Cryotherapy: – whole body - is standing in minus 190 degrees celsius for 3 minutes a good idea?

Cryotherapy – whole body - is it a good idea to stand nearly naked for 3 minutes in a chamber that is minus 90 to minus 190 degrees Celsius (or colder..) ?

October 6th, 2021 <9 minute read.

Why would one stand nearly naked in a room / chamber at minus 90 degrees Celsius, or minus 110 degrees Celsius, or even -190 degrees Celsius, for 3 minutes?

I seek to answer this for you.

60 second summary:

Cryotherapy (“Cryo”) - whole body- (“WBC”)(see above photo, an electric chamber) is the act of super chilling your whole body, or parts of your body, in a chamber- with either the whole body (head included) or just your “partial body” with your head and neck exposed (nitrogen chamber), at very cold temperatures (maybe -90 to -110 degrees Celsius or colder- perhaps down to minus 200 degrees Celsius if using nitrogen with your head outside the chamber) for 3 to maybe 5 minutes, to achieve the benefits sought. The benefits, from metabolic boosts to pain relief and rheumatism treatment and so on- set out below- will likely be very person specific, and generally require sequential treatments ie every day, for one to two weeks (and maybe longer) and possibly twice a day. Some research indicates that WBC colder than -100 Celsuis treatment is needed for more effective for treatments.

But first, we should ask three questions before doing anything medical ie Cryotherapy, (could this be considered a drug?) in this case:

1) If one does cryotherapy, how high is the probability of harm? (and how bad..?) (Conclusion: seems very low if done right)

2) If you do cryotherapy, what is the probability of benefit? (and how much benefit?) (Conclusion: seems quite high depending on the issue and the person)

3) What is the opportunity cost of doing cryotherapy? (Conclusion: cost and time expended)

And for the avoidance of doubt, this is not medical advice and anyone seeking treatment for something needs to consult with their licenced medical professional.

I will address a number of things to do with whole body cryotherapy. This will be reviewed in the following sections:

1) What is whole body cryotherapy?

2) Who should use it, and what are the potential benefits?

3) Where do I get it done?

4) What are the risks and rewards?

5) Summary

1) What is whole body cyrotherapy?

Whole body cryotherapy is the process of standing in a super chilled chamber, with either your head also chilled within the chamber, (Electric systems… like your fridge) or your head and neck outside (“Partial body Cryo”, nitrogen based systems) the super-chilling area. Such cryotherapy has been in use for over 30 years, and is now found in widespread use across Europe and the USA, both in medical centers and spa / wellness and athletic centers. WBC was developed in Japan in 1978 for the treatment of rheumatoid arthritis.

Some services are offered where only very specific parts of the body are super chilled eg face, abdomen, joints, with local applied super chilling devices, maybe -30 degrees Celsius, but this note is focussed mainly on whole body cryotherapy.

There are a range of different suppliers of chambers, and different clinics offer different approaches. Some are ones where you simply step in to them and standing there at maybe minus 80 or minus 90 degrees Celsius or minus 110 or minus 120 degrees Celsius, for 3 to 5 minutes, but first putting warm slippers and socks on, plus shorts, plus a face mask and something to protect your ears. Eyes do not need to be covered. These electric “head included” chambers include the super chilling of your head, whilst it appears that many of the “head exposed” / “partial body” chambers use super chilled nitrogen, and keep you head -and neck and shoulders - outside the chilling (and nitrogen), and can go down to minus 200 degrees Celsius.

Mechanisms of action: as the body chills rapidly then blood rushes to the core of the body to protect the organs. When one steps out of the “chiller” then blood rushes back to the rest of the body and re-enervates it.

Picture 1: A nitrogen chamber. (Fahrenheit temperature)

Other Cryo therapies, aside from Whole and Partial body therapies

Note that there are other cryo type therapies, such as localised cryotherapy, or cyroslimming eg see Cryoskin - Restore Hyper Wellness to lose weight or tone skin; Cryolipolysis- localised fat freezing to lose weight; cryotoning- to remove cellulite; cryoskin facials- to improve facial skin elasticity, which are mainly cosmetic as opposed to the more medically focussed therapies discussed in this note.

Note that occasionally these other cosmetic “therapies” can go wrong, such as the super model Linda Evangelista cold therapy- Cryolipolysis- having the opposite effect of reducing fat cells and actually increasing them.. said to occur in a tiny proportion of people, and called PAH - paradoxical adipose hyperplasia. In 2021 she is suing the manufacturers of the Zeltiq’s cool sculpting devices. She states that she had sought to break down fat cells in her abdomen, flanks, back and bra area, inner thighs, and chin, and within a few months, she developed “hard, bulging, painful masses under her skin in those areas.” Generally, the area of concern is “vacuumed” into the hollow of an applicator, where it is subjected to very cold temperature. The surgeons’ society said the complication rate was low, with less than 1 percent of patients who may develop paradoxical fat hyperplasia, which is an unexpected increase in the number of fat cells. The side effect is more common in men than in women, the society said. (From a paper on this, noted in the references section: Paradoxical Adipose Hyperplasia (PAH) is a rare adverse effect in which patients develop painless, firm, and well-demarcated tissue masses in the treatment areas approximately 3-6 months following cryolipolysis. In our experience, additional cryolipolysis treatment is not an effective treatment and may worsen the condition”. They also stated that in an active practice the rate of PAH was closer to 0.5%, and even this may also be underreported due to reluctance of patients to report the negative reaction). P.A.H. is sometimes referred to as the “stick of butter effect,” because it can look like a stick of butter hidden under the skin.

CoolSculpting can be administered by doctors — usually dermatologists or plastic surgeons, and is FDA approved. After applying gel to the skin to protect it from damage, the doctor will use special applicators to cool the skin to just above the freezing point in fatty areas such as the chin, the abdomen, the thighs, the arms, the back or underneath the buttocks. The cold, which is administered to the skin for 30 minutes to two hours, “kills off fat cells, without damaging surrounding nerves, muscles, or skin cells,” said Dr. Whitney Bowe, a New York City-based dermatologist. To achieve the desired effect, patients typically need two to four treatments of CoolSculpting, with results appearing about four months post-procedure. According to Dr. Vega, PAH appears gradually, about one to two months after treatment, and shockingly, the new fat is typically in the shape of the CoolSculpting device applicator. New York City-based dermatologist Dr. Macrene Alexiades adds that the swelling "may continue to enlarge out to one year" while BMI remains stable "in order to determine that the increase in fat is not due to weight gain, but rather a direct result" of the procedure. Additionally, liposuction of this type of fat can be much more difficult and unpredictable.

Where PAH does not occur, over the next one to six months, the fat cells die, Dr. Bowe said, and patients usually see a reduction in fat in the treated areas of about 20 percent; patients will often have two or more treatments to the same area to reduce fat by 40 to 50 percent, eliminating small bulges and giving the area a more toned look. Treatment regimens usually range in price from $600 to $3,000. (2021) More than eight million CoolSculpting treatments had been administered in the U.S. as of 2019, according to the CoolSculpting website. As for what happens to the tissue when P.A.H. develops, that’s also unclear. It’s possible that as the body tries to repair the damage from CoolSculpting, it recruits other cells or turns on repair mechanisms that result in tissue growth, Dr. Bowe said. “But we don’t really fully understand why it happens.”

The author is not aware of any such negative effects in whole body cryo.

2) Who should use it and what are the potential benefits?

Many claims are made of the benefits of WBC, with the same claims oft repeated, such as:

- Better sleep (after 5 to 10 sessions over a few weeks- maybe 2 to 3 sessions a week)

- Pain relief (temporary, but longer term- maybe for months, after a number of sequential sessions)

- Relief from the pain of Rheumatoid arthritis (2 to 3 daily sessions at -110c, for 1 to 3 weeks) (10 to 15

sessions works for many)

- Osteoarthritis (degenerative-rheumatic diseases) (osteoarthritis of large and small joints)

- Rapid exercise recovery

- Weight management - burn up to 800 calories a session (maybe a longer term metabolism boost if

brown fat is created)

- Immune system boost

- Fibromyalgia (>20 to >30 exposures for long term effects)

- Burn-out syndrome

- Beauty benefits (skin improvement; boost in collagen production)

- Anti-inflammatory

- Increased alertness and focus

The author has not reviewed any scientific claims to validate these claims although Dr Winfried Papenfuss in his book “Power from the cold” states that he has worked in this area for well over 20 years, cites a number of research papers and trials, and has found many people reporting many of these benefits. It should be noted that he states that whilst many report the benefits, some do not, so it can be very person specific. Papenfuss also notes that -110C cryotherapy can promote the benefits, but they are not seen at -80C, and that some diseases where “effectiveness of WBC has been adequately proven”. However it appears for many then the main benefit categories are:

1) pain relief, or pain elimination;

2) Inflammation inhibition / immunomodulation;

3) effect on skeletal musculature;

4) functional improvement of the joints;

5) mood improvement;

6) economisation in the cardiovascular system and the energy budget (HRV improvement).

For the cryotherapy to be effective one must do it sequentially and not interrupted- there is a cumulative effect- a break for more than a few days means one will have to start again.

Note that when taking a session ensure that beforehand:

- You have not exercised within one hour of the session (and wait one hour after) ie no moist or heated skin

- You are not wet anywhere - ie no shower taken within an hour

- You do not have creams, lotions or oils

- Contact lenses, spectacles and hearing aids, all jewelry must be removed

- Skin and hair must be dry

- No alcohol is taken

- No physical or psychological exhaustion

- Blood pressure must not exceed 160/100 (after leaving the chamber the BP is a little increased)

One can walk slowly around in circles in the chamber but no rapid or hurried movements (excessive rapid movements can risk cold burns)

Health condition: A range of contraindications is listed on page 99 of the book “power from cold” with many listed below. But as the blood rushes to the heart and central organs, those with heart problems are generally counselled to not use Cryo.

3) Where can I get it done?

There are hundreds of cryotherapy “clinics” around the world, google your local area to see what is available and what works better for you.

For a comparison of whole body, head included, versus the head excluded nitrogen based chambers see: Electric vs Nitrogen – US Cryotherapy (however it may be biased..)

For example in the UK- Canary Wharf has Le Chalet Cryo | Home (lechalet-cryo.com) : (minus 90 degrees head included /electric); Nottinghill, London, The Best Cryotherapy in London - Apogii Clinic Notting Hill (-110 degrees, electric) or central London- Harvey Nichols. Whole Body Cryotherapy - 111CRYO (111cryoheat.com) (-90, electric), and many others.

Picture 2: Inside an electric chamber.

In USA:

New York:

Restore Hyper Wellness New York - Upper East Side; Whole Body Cryotherapy treatment l Advanced Cryo NYC (-274º F / -170Celsius) / Nitrogen- head exposed.

San Francisco:

Whole-Body Cryotherapy – US Cryotherapy (Electric, head inside, not nitrogen)

Cryotherapy San Francisco – Cryotherapy San Francisco (cryosf.co) (nitrogen, head out)

Los Angeles:

Cryozone, Santa Monica: Whole-Body Cryotherapy & Localized Cryotherapy Santa Monica (thecryozone.com) (Nitrogen, head out)

Juts to be clear the author is not recommending or cautioning against any specific clinic.

4) What are the risks?

When doing anything out of the ordinary, one should evaluate the risks and potential for damage.

There are ABSOLUTE contraindications- ie do not do under any circumstances. For a full list see page 99 of the book “power from cold”. A sample of contraindications

- Age over 75 (over 60 caution should be taken and the aging organism reacts to stimuli more slowly and adapts more slowly- so maybe a shorter stay in the chamber but have more sessions) (there are also more multi-morbidities in aging organisms)

- Cardiac pacemaker

- Thyroid gland dysfunction

- Hyperhidrosis

- Untreated high blood pressure

- Heart attack within last 6 months

- Arrhythmia, symptomatic cardiovascular disease

- Other heart conditions

- Peripheral arterial occlusive disease

- Expired venous thrombosis

- Acute diseases of airways; symptomatic lung disorders

- Acute kidney and urinary tract diseases

- Fever

- Bleeding disorders

- Severe anemia

- Infection

- Cold allergy signs

- Tumor and serious infectious diseases

- Seizures

- Bacterial and viral skin diseases

- Pregnancy

- Claustrophobia

- And other indications

There are differences also depending on the time of day, sex (women are more cold sensitive than men).

Dr Papenfuss states that he has found negative effects only very rarely.

And hot and cold therapies are not competitive (but do not do them close together).

5) Summary

Depending on what you want to achieve, Cryo appears to offer a number of health benefits, with few long term risks as long as those with contraindications avoid the therapy and flow correct procedures. Choose your preferred providers, likely with colder than -100 Celsius, maybe better to be electric, and undertake your sequential / daily (once or twice a day) 10 plus sessions to see if it works for your situation and objectives.

References:

1. Power from the cold. Prof Dr sc.med Winfried Papenfuss. Sixth edition, July 2019

2. Paradoxical Adipose Hyperplasia Secondary to Cryolipolysis: An Underreported Entity? Singh et al. Lasers in Surgery and Medicine 47:476–478 (2015) ). DOI 10.1002/lsm.22380

3. Cryotherapy Research (thecryozone.com)

4. Numerous websites