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Writer's pictureThe Renaissance Surgeon

Embracing the Cold for Health and Performance

Updated: May 31, 2023

We need the cold. If it’s not cold enough to snow, you can’t ski. I fondly remember ski vacations with my family while I was growing up. Often, the place where we were lodging would have an outdoor hot tub, providing contrast to the cold mountain air. At night, my dad would take us kids down to the spa to soak our ski-sore limbs. Sometimes, there would be a snow bank next to the hot tub. My brothers and I would play a game to see who could lay down in the snow and for how long, before scampering back to the warmth of the hot tub. My dad watched from the safety of the jacuzzi. As a father, I now know the feeling: I’m watching my kid do something I would distinctly prefer that he not do, but it doesn’t rise to the level of something that I’m going to actively interdict. Consequently, I have to sit with my unease, continually reexamining my decision. Back then, we were just acting on a dare. Unbeknownst to us, we were also playing with deliberate cold exposure and hot-cold contrast.


Early morning pain-fest

A few decades later, I watch my own kids shun jackets on brisk winter days, unable to cajole them into wearing what seems like an appropriate amount of warmth-retaining attire. My daughter has even spontaneously replicated the lay-in-the-snow-next-to-the-hot-tub move just as I have replicated the family ski vacation. Kids have higher levels of brown fat, a metabolically active tissue that can be heat-producing. Babies cannot shiver, and rely on brown fat to stay warm. Brown fat is energy-consuming and thus desirable from a metabolic perspective. We now know that cold exposure can activate brown fat, increasing metabolism and insulin sensitivity. Although weight loss is not a personal goal, I am interested in exploring cold exposure due to the other benefits, like increasing dopamine, mental resilience, immunity and sports performance.


I started off my cold journey with cold showers. I would take a hot shower as normal and then turn the dial to cold at the end. A research study found that 30 seconds of cold shower per day for 30 days resulted in less sick leave among study participants. At first I only subjected myself to 15 seconds, but I gradually built myself up to 2 minutes. This became my standard shower routine. I didn’t measure any outcome, but it generally felt healthy to do so. It wasn’t pleasant, but afterwards I felt as if I’d run through a wall, alert and full of energy. After I had gotten used to it, however, the mental challenge was gone. As for immunity, I can’t say I noticed a drop off in how often I got sick. I already was seldom ill, and rarely took sick days. I did notice a big drop off in getting colds when I started supplementing vitamin D regularly about six years ago. And for what it’s worth, the ‘VID came through my house three times but only got me once.


Cold showers are nothing, however, compared to full body immersion in cold water. (a.k.a. the cold plunge). I tried it for the first time on a frigid mid-January morning. Not exactly the best way to ease into it, but after a couple years of cold showers, I figured I would give it a go. The air temperature was 27 degrees F. Although I didn’t have a thermometer in the water, I can say it was frigid, likely in the 30s or 40s. The cold shock gasp response was as advertised. I immediately started hyperventilating. After a minute or so, I was able to control my breathing. My body was producing internal pain killers and clamping down on the blood flow to my skin. After achieving a minute of immersion, I was satisfied that I had done enough, and promptly extracted myself. Despite going directly from the barrel to a weight training workout, I found I could not get warm. The blood in my extremities that was cooled by the ice barrel was now circulating through my core. I learned that this, too, is typical, in those not acclimated to the cold exposure.


As I started to acclimate, I started fine-tuning my protocol. An early morning plunge up to the neck with a winter hat on, then into a robe. I found getting into the ice barrel naked to be a different experience. (Though I imagine that for winter open water swimming, nudity would make more of a difference.) You can shift around a little bit in the ice barrel, but not too much. When you move in the cold water, you dissipate the layer of water close to the skin that your body has heated, so you are welcomed with new stabs of cold. I went buff on a relatively balmy 56-degree-water day, but water below 60 degrees F is still cold enough to elicit the cold shock response. Overall, it wasn’t too much different. Same pain. The main benefit of naked cold barreling, as I see it, is not having to launder a bathing suit, or stand in the cold air afterwards in a wet garment.


When I first started ice barreling, I used it as an excuse to stop the cold showers. However I quickly resumed. Although the mental and metabolic effects of cold water immersion are more pronounced and well-studied, I wanted to bring back the daily mental challenge of turning that dial to the cold. (Yes, I realize I could also do cold water immersion every day, but the shower is easy and quick.) As David Goggins has written:


​​“It takes relentless self discipline to schedule suffering into your day, every day.”
- David Goggins

I’ve experienced a performance increase over the cold shower years, though probably attributable to multiple interventions. I’m planning to stick with the cold water immersion for the time being, and see if I can move the needle again this year!


Want to protocol your own cold exposure experience? Download the April toolkit by joining my membership program. Each month I explore one aspect of performance, fitness or longevity and put the essentials into a digestible, actionable format for members.



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