en-Deliberate Cold Exposure for Diabetes - glucose monitoring data


How Does Icebathing Impact Insulin Resistance?

According to Dr. Benjamin Bikman in Why We Get Sick (2020) many of the leading causes of death originate in a phenomenon call insulin resistance. Although the mechanisms of insulin resistance are complex, mitochondrial abnormalities are the primary culprit (e.g., Kim et al. 2008).According to the mitochondrial theory of insulin resistance, excess energy in the form of glucose enters the cell faster than it can be consumed, creating a logjam of free radicals that damage the mitochondria. Thus, shutting down insulin receptors at the cell walls may be the body's desperate attempt to slow the transport of glucose to mitochondria, protecting them from further free radical a damage. As a consequence, blood glucose levels remain higher than normal, signaling islet cells in the pancreas to secrete more insulin. 

In this scenario, insulin receptors and islet cells are working against each other. The insulin receptors are shutting down to keep glucose away from the mitochondria, while the islet cells are producing more insulin to try and shove the glucose in. The result is a paradox of high blood glucose and high insulin. 

Several scientific studies have demonstrated that deliberate cold exposure will clear glucose from the bloodstream and improve insulin sensitivity. For example, Hanssen et al. (2015) concluded that:"cold acclimation for 10 days has very marked positive effects on whole-body and skeletal muscle insulin sensitivity and thereby provide a new avenue to improve the metabolic health of patients with Type 2 diabetes."

Continuous blood glucose monitoring data from Wade Hogg (used by permission) shows immediate improvement in blood glucose levels during an ice bath.
 This is Wade Hoggs, who is using ice bathing to treat his Type 2 diabetes. Wade's results are typical of someone in the advanced stages of insulin resistance, and consequently at elevated risk of cardio-vascular disease, cancer, Alzheimer's, and other life-threatening illnesses.

As the metabolic benefits of deliberate cold exposure become better documents, biohackers have started using continuous blood glucose monitors (CGM) to measure the effects of the ice bath. For example, these results (at left) are from Kristin Wietzel's 6 min plunge in 40F water.She reports that her blood glucose started at a healthy, normal 95 mg/dL when she first stepped into the icey water, and then spiked up to 136 mg/DL right away, before coming back down to the same level it was before she got cold.Kristin's findings are consistent with experiences we've heard from other biohackers performing similar experiments, and they raise the question, "If deliberate cold exposure is so good for clearing blood glucose, then why do my levels go UP instead of down?"

The answer is this: when you step into the cold, your smooth muscle tissues involuntarily contract. Your sympathetic nervous system believes that you are under threat, and activates a flight-or-fight response that instructs the liver to release glycogen stores into your bloodstream, in case your muscles should need an instant boost of energy. That's the initial spike.As you relax your breath, and strengthen your parasympathetic response, the brown fat cells in your body begin clearing that extra glucose from the blood stream and burning it to produce heat.Kristin's results are typical of someone who is metabolically healthy, and an experienced cold exposure practitioner. Her insulin receptors and islet cells are in balance, and her blood glucose levels are healthy.The results on the right, however, are different.

Notice that his blood glucose levels are in poor control prior to his ice bath, peaking at 252 mg/dL in the morning, and hovering just above 200 mg/dL right up until he achieves whole body cold water immersion.Then, shortly after 11A he enters the Forge and his blood glucose readings drop immediately. In fact, they get close to the same level as Kristin's (146 vs 136 mg/dL, respectively).

Wade's levels drop because he already has elevated blood sugars at the time of his sympathetic activation. His liver doesn't need to release glycogen.In response to the blood, his insulin receptors open up and flood his shivering muscles and brown fat with the glucose they need to generate heat through cold thermogenesis. And now, instead of resulting in a electron logjam at the mitochondria that result in free radical damage, the mitochondria burn the excess glucose as fast as they can to generate heat in an attempt to keep Wade's body warm.

In effect, the ice bath retrains Wade's metabolism to restore the balance that has long been absent. What's more, deliberate cold exposure recruits new brown fat, which are packed with new mitochondria. In the process of mitochondria synthesis, error-correction mechanisms of mitochondria DNA reproduction select for only the best copies, improving the quality of Wade's mitochondria overall and potentially reversing the free radical damage that is signaling his insulin receptors to shut down.