Sauna versus Cold Exposure

Rhonda Patrick: summarizing sauna and cold exposure benefits, plus the open question of combining them

Rhonda Patrick

“Sauna use improves cardiovascular function, longevity, and brain health partly by activating the FOXO3 stress-response pathway, while cold exposure boosts norepinephrine (improving focus, mood, and anxiety) and stimulates mitochondrial biogenesis in adipose and muscle tissue, potentially enhancing endurance. A key unresolved question is whether transitioning directly from hot sauna to cold water negates either set of adaptations.”

Huberman: deliberate cold exposure as a chosen challenge for brain health

Andrew Huberman

“Deliberate cold exposure—whether via cold shower, cold plunge, or ice bath—is most valuable not when it feels easy (e.g., after a hot sauna or intense exercise) but when it is genuinely uncomfortable and unwanted. Regularly doing hard, aversive things like cold exposure strengthens the anterior mid-cingulate cortex, a brain region linked to willpower and perseverance, making it a key practice for long-term brain health.”

Rhonda Patrick: cold shock proteins and sauna as complementary hormetic stressors

Rhonda Patrick

“Both sauna and cold exposure act as hormetic stressors with distinct molecular mechanisms: heat activates heat shock proteins and sensitizes the opioid/endorphin system, while cold activates cold shock proteins such as RBM3, which promotes regrowth of lost synapses at dendritic spines. Research in mice exposed to ~4°C showed dramatic upregulation of RBM3 in the brain, suggesting cold exposure may have neuroprotective effects relevant to synapse maintenance. These parallel but separate stress-response pathways make sauna and cold exposure complementary rather than redundant interventions.”

Huberman: Heat and cold exposure work through opposing hypothalamic thermostat mechanisms

Andrew Huberman

“Heating the body surface triggers medial preoptic area neurons to cool the body's core, while cooling the surface causes those same neurons to raise core temperature — making heat and cold exposure physiologically opposite interventions through the same hypothalamic thermostat. For women, regular sauna use improves insulin and glucose control, upregulates heat shock proteins, and enhances serotonin production from the gut, which can help reduce hot flashes by strengthening the hypothalamic temperature-regulation signal.”

Rhonda Patrick: UCP1, norepinephrine, and fat burning during cold exposure

Rhonda Patrick

“Cold exposure triggers norepinephrine release, which activates uncoupling protein 1 (UCP1) in mitochondria, causing them to burn fat to generate heat rather than efficiently produce ATP. Hyperventilation-induced respiratory alkalosis may also play a role by altering blood pH and modulating pain and thermal receptors. These mechanisms together explain the thermogenic and metabolic effects of cold immersion.”

Rhonda Patrick: cardiovascular risks and heat shock protein activation in hot-cold contrast therapy

Rhonda Patrick

“Alternating between hot sauna and cold exposure carries potential cardiovascular risk for people with unstable coronary artery disease, as the transition from vasodilation to vasoconstriction can trigger coronary artery spasm. For the general population, however, the practice appears safe and may offer additive hormetic benefits, since both heat and cold independently activate heat shock proteins as part of a shared stress-response pathway.”

Rhonda Patrick: Cold shock proteins and the distinct biology of cold vs. heat stress

Rhonda Patrick

“Both sauna and cold exposure act as hormetic stressors, but through distinct molecular pathways. Sauna activates heat shock proteins and modulates the opioid/endorphin system, while cold exposure activates a separate class of cold shock proteins, including one expressed at dendritic spines in the brain, as demonstrated in a Nature study where mice exposed to ~4°C showed significant drops in core body temperature alongside this cold- shock protein response.”

Rhonda Patrick: sauna frequency and cardiovascular mortality reduction

Rhonda Patrick

“Regular sauna use at moderate temperatures (around 175°F with ~30% humidity for ~20 minutes) offers significant cardiovascular and all-cause mortality benefits, with four or more sessions per week associated with up to 50% reduction in cardiovascular mortality and 40% reduction in all-cause mortality. Using the sauna after both aerobic and resistance training can extend exercise-mimicking physiological effects, and deliberate heat exposure may also benefit those unable to train due to injury.”

Rhonda Patrick: Optimal sauna temperature range for dementia risk reduction

Rhonda Patrick

“Regular sauna use (4–7 times per week) is associated with a 60–65% lower risk of Alzheimer's disease and dementia, reflecting a hormetic stress response that builds resilience. However, this benefit follows an inverted-U dose-response curve: temperatures above 200°F (93°C) are associated with a two-fold increased risk of Alzheimer's disease, underscoring that the right dose of heat stress — not the maximum — drives protective outcomes.”

Rhonda Patrick: cold exposure triggers norepinephrine and mitochondrial biogenesis

Rhonda Patrick

“Cold exposure acts as a hormetic stressor that triggers norepinephrine release from the adrenal glands and central nervous system, influencing metabolic health, mood, and neurodegeneration. Cold water immersion also increases PGC-1 alpha in skeletal muscle, a protein that drives mitochondrial biogenesis — the production of new, healthy mitochondria. These mechanisms suggest habitual cold exposure may protect against metabolic disease and support brain function.”

Huberman: why people do deliberate cold exposure and sex-based differences

Andrew Huberman

“Deliberate cold exposure — via cold showers, plunges, or ice baths — is primarily valued for its prolonged post-exposure increases in catecholamines (dopamine, epinephrine, norepinephrine), which produce lasting alertness and a semi- euphoric state rather than meaningful metabolic changes. There are likely sex-based differences in cold exposure responses, partly due to differences in vasoconstriction versus vasodilation, and conditions like Raynaud's syndrome are a relevant consideration for women in particular.”

Huberman/Guest: Heat preferred over cold for women, with Finnish sauna recommended over infrared

Andrew Huberman

“For women, heat exposure via traditional Finnish sauna (185–210°F) is generally preferred over deliberate cold exposure, as everyone responds to heat and adaptations are more consistent. Infrared saunas are considered inferior because they heat the skin but not the body's core, whereas a true Finnish sauna achieves the deep core warming necessary for meaningful physiological adaptation. Cold exposure may still be recommended for specific populations such as open-water swimmers preparing for vagal responses.”

Huberman: personal cold exposure practice and catecholamine benefits

Andrew Huberman

“Deliberate cold exposure via cold shower or cold plunge reliably increases catecholamines—dopamine, epinephrine, and norepinephrine—producing mood and energy benefits lasting many hours afterward. Beyond the physiological effects, voluntarily confronting the discomfort of cold (especially for those who are highly heat-adapted and dislike cold) builds willpower and activates brain regions associated with perseverance, making the psychological challenge itself a key reason to practice it alongside heat exposure like sauna.”

Rhonda Patrick: sauna mimics exercise and cold exposure activates brown fat

Rhonda Patrick

“Deliberate heat exposure through sauna or hot baths mimics moderate-intensity cardiovascular exercise, improving endothelial function, arterial compliance, and triggering a heat shock protein response that remains elevated for approximately 48 hours. Combining sauna with exercise provides greater cardiovascular benefit than exercise alone. Cold exposure represents a distinct form of thermal stress with different mechanisms, notably the activation of brown adipose tissue, a thermogenic fat tissue.”

Huberman: practical guidelines for cold exposure intensity and timing

Andrew Huberman

“Effective cold exposure requires water cold enough to trigger discomfort and an urge to exit, but not so extreme it causes an icy burning sensation. Timing matters: morning cold exposure feels more jarring than evening sessions, and context such as exiting a sauna can lower the psychological barrier. A useful framework is overcoming successive 'walls' of resistance — first the reluctance to enter, then the initial breathing response — rather than targeting a fixed duration.”

Huberman: Cold exposure as anti-inflammatory therapy for endometriosis

Andrew Huberman

“Deliberate cold exposure applied around ovulation and sustained for 10 days across three menstrual cycles can attenuate endometriosis symptoms by dampening the inflammatory processes that drive tissue growth. This pilot study finding opens a novel clinical avenue for using cold therapy to modulate inflammation in hormonal conditions. However, Wim Hof-style cyclic hyperventilation must never be combined with breath holds near water, as this combination has been linked to drownings.”

Rhonda Patrick: cold exposure activates brown fat to improve glucose metabolism

Rhonda Patrick

“Cold exposure activates brown adipose tissue (brown fat), which significantly increases thermogenesis and provides an alternative pathway for glucose uptake that can exceed insulin- stimulated uptake in skeletal muscle. This makes brown fat a compelling therapeutic target for metabolic disorders, as its activation improves glucose and insulin sensitivity, increases fat utilization, and protects against diet-induced obesity. Norepinephrine, released systemically during cold exposure, is a key mediator of these wide-reaching metabolic effects.”

Rhonda Patrick: cryotherapy vs. cold water immersion for mood and thermogenesis

Rhonda Patrick

“Cryotherapy at approximately -256°F administered five times per week for two weeks produced a dramatic antidepressant effect in people with major depressive disorder, with Hamilton scale improvements of ~17 points versus a clinically relevant threshold of 2.5. Despite this, cold water immersion is subjectively more potent due to direct skin-water contact. The segment also transitions into discussing cold exposure's role in thermogenesis and brown adipose tissue activation.”

Dr. Rhonda Patrick: Maximizing Healthspan with Exercise, Sauna, & Cold Exposure

Rhonda Patrick

“…to deliberate heat exposure with a big focus on regular hot sauna. So, we're going to talk about being, you know, it being an exercise mimetic. We're going to talk about heat shock proteins, Alzheimer's disease. We're going to talk about infrared saunas versus”

Use of Sauna and Cold to Increase Net Resilience, Mitochondrial Biogenesis, Mood and Longevity

Rhonda Patrick

“from personal experience I prefer to do the sauna after exercise uh because one the sauna is also exhausting so I try to do the sauna before I workout my workout won't be as good um and also I think that you know after the workout I like doing it because it's”

Female-Specific Exercise & Nutrition for Health, Performance & Longevity | Dr. Stacy Sims

Andrew Huberman

“…arting to explore this especially the in my opinion the the sauna work uh one thing I suppose that we should um discuss very briefly before we move on since we've been talking about resistance training we've been talking about deliberate cold exposure there is”

AMA #18: Cold Therapy Advice, Skin Health Tips, Motivation, Learning Strategies & More

Andrew Huberman

“I'm pretty heat tolerant so I'll put the traditional sauna not infrared sauna but traditional sauna to about 210 and I'll last about 10 to 20 minutes in there maximum and then I'll go into the Cal plunge and back and forth okay so if you're going to do the Cal”

How to Train According to the Experts

Rhonda Patrick

“…as well growth hormone is elevated when you're getting the sauna and that can have aspects for Recovery as well so there's a lot of reasons to to combine deliberate heat exposure with also resistance training workout and I would say that is not the case for d”

COVID-19 Q&A #1 with Rhonda Patrick, Ph.D.

Rhonda Patrick

“…d it was conducted in Finland where most people have a home sauna the average sauna exposure reported in the study was approximately 20 minutes per session and the temperature was 174 degrees Fahrenheit or 79 degrees Celsius the data was adjusted for a variety”

Dr. Andy Galpin: The Optimal Diet, Supplement, & Recovery Protocol for Peak Performance

Rhonda Patrick

“…into the deliberate heat exposure through also jacuzzi and sauna. Yeah. Um there's cold water immersion. I'd love to talk about how so with with the heat exposure and jacuzzi sauna. It sounds like jacuzzi might be might be the uh winner with respect to um my”

Why Exercise Intensity Matters for Longevity | CrossFit for Health 2024

Rhonda Patrick

“…from experts we have one one a question about the uh finish saunas versus the infrared saunas um is the mechanism that uh they're providing benefit uh just because of the the temperature and the increased heart rate um is that what makes finish better than inf”