Defiant Health Radio with Dr. William Davis
Defiant Health Radio with Dr. William Davis
Cold Water Immersion: Cardiac Russian Roulette
The practice of immersing your body in ice water is growing in popularity based on claims of improved mood and well-being, muscle recovery after exercise, even longevity. But this ignores the well-established fact that sudden cardiac death is a real risk due to coronary spasm, causing heart attack, and unstable heart rhythms due to a situation called autonomic conflict. There are a growing number of lawsuits that have been filed for the many sudden cardiac deaths that have occurred. So let’s discuss what we know about this concept of cold water immersion and why it is such a dangerous practice.
• Immersion in water around 15°C/60°F triggers dangerous physiological responses
• Cold exposure causes coronary arteries to spasm, potentially leading to heart attack
• Most adults have some degree of endothelial dysfunction, making them vulnerable
• "Autonomic conflict" occurs when both nervous system branches activate simultaneously
• Multiple lawsuits have been filed over deaths from ice baths and polar plunges
• Safer alternatives exist for achieving the claimed benefits of cold exposure
• Cold showering (starting warm and gradually cooling) may offer similar benefits with less risk
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The practice of immersing your body in cold ice water is growing in popularity, based on claims of improved mood and well-being, muscle recovery after exercise, even longevity, but this ignores the well-established fact that sudden cardiac death is a real risk due to coronary spasm causing heart attack and unstable heart rhythms due to a situation called autonomic conflict. There are a growing number of lawsuits that have been filed for the many sudden cardiac deaths that have occurred. So let's discuss what we know about this concept of cold water immersion and why it is such a dangerous practice. Let me also tell you about Defiant Health's sponsors Paleo Valley, our preferred provider for many excellent organic and grass-fed food products, and BiotiQuest, my number one choice for probiotics that are scientifically formulated, unlike most other commercial probiotic products available today. I'd like to make you aware of a new source for our favorite microbe, lactobacillus roteri, and a skin formulation I designed that improves skin from the inside out. Let's take a few minutes and talk about this concept of so-called cold water immersion, and all that means is putting yourself in a tub or bathtub typically filled with ice cubes, so the water is very cold, approximately 15 degrees Celsius or about 60 degrees Fahrenheit.
Speaker 1:Now there are people who advocate this because they claim that it improves mood, concentration, creativity and recovery from exercise, and maybe make other fairly wild claims. They will change your life, it's going to change human life. It's going to extend your life Pretty bold assertions, right? People like Wim Hof the Iceman? He's the man from the Netherlands who popularized this idea by doing such things as sitting on an iceberg in a bathing suit for extended periods and showing that he survived, and he claims that his performance in life and his well-being was improved. Is there any truth to all of this? Well, since those claims started getting made, multiple clinical trials have been done, looking at volunteers who've subjected themselves to cold water, typically for 15 to 30 minutes and typically at those temperatures I cited. What happens? Well, acutely, there's a rise in heart rate, around 110, 120, 130 beats per minute. There's a rise in blood pressure to the hypertensive range of about 140 over 90. There is loss of muscle strength. Afterwards, there may or may not be an improvement in aerobic performance. The evidence is kind of mixed. There's probably a very slight improvement in recovery and reduction of muscle soreness after being exposed to the cold water, and there does seem to be self-perceived reports on improved mood and a sense of well-being. So what's the problem here? There are very serious problems here. Let me tell you why.
Speaker 1:So we've known without question for many years that exposure to cold water is very dangerous. This has been well established. People who've fallen into, say, the Arctic waters or the North Atlantic, falling off a ship, what happens to them? Well, if they don't get rescued right away, they die of hypothermia, low body temperature. Your body temperature only has to drop to about 92 degrees Fahrenheit, 90 degrees, something like that, and you will die because your body shuts down, your musculature shuts down and your brain shuts down and you drown. So that takes about 30 minutes, even in cold Arctic water. But here's the problem Most people die before they become hypothermic.
Speaker 1:This is well established. You start shivering within a few minutes, your muscles start to get weak and fail to contract within a few minutes. But the real danger here is heart issues. So what happens is when your coronary arteries those are the arteries that feed your heart. There's only three the left anterior descending, the left circumflex and the right coronary artery. Only three coronary arteries so that's all we have are very cold, sensitive, and when you're exposed to cold, it only takes seconds to minutes for one or more of those arteries to spasm. And when arteries, when the coronary arteries, spasm, you have a heart attack and that generates unstable heart rhythms and that causes you to die. So you can fall into the water, say off a ship in the North Atlantic where the water is very cold, and even though you're not hypothermic, within a few minutes you die sudden cardiac death. That is well established. By the way, coronary spasm is a very scary thing.
Speaker 1:If you've ever heard of this entity, this condition called myocardial infarction, heart attack with normal coronary arteries this is not all that uncommon. People have a heart attack, right, they have heart muscle enzymes that go up like creatine kinase or EKG shows a heart attack. They're in the emergency room. They go to the cath lab where we take angiograms of the heart's arteries and they're normal. There's no blockage. There's no 100% blockage, as often happens in heart attack, or 95% blockage that may have spasmed or ruptured. They may have normal coronary arteries or what appear to be normal coronary arteries.
Speaker 1:So what caused the heart attack? That is, what caused the arteries to momentarily close for a few minutes or half an hour or whatever, something like that. Well, that requires something called endothelial dysfunction. All that means is the internal paper-thin lining of all your arteries is called the endothelium. It's a single cell layer that is very important because it's the master controller of arterial tone, whether arteries are closed or open or partially closed.
Speaker 1:What causes these arteries to have endothelial dysfunction? All kinds of things. Having high blood pressure, type 2 diabetes, just having high blood sugar will do it. Eating wheat, grains and sugars that provokes formation of small LDL particles? That will do it. Just after a meal, the so-called postprandial period that can do it. Lack of vitamin D can do it. Lack of omega-3 fatty acids can do it. Lack of magnesium can do it. In other words, that's just a partial list.
Speaker 1:There are dozens of factors that cause your arteries to be prone to closure or spasm because of endothelial dysfunction. By the way, a very important cause of that is lack of hyaluronic acid. Hyaluronic acid has nearly disappeared from the modern diet because we abandoned most of us the consumption of organ meats like brain, skin and tongue, rich in hyaluronic acid. Because hyaluronic acid, although it's a fiber that nourishes bacteria in your microbiome, gastrointestinal microbiome, it's also the number one ingredient in the so-called glycocalyx, that's the hair-like projections that line the endothelium on the blood side and determine the degree of endothelial function or dysfunction. So you can imagine if you're leading a life absent hyaluronic acid. You don't have the ingredients to form the glycocalyx. You are prone to endothelial dysfunction. How common is endothelial dysfunction? It is widespread. Most adults have it, so it's not uncommon, it's not a rare thing. You don't have to have overt coronary disease to have endothelial dysfunction. You could be 22 years old and have endothelial dysfunction. But that's the process that underlies coronary spasm and closure of the coronary arteries and what provokes that Exposure to cold.
Speaker 1:We now know it's hard to keep track of this because the media doesn't report all the deaths that occur from cold exposure, cold water exposure. But if you just Google deaths from cold water immersion or the cousin of cold water immersion, which is these polar bear plunges that people do every January another example of cold water exposure right, there are dozens of deaths, probably widely underreported because not all deaths are reported to the media. Several dozen deaths, perhaps hundreds of deaths, from people who have exposed themselves voluntarily, not drowning, not falling off a ship, but doing so voluntarily by following this idea of immersing yourself in ice baths or ice water or jumping in a lake or ocean. That's very, very cold. We know with confidence, this leads to death, often in young people, not just older people. And, of course, people who shovel snow die.
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Speaker 1:So one consequence of cold exposure, cold water immersion or polar plunges is coronary spasm and artery closes and you have an unstable heart rhythm and you die of ventricular tachycardia, ventricular fibrillation, torsade. Oddly, torsade Torsade just means it's torsade de pointe, it's a French term for what's called turning around a point. All it means is on an EKG it kind of has this fluctuating rhythm and it is a cause for sudden cardiac death. We'd see this in the coronary care units all the time, mostly from people taking diuretics and having low magnesium. And if you don't give them magnesium right away intravenous, they'll die because that rhythm is associated with no pumping action of the heart. The heart just quivers, it stops pumping and you die. So that's a very common rhythm with cold water immersion.
Speaker 1:Another consequence is, even without, coronary spasm and closure of a coronary artery because of the flood of both sympathetic fight or flight and parasympathetic, meditative or relaxation response. The combination is triggered by cold exposure and some people call that autonomic conflict, because you have the activation of both the sympathetic and the parasympathetic systems. Think about those systems, the parasympathetic system, the sympathetic system as the brake and gas pedal in your car. So the gas pedal is the sympathetic system, the brake pedal is the parasympathetic system. What if you hit both of them? Your car is probably not going to go anywhere, be really confused or you might jerk right.
Speaker 1:Same kind of thing happens in the heart when you activate both to an extreme simultaneously and the heart responds with unstable heart rhythms, just as it would if one of the arteries closed. So you can get torsade, you can get ventricular fibrillation, you can get atrial ventricular block. That's where the top of the heart is pumping rapidly, say 130 beats per minute, and the bottom of the heart is beating, not receiving all those signals, and beats slowly, maybe 30 beats per minute, because there's blockade of the electrical conduction from the top to the bottom of the heart. And if your heart rate is effectively 30, you pass out. And if you're in cold water you're going to die, right, you're going to drown. And so cold water exposure, whether it's intentional or inadvertent, will lead to coronary spasm in many people or unstable heart rhythms.
Speaker 1:Now there have been so many deaths and there have been many lawsuits filed, by the way, both for people advocating cold water immersion, like Wim Hof and people who've conducted these polar plunges in January. There are multiple lawsuits now being waged, so much so that I anticipate there's going to be a class action suit against the people advocating this practice. So if you've been telling people, if you're a doc or a health coach or just a proponent of cold water immersion, back off. It is well documented these practices lead to sudden cardiac death. Even if there's no hypothermia, you can die within minutes of sudden cardiac death. Now this is an example of some of the silliness that comes from some of these advocates. Some people call it biohacking, and so what happens here is these people who advocate these practices didn't think it through thoroughly or didn't thoroughly think about the evidence, because it's not like there's no evidence.
Speaker 1:There's abundant evidence to show us that cold water exposure can be fatal in many instances. You go on some of these websites where they advocate, for instance, cold water immersion, and there may be 25 or 30 references. You probably think, wow, this person really did their homework. Until you click on each and every one of those references and find out that almost none of them are relevant to cold water exposure. They might be something completely different, unrelated. But at first glance, at first blush, it looks like there's a ton of evidence and there's not a ton of evidence for benefits, modest benefits maybe, an improvement in mood, improving well-being.
Speaker 1:But you can achieve those things in other ways, right? You can exercise, you can meditate. There are so many other ways to achieve better feeling. You can manage your microbiome, you can restore lactobacillus reuteri. So many other things you can do and you're not going to chance death. What if I told you here's a diet change and you say, well, is it safe? I, what if I told you here's a diet change and you say, well, is it safe? I say, well, there's a chance you could die of sudden cardiac death within the first few minutes of trying. Would you even try? Of course you wouldn't. Yet that's what these people are selling Now.
Speaker 1:This is true of many practices coming out of this biohacking world. Not to say that everything coming out of the biohacking world is bad it's not. There are some good lessons coming out of it. In fact, I'm a big proponent, I'm a big advocate of crowd-sourced wisdom, of those of us who all ask the same questions. Let's say how to improve performance in sports or in mental exercise, and good lessons can come out of it.
Speaker 1:The problem is when it's being advocated by people who are fairly unschooled, unsophisticated, don't examine the evidence, don't consider the extent, the full breadth of evidence. Then you have silly advice like immerse yourself into cold water. So I hate to say it this way they need an adult in the room, they need somebody who understands the issue. So, having practiced cardiology for several decades, I can tell you coronary spasm, unstable heart rhythms are a very scary thing, something I dealt with every day for about 30 years. I can tell you that these are things you do not want any part of and you don't want to bring it on yourself.
Speaker 1:This is not like an accident. These people are jumping in the water on purpose. So please do not do this. Tell people around you don't do it. And if you want to get some of the benefits of cold water, maybe take a cold shower, start warm, bring it down gradually so you don't confuse your heart and have it go into an unstable heart rhythm or cause coronary spasm and so and then maybe sit there for a few minutes. That is probably safe, no-transcript. So you're probably okay with cryotherapy in an air atmosphere, but know that water immersion is extremely dangerous. Nobody should be doing it.
