Cold Exposure Research Analysis

Q: Can cold exposure help with depression?

Because norepinephrine levels play a significant role in depression,[36] cold exposure has been investigated for some time as an additional treatment alongside standard therapies.[37] The results to date have been encouraging. After adults diagnosed with depression were exposed to 10 cryotherapy sessions in a randomized controlled trial, significant improvements were noted in depression symptoms, disease acceptance, quality of life, and self-assessed mood.[38] These results are consistent with reports of similar results from additional trials.[39][37][40] Although promising, the studies on cold exposure and depression to date have been less rigorous and tend to involve small numbers of participants and short follow-up periods. More research is needed to determine the long-term efficacy and optimal cold exposure protocols for different populations.[40]

Q: Does cold exposure improve glucose metabolism?

Some small trials on cold water immersion found that cold exposure can increase insulin sensitivity[41] and reduce fasting insulin levels.[42][43] However, these studies all involved small numbers of participants and either were observational in design[42][43] or lacked blinding and randomization.[41] Although the research is potentially promising, more rigorous studies are needed to validate these results and to determine whether the effects are clinically relevant. If future studies on cold exposure do end up confirming a significant effect on glucose metabolism, its effect on glucose homeostasis may occur through the increased production of adiponectin, an agent with insulin-sensitivity-enhancing effects.[44]

Q: Is cold exposure an effective intervention for body weight and/or fat loss?

Trials that tested the effects of cold exposure on body weight and fat loss have reported inconsistent results,[45] and the long-term efficacy of cold exposure interventions on obesity has yet to be established.[46] Although research to date points toward a lack of efficacy for cold exposure as a stand-alone long-term weight loss intervention, there have been promising results over smaller timescales. In a randomized controlled trial with 51 participants, 2 hours of daily cold exposure at 17°C (63°F) for 6 weeks resulted in increases in energy expenditure, thermogenesis, and brown adipose tissue (BAT) activation that resulted in a significant amount of fat loss compared to the control participants who were not exposed to the cold.[34] Because people with overweight or obesity tend to have lower amounts of BAT[47][48][49][50][51][52] and cold exposure interventions may improve metabolic health through the expansion of BAT stores and increased nonshivering thermogenesis,[45] more research is warranted to determine whether cold exposure could be helpful alongside other interventions that target obesity.

Q: Can cold water immersion help to promote recovery or enhance adaptation from exercise?

It’s important to make the distinction between recovery and adaptation when considering the effects of cold water immersion postexercise. Part of the stimulus for muscle adaptation to any type of exercise involves damage to the local tissues, to a certain degree, which triggers an inflammatory response and frequently delayed-onset muscle soreness, which results in a temporary reduction in strength and range of motion.[53][54] Recovery is the process of restoring normal function after the training stimulus, such as repairing tissue damage and replenishment of fuel stores. In contrast, exercise adaptation is a longer-developing process that involves physiological changes that better equip the body to handle similar types of training stress in the future. Examples of exercise adaptation include the development of larger, stronger muscles from weight training or the development of increased endurance from endurance training such as running, cycling, or swimming.[55] We consider the effects of postexercise cold water immersion on adaptation from weight training and endurance exercise separately below. Weight training: Postexercise cold water immersion has a suppressive effect on gains in strength and muscle mass from weight training,[56][57][58][59] so it should be avoided for at least several hours after weight training. Although research to better understand the mechanisms involved is still ongoing, cold water immersion seems to have a suppressive effect on the short-term anabolic (muscle-building) signaling processes that are important for triggering longer-term muscle adaptations.[56] Endurance exercise: In contrast to the clear suppressive effect on muscle adaptations after weight training, most studies have found that cold water immersion has negligible effects on adaptation from endurance exercise.[59][60][61][62]

Q: Can cold exposure cause heart attacks?

Cold exposure can potentially cause heart attacks in certain individuals. The cold-shock response activates the sympathetic (“fight or flight”) nervous system, which increases the heart rate and blood pressure. Although this response is important for preserving core body temperature in the cold and is well tolerated by individuals without apparent health conditions, the sudden increase in stress on the heart could potentially cause a heart attack in people who may be vulnerable.[67][27] Vulnerable individuals also may be at an increased risk for sudden cardiac death when the face is submerged during cold water immersion. Although cold water immersion typically involves immersion up to the chest or neck, which triggers the cold shock response and activates the sympathetic nervous system, full-body submersion, in which the face is under water, also triggers the “diving response,” which slows heart rate through a parasympathetic (“rest and digest”) nervous system response. The conflicting signals coming from the two limbs of the autonomic nervous system to the heart have been proposed to cause an “autonomic conflict”, which could potentially cause sudden cardiac death in vulnerable individuals.[24] Although this has yet to be proven, cold water submersion is known to increase the incidence of cardiac arrhythmias in individuals without known health conditions,[68][69][70] and it has been proposed that sudden cardiac death may at times be the actual cause of deaths from cold water submersion that were previously attributed to drowning or hypothermia.[24]

Q: Can white fat be transformed into brown fat by the cold?

Because the types of fat cells (adipocytes) that make up white adipose tissue (WAT) come from a different developmental lineage than the brown adipocytes in brown adipose tissue (BAT), the cells in WAT can’t transform into brown adipocytes.[63] However, in response to regular cold exposure, the adipocytes in WAT undergo a transition to a thermogenesis-capable state by expressing some of the same proteins that facilitate heat production in BAT, such as uncoupling protein 1 (UCP1, also known as thermogenin).[64] The cold-adapted white cells appear light brown in comparison to their non-cold-adapted counterparts and are often referred to as “beige” adipocytes due to their darker color. Papers in the research literature commonly refer to the cold adaptation process in WAT as “beiging” or “browning”.[65]

Q: Do I need to be cold enough to shiver to experience the metabolic-rate-boosting benefits of cold exposure?

Although the intense shivering that is induced by unaccustomed cold exposure can cause significant increases in the metabolic rate, shivering isn’t necessary to get a metabolic boost from cold exposure. In one study, participants who were exposed to mild cold (66°F/19°C) for 10 hours every night for a month had a 42% increase in brown fat volume and a 10% increase in fat metabolic activity.[6] Although the participants in that particular study resided in a clinical research unit for the duration of the study, which allowed the researchers to test a specific set of conditions that may not reflect those of free-living humans, it is clear that humans acclimate to cold temperatures in part through increased brown adipose tissue activity and nonshivering thermogenesis. Additionally, with regular cold exposure, shivering thermogenesis (ST) attenuates (decreases over time with exposure) and nonshivering thermogenesis (NST) increases.[66] The transition from ST to NST can occur relatively fast, as noted in the above study, in which daily cold water immersion for 1 hour in 14°C (57°F) water reduced shivering thermogenesis by 20% without a change in total heat production.[66]

Bill Willis

Cold Exposure

•Last Updated: March 25, 2025

Cold exposure is the practice of voluntarily exposing the body to temperatures that are colder than comfortable, triggers an adaptive stress response. This response is currently a topic of research for benefits on the mind and body.

Dosage

Research feed

Cold Exposure is most often used for

Bill Willis, PhD

Katie Jantz, RPh, MSc

•

Conni Covington

Last Updated:March 25, 2025

Dosage Information
Research feed
Frequently asked questions
Update History
Research breakdown
References

What is cold exposure?

Any method of exposing the body to temperatures that are lower than comfort levels is sufficient for a cold exposure stimulus. However, due to differences in the abilities of water and of air to transfer heat, both the method and duration of exposure and the temperature determine how rapidly the body cools, which ultimately determines the physiological and psychological responses. Examples of cold exposure stimuli include being outdoors in the winter while wearing light clothing, cryotherapy, cold showers, and various forms of cold water immersion (CWI).^[1] Of the various types of cold exposure, CWI has been the topic of the most recent body of research.

Note: Recent literature has tended to use the term “cryotherapy” as a more general, catch-all term for cold exposure. In the context of this page, we use cryotherapy in the more specific sense of whole-body cryotherapy, which involves sitting for 2 to 3 minutes in a chamber in which the air temperature is rapidly lowered to −100°C (−148°F) or lower using liquid nitrogen.^[2]

What are cold exposure’s main benefits?

Cold exposure may have numerous benefits on the mind and body, and these benefits are currently under investigation. However, it is important to note that the way in which the stress from cold exposure interacts with various human body systems isn’t completely understood. More research is needed to determine whether certain effects are beneficial and in which populations or individuals cold exposure may be more or less appropriate.^[1]

Cold exposure has been shown to have 5 primary benefits.

Increased metabolic rate Cold exposure increases the metabolic rate^[3] through thermogenesis in the body, a process in which various metabolic pathways are activated to generate heat in an effort to preserve the core temperature.^[4] Shivering thermogenesis is one of the biggest contributors to an increased metabolic rate during cold exposure and can increase the metabolic rate in the short term by as much as 500%, given a sufficient decrease in the core temperature.^[5] However, nonshivering thermogenesis (NST) is also responsible for an increased metabolic rate as part of the body’s adaptation to regular cold exposure.^[6]

Increased cold tolerance With frequent cold exposure, the body becomes more efficient at activating thermogenic processes to maintain the core temperature. Regular cold exposure in humans increases nonshivering thermogenesis, which increases from baseline in direct proportion to cold tolerance.^[7]^[8] Additionally, studies in Norwegian fishermen — who tend to work in cold environments and are often required to immerse their hands in cold water — have suggested that cold-water finger dexterity may increase with regular cold exposure.^[9]^[10]

Increased focus and energy levels Cold exposure from cold water immersion (CWI) triggers the rapid release of catecholamines such as dopamine and norepinephrine,^[11]^[12]^[13]^[3] which are associated with increased focus, energy, and motivation levels.^[14]^[15] In a randomized controlled trial that tested the effects of cold water immersion for an hour at various temperatures, immersion in 14°C (57°F) water increased levels of the catecholamines norepinephrine and dopamine by 530% and 250%, respectively. The levels of these neurotransmitters remained elevated significantly above baseline at the 2-hour endpoint.^[3] Because catecholamines remained elevated above baseline at the 2-hour endpoint, more research is needed to determine whether they remain elevated throughout the day, which would be consistent with claims that CWI promotes a heightened mental state for several hours postexposure. Additional studies are also needed to determine whether shorter-duration CWI and extended-duration CWI may cause similar increases in catecholamine levels. However, these results are consistent with reports in another trial that the participants felt more alert, focused, and inspired after only 5 minutes of CWI.^[12]

Improved mood The positive effects of cold exposure on mood are related at least in part to its ability to increase norepinephrine levels.^[16] The participants in one trial who were exposed to CWI at 20°C (68°F) for 5 minutes experienced increased positive emotions and reported feeling less nervous and distressed, as well as more active, alert, inspired, proud, and attentive. Although the mechanisms that cold exposure affects to alter mood aren’t currently well understood, the changes in the emotional states of the participants were associated with increased connectivity between the areas of the brain that are involved with self-regulation, emotion, and attention control.^[12]

Increased resilience and mental toughness More research — including randomized controlled trials — is needed to more thoroughly test the associations between the emotional states of participants in cold water immersion studies and increased connectivity between the areas of the brain that are involved with self-regulation, emotion, and attention control. However, these associations are consistent with additional observations suggesting that cold water immersion may increase perceptions of self efficacy, resilience, and mental toughness.^[17] and supported by a larger body of evidence linking cold acclimation to a blunted sympathetic stress response.^[18]^[19]^[19]^[20]^[18]^[21]^[22] The blunting of the “fight or flight” sympathetic stress response, alongside enhanced activation of the “rest and digest” parasympathetic nervous system, may explain the tendency for cold exposure to cause increased perceptions of resilience and mental toughness. In other words, cold exposure may increase “grit” by encouraging a sense of “calm under fire”.

Are there any supplements that can enhance or mimic the benefits of cold exposure?

Can cold exposure help with depression?

Does cold exposure improve glucose metabolism?

Is cold exposure an effective intervention for body weight and/or fat loss?

Can cold water immersion help to promote recovery or enhance adaptation from exercise?

What are cold exposure’s main drawbacks?

Although cold exposure can potentially have benefits, it’s important to be aware that there also are significant potential risks. People who are overly sensitive to cold or who have Raynaud’s phenomenon — a disorder that causes blood vessels to inappropriately constrict in response to cold or stress — should consult with their physician before experimenting with cold exposure. Because people with Raynaud’s experience exaggerated blood vessel constriction in response to cold exposure, there is an increased risk of frostbite and/or hypothermia.

It’s also important to note that the potential drawbacks to cold exposure aren’t limited to people with health conditions that are worsened by cold conditions. The following potential drawbacks of cold exposure can affect anyone if the cold exposure stimulus is too long, too intense, or otherwise inappropriate for an individual’s level of experience and acclimation:^[1]

Hypothermia: Prolonged exposure to cold temperatures can cause the body's core temperature to drop, leading to hypothermia, which can potentially be fatal without timely medical intervention.
Frostbite: Exposure to extreme cold can cause frostbite, which involves the actual freezing of skin and underlying tissues.
Cold shock: Sudden immersion in cold water can cause an involuntary gasp reflex also known as the "cold shock response", which can lead to drowning if the person is unable to swim or keep their head above water.^[23]^[24]

Can cold exposure cause heart attacks?

How does cold exposure work?

The benefits and the risks associated with cold exposure are caused by the stress responses that it triggers, and cold exposure is both a physical and a psychological stressor.^[25] Upon exposure to cold water, temperature-sensing ion channels in the skin called transient receptor potential (TRP) channels are activated, which transmit information to the brain through connected sensory neurons.^[26] This causes the brain to increase the activation of the sympathetic nervous system (involved in regulating the “fight or flight” response), which triggers numerous physiological responses to deal with the cold.^[18]

Immediately after entering uncomfortably cold water, the “cold shock response” is triggered, which causes gasping, hyperventilation, and increased heart rate and blood pressure. The peripheral blood vessels that supply blood to the limbs, hands, and feet also constrict to preserve the core body temperature.^[27] As the core temperature begins to drop, skeletal muscles start to shiver, which creates significant amounts of heat through shivering thermogenesis.^[1]^[3] With repeated cold exposure, shivering thermogenesis gradually diminishes, and the body relies more and more on nonshivering thermogenesis for warming.

Can white fat be transformed into brown fat by the cold?

Do I need to be cold enough to shiver to experience the metabolic-rate-boosting benefits of cold exposure?

What are other names for Cold Exposure?

Note that Cold Exposure is also known as:

Cold exposure
Cold therapy
Cold water immersion
Cryotherapy
Cold showers

Cold Exposure should not be confused with:

Heat Treatment

Dosage information

Benefits have been observed at 6°C degrees below comfort level, which is typically 16°C (60.8 ºF).

Greater metabolic losses are observed with greater intensities of cold exposure.

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Research FeedRead all studies

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Update History

30 days ago

All new FAQs were added to this page.
major

A new intervention page on cold exposure was created which includes all new FAQs that discuss the effects of cold stress on the body when it is used for therapeutic or wellness applications.

Written By

Bill Willis

Edited By

Molly Gregas

Reviewed By

Katie Jantz

Research Breakdown

🚧 Under Renovation 🚧

The information in this section is slated for renovation — it will soon be transformed into a more usable (and readable!) form in the coming months. As such, the text in this section may be out of date and not up to Examine’s current standards for writing style.

What is cold exposure

Insulative actions

NST - Muscle response to cold exposure

NST - Body fat response to cold exposure

Shivering thermogenesis

Other interactions with Cold Exposure and Metabolic Rate

Significance

References

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^Bleakley CM, Bieuzen F, Davison GW, Costello JTWhole-body cryotherapy: empirical evidence and theoretical perspectives.Open Access J Sports Med.(2014)
^Srámek P, Simecková M, Janský L, Savlíková J, Vybíral SHuman physiological responses to immersion into water of different temperatures.Eur J Appl Physiol.(2000 Mar)
^Brychta RJ, Chen KYCold-induced thermogenesis in humans.Eur J Clin Nutr.(2017 Mar)
^Haman F, Blondin DPShivering thermogenesis in humans: Origin, contribution and metabolic requirement.Temperature (Austin).(2017)
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^The Relationship Between Cold-Water-Immersion Activities, Mental Health, Self-Efficacy, Resilience, and Mental Toughness
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Primary Use

Fat Loss

[ref-1] ^Esperland D, de Weerd L, Mercer JBHealth effects of voluntary exposure to cold water - a continuing subject of debate.Int J Circumpolar Health.(2022 Dec)

[ref-2] ^Bleakley CM, Bieuzen F, Davison GW, Costello JTWhole-body cryotherapy: empirical evidence and theoretical perspectives.Open Access J Sports Med.(2014)

[ref-3] ^Srámek P, Simecková M, Janský L, Savlíková J, Vybíral SHuman physiological responses to immersion into water of different temperatures.Eur J Appl Physiol.(2000 Mar)

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