Age over 80

For cold water specifically: known inherited arrhythmia syndromes

Key Interactions

Beta-blockers (propranolol, metoprolol): Monitor

Prescription stimulants (amphetamine, methylphenidate): Caution (theoretical)

Antipsychotics (olanzapine, chlorpromazine) and benzodiazepines (diazepam, lorazepam): Caution (theoretical)

Glucose-lowering drugs (insulin, glimepiride): Monitor (theoretical)

Anthracycline chemotherapy (doxorubicin) and triptans (sumatriptan): Avoid chamber sessions during use (theoretical)

Decongestants (pseudoephedrine, phenylephrine): Caution (theoretical)

NSAIDs (ibuprofen, naproxen): Caution (theoretical)

Alcohol: Avoid before cold water

Stimulant supplements (caffeine pre-workouts, yohimbine): Caution (theoretical)

High-dose antioxidants (vitamin C 1 g, vitamin E 400 IU): Caution (theoretical)

Brown-fat activators (capsaicin, green tea catechins): Minor

Sauna and heat therapy: Monitor (theoretical)

Hyperventilation breathing techniques: Avoid in water

Risk & Side Effects

High: Blunted strength and muscle gains from training; acute rise in blood pressure

Low: Cold shock, heart rhythm disturbances and drowning in cold water; hypothermia and post-immersion collapse; immersion pulmonary edema; skin reactions and cold injuries; cold-induced anaphylaxis in cold urticaria; serious vascular and neurological events after chamber sessions; asphyxia and burns in nitrogen-cooled cabins

Speculative: Theoretical cancer progression

Monitoring

Marker	Target	Why
Blood pressure	No established target for cryotherapy; track against own baseline	Safety check: ≥160/100 mmHg defers sessions
Resting heart rate	60–100 beats per minute (standard reference range)	Safety check: >110 beats per minute excludes chamber use
Hemoglobin	Women 120–160 g/L; men 135–175 g/L (standard reference range)	Safety check: ≤80 g/L excludes chamber use
Platelet count	150–400 ×10⁹/L (standard reference range)	Safety check: <50 ×10⁹/L excludes chamber use
LDL cholesterol	No established target for cryotherapy; track change from own baseline	Expected to change: fell more than in controls
Triglycerides	<1.7 mmol/L (<150 mg/dL) (standard reference range); track change from own baseline	Expected to change: lower after chamber courses
Fasting glucose	3.9–5.5 mmol/L (70–99 mg/dL) (standard reference range); track change from own baseline	Expected to change: fell more than in controls
HbA1c	Not specified in the ER	Pairs with fasting glucose as a 3-month glucose average

Cadence: Baseline check of blood pressure, resting heart rate and cardiovascular history before starting; blood pressure and heart rate before every chamber session; lipid panel and fasting glucose at 3 months, then every 6–12 months; complete blood count every 12 months, or sooner if symptoms arise

Qualitative Assessment

Muscle soreness ratings after hard training sessions
Sleep quality and time to fall asleep, including on evenings with cold exposure
Mood, energy and alertness in the hours after exposure
Pain scores for any chronic pain condition
Strength progression in a training log, to detect blunted gains
Skin reactions, numbness or lingering cold in hands and feet
Cold tolerance: time before strong shivering at a fixed temperature

Cryotherapy for Health & Longevity

Protocol

Benefits

Risk & Side Effects

Monitoring

Qualitative Assessment