
Whole-body cryotherapy as adjunct treatment of depressive and anxiety disorders - amelius
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2734249/
======
arkades
> The subjects in the study group were additionally treated using a cycle of
> 15 visits to a cryogenic chamber carried out daily from Monday to Friday.

In a 3 week study of treatment for conditions where social withdrawal is a
critical element, one of the groups had three weeks of additional, mandated
social participation.

One of these groups also had a unilateral, massively higher level of education
(approx 1/3 of the intervention group was college educated; less than 5
percent of controls were). To the extent that education correlated to SES
strongly correlates to positive health outcomes, that’s not a small
difference.

This is an interesting pilot, and I’d be in favor of a reasonable follow-up
study. But in itself it doesn’t show jack.

~~~
WalterSear
It's part of a respectable body of science researching the effects of heat
shock protein release on autoimmune driven conditions. Both hyper and
hypothermia cause the release of heat shock proteins, which trigger the immune
system to dial down inflammation. This is co-option of the body's natural
process for recovery after serious illness, where heat shock proteins are
released in response to natural fever, triggering tnf-regulator cells and
other processes.

The twist is that we are starting to appreciate and investigate the use of
heat shock protein release induction directly on mood disorders. A sizeable
portion of depressed people, specifically the anhedonic subtype, respond to
treatments that target the immune system, or it's effects on the brain. These
people tend not to respond to most classes of antidepressants, aka treatment
resistant depression, or cognitive therapies, since (on the whole) you can't
think your way out of an autoimmune disease.

~~~
arkades
There are a number of physiologically plausible mechanisms underlying various
plausible therapies that turn out not to have clinical effects. That is why we
test them empirically.

And this study was not structured to plausibly prove clinical efficacy,
regardless of how plausible you feel the underlying physiological mechanism
is.

~~~
WalterSear
Let me restate myself, then: this study is building on ones that have already
presented plausibly proven clinical efficacy.

[https://www.youtube.com/watch?v=6DtJGJWjDys](https://www.youtube.com/watch?v=6DtJGJWjDys)

[https://www.ncbi.nlm.nih.gov/pubmed/27190490](https://www.ncbi.nlm.nih.gov/pubmed/27190490)

[https://www.sciencedirect.com/science/article/pii/S027858460...](https://www.sciencedirect.com/science/article/pii/S027858460700070X)

[https://www.foundmyfitness.com/reports/cold-
stress.pdf](https://www.foundmyfitness.com/reports/cold-stress.pdf)

~~~
arkades
So, I haven't seen this before. So I thought I'd take a look:

Sources 1 and 4 are both from the "FoundMyFitness" folks. One is a YT video,
and the other is a layman's article that, from what I see, is an argument
including things like "here are various physiological routes that may play a
role. Therefore, it works." A lot of pointing at mice models.

Almost no reference to human studies at all. I went through it looking for
what they referred to as evidence in humans, and found citations like Shevchuk
2008 ("Practical testing by a statistically insignificant number of people,
who did not have sufficient symptoms to be diagnosed with depression, showed
that the cold hydrotherapy can relieve depressive symptoms rather
effectively"), and Gordh 1998 (an assessment of administration of 10 patients
receiving epidural clonidine for pain relief, not cryotherapy), and Pertovaara
2003 (an assessment of rats getting fadolmidine, an alpha-2 agonist like
clonidine).

Your link #2, Tricas-Moreno 2016, is a case study of a single young athlete
with ankylosing spondylitis receiving multimodal physical therapy - "with
orthopedic joint mobilization, dry needling, exercise, and whole-body
hyperthermia." Not that a single case report actually means anything, but for
what it's worth, he received the opposite of cryotherapy.

And source 3, Pae 2007, was a descriptive study showing that certain genetic
variants for inflammatory mediators were associated with better or worse
responses to antidepressants ("In conclusion, genetic variants within the
genes coding for HSP-70 family proteins may affect the action of
antidepressants and thus their therapeutic efficacy,") and that these markers
went up or down in response to antidepressants, not that the presence of
inflammation itself was causal. Nor was there any empirical assessment at all
of cryotherapy as a treatment modality.

So, to summarize: Source 1 and 4 seem to be some layman's stuff that, at best,
points at some studies that suggest a possible mechanism, at the 10,000-foot
level of "inflammation happens, it might be involved with depression, if you
do things that might mediate some types of inflammation, you might mediate
depression." Source 2 is a physical therapy case study of a guy that got _the
opposite_ therapy. Source 3 elaborates slightly on "inflammation may play a
role in depression."

None of this at all shows any clinical efficacy, whatever. None of these are
clinical studies of cryotherapy in depression.

~~~
WalterSear
Sorry, that was the wrong ankylosing spndylitis reference. The last link, like
the first, I passed on because it is full of references to primary articles.

In any case, you don't seem to have the background in rheumatic diseases to
evaluate any of this, and I don't have the time to pass on the knowledge I've
garnered, as a sufferer, and also a life sciences engineer working on
autoimmune and genetic engineering problems. Consequently this has already
devolved into a Joe Rogan-style internet argument.

If this stuff is important to you,keep watching the news, there's a lot of
good research that's going to reach outside academia in the next couple of
years, regarding hyper/hypothermia, heat shock proteins, and autoimmune and
mood disorders.

~~~
arkades
Your first and last links didn't have references to primary articles of
_clinical assessments._ Your third article was _more of the same_. Your second
article was just funny because it pointed to _the opposite therapy_.

> as a sufferer, and also a life sciences engineer working on autoimmune and
> genetic engineering problems.

I wish you could join me in the irony of being a physician with an autoimmune
disease being told "you don't seem to have the background" to evaluate your
citations.

~~~
WalterSear
That _is_ ironic. Unfortunately, according to my oncologist friends, it's also
commonplace.

You reviewed what I posted with an aim to _proving me wrong_ , not expanding
your knowledge, and _then_ prove me wrong. Kind of a terribly attitude in a
physician, and really self-destructive to those dealing with autoimmune
disease.

~~~
joveian
"You reviewed what I posted with an aim to proving me wrong"

As an uninvolved reader I had the opposite impression.

------
pkaler
I started cryotherapy last year. I went every day for 30 days. I know go about
once a week. I'm headed to hot yoga followed by cryotherapy for the extra
shocking effect.

Anecdotally, I find it helps me recover from training. This is probably too
much information, but I find it is excellent for the gentlemanly bits down
under.

I'm 39. Give me more of anything that makes me feel 19 again.

~~~
capsulecorp
TRT

~~~
chrisweekly
TRT?

~~~
andai
Testosterone replacement therapy.

~~~
chrisweekly
thanks

------
nabla9
Side note: this is somewhat similar to the old methods of treating mental
patients.

Ice-cold baths were used to treat mental patients who showed signs of low
mobility and lethargy or manic-depressive psychoses. Often against their will.

~~~
atom-morgan
I used to _hate_ cold showers but I now finish off my showers every morning as
cold as my shower can go. If you have low energy levels in the morning I can't
recommend it enough.

------
graeme
To what extent is either a cold shower or an ice bath similar to the
cryotherapy used in this experiment?

~~~
scottlocklin
"Cryotherapy" as used in this study is basically being nude in REALLY cold
chambers; like -120 or -160C for fairly short periods of time. I have no idea
how they came up with the idea of making the chamber that cold. I suppose
someone looked at extreme saunas and tried the opposite.

You probably know about Wim Hof and the various sports/human performance
things involving cold (no doubt as touted on Joe Rogan as every fruity health
fad seems to be). Personally I think it probably does do something, though
every individual reaction is different. I've always done the cold water at the
end of the shower James Bond thing. I recently moved from the Bay Area where
it is 70F all year to a place where it was recently -30F with the wind chill.
The cold seems to fill me with vigor; love it. Love the Sauna as well.
Generally speaking I think the human organism thrives best with a little
hormesis.

~~~
heyjudy
Yeah, that's dangerously cold: corneal, lip and ear damage territory. Sounds
like "unpleasant must be magic panacea" department unless proven with good
studies.

~~~
michaelcampbell
Often these things are containers you get into that your head is not in.

Your point is well taken, but at least those 3 bits are probably safe from
these types of containers.

------
RobLach
If you look past the sciencese of "short-term adjuvant treatment for mood and
anxiety disorders", basically:

"It feels fun to shock your body with cold"

------
minism
It sounds interesting, but I'm not quite sure how to feel about the conclusion
that the effects here may be short-term. Anxiety and depression are generally
big picture/long term issues for people rather than acute instances.

------
cassowary37
Not randomized, not blinded. Likely to be a powerful placebo response.
Awaiting the companion article, Steam bath as an adjunct treatment.

Also note that the 'nih.gov' link probably unduly impacts credibility - it's
just the pubmed central site, not an NIH-supported trial.

~~~
tsomctl
Umm, what about the huge adrenalin and testosterone rush that you get?

> Apart from activating the body’s system of temperature regulation, there is
> also a hormonal response, which increases body metabolism and the
> concentrations of adrenaline, noradrenaline, adrenocorticotropic hormone
> (ACTH), cortisone, pro-opiomelanocortin (POMC), and β-endorphins in blood
> plasma as well as male testosterone levels

The most awesome head high I've ever experienced was jumping into a icy creek
after hiking all day on a hot spring day.

~~~
tartoran
I seldom do it but after I jump into icy cold water I get a very good mood for
the rest of the day.

~~~
c1sc0
Look up the stuff Wim Hoff “Ice Man” is onto. Hot/cold shocks of any form are
super fascinating.

