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Research · Practices

Cold water immersion

Meta-analyses find cold water immersion after exercise lowers muscle soreness for up to 96 hours compared with rest. Used regularly after resistance training, it reduced strength and muscle gains. A 3,018-person trial of cold showers found less sickness absence and no fewer illness days. Recorded harms include cold shock arrhythmias, hypothermia, immersion pulmonary edema and transient amnesia.

Add to Bio HackChecked 2026-11-13
Status
A practice, not a regulated product.
Also called
cold plunge, ice bath, cold shower, CWI, cold water therapy, cold water swimming, winter swimming, cold exposure, deliberate cold exposure
Practiced for
muscle soreness, recovery, inflammation, mood, stress, depression, alertness, dopamine, immunity, fat loss, metabolism, brown fat, insulin sensitivity, sleep, testosterone, resilience

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

What people practice it for, and what was found

Shown to help6

Strong

Muscle soreness after exercise

Shown to reduce muscle soreness for up to 96 hours after exercise compared with rest, in pooled trials rated low in quality.

The numbers and sources
Effect
A Cochrane review of 17 trials (366 participants) found less soreness than passive rest at 24 hours (SMD -0.55, 95% CI -0.84 to -0.27), 48 hours (SMD -0.66, 95% CI -0.97 to -0.35), 72 hours (SMD -0.93, 95% CI -1.36 to -0.51) and 96 hours (SMD -0.58, 95% CI -1.00 to -0.16). Cold water did not differ from contrast or warm water immersion [1]. A meta-analysis of 9 RCTs described cold water immersion as slightly better than passive recovery for immediate and delayed soreness [2]. An update with 44 trials found it superior to control for delayed soreness in every subgroup except the longest immersions [3]. Across 52 studies, soreness was lower 24 hours after high-intensity exercise (SMD -0.89, 95% CI -1.48 to -0.29) and perceived recovery was higher (SMD 0.66, 95% CI 0.29 to 1.03) [4].
Population
366 participants in 17 small trials [1]. Participants in 9 RCTs [2]. Athletes and non-athletes in 44 trials [3]. Physically active people in 52 studies [4].
Sources
[1], [2], [3], [4], [5]
Caveats
Soreness is self-rated and nobody can be blinded to cold water. Study quality was low and results were heterogeneous [1]. A 2026 umbrella review of 14 reviews found the same primary studies reused across reviews, so their agreement is not independent replication. It rated confidence low in 2 reviews and critically low in 12, and called the clinical importance of the soreness effect uncertain [5].
Moderate

Heart rate variability

Shown to raise heart rate variability for up to 15 minutes after cold exposure in healthy adults, alongside a slightly lower heart rate and slightly higher blood pressure.

The numbers and sources
Effect
Across 24 studies of cold water immersion and cryostimulation, heart rate variability indices rose after exposure, including RMSSD (SMD 0.61) and high-frequency power (SMD 0.46), persisting up to 15 minutes. Heart rate fell (SMD -0.16) and mean blood pressure rose (SMD 0.28) [13]. An umbrella review of post-exercise studies also reported better heart rate variability immediately after immersion [6].
Population
Healthy participants in 24 studies [13].
Sources
[13], [6]
Caveats
The pooled analysis mixes cold water immersion with whole-body and partial-body cryostimulation. Effects were measured within minutes, and the authors note they depend on individual characteristics and cooling technique [13].
Limited

Sickness absence and immune markers

One trial of 3,018 adults found 29% less sickness absence with a daily cold shower finish for 30 days. Days of illness did not differ.

The numbers and sources
Effect
Adults randomized to end a daily shower with 30, 60 or 90 seconds of cold water had 29% less sickness absence from work than controls (incident rate ratio 0.71, P = 0.003). Illness days showed no significant group effect [17]. In 60 adults randomized to daily cold or hot showers for 90 days, the cold group showed higher immunoglobulin levels and higher interleukin-2 and interleukin-4 at 90 days, with no difference in interferon-gamma or TNF-alpha [18]. Pooled trials found no significant effect on immune function immediately or 1 hour after immersion [14].
Population
3,018 Dutch adults aged 18 to 65 without severe comorbidity [17]. 60 healthy Egyptian adults [18]. Healthy adults in 11 trials [14].
Sources
[17], [18], [14]
Caveats
Sickness absence was self-reported by people who knew their group, and people felt ill as often in both groups [17]. Blood immune markers are not infections avoided [18].
Why limited
This rests on one trial, of 3,018 people. Strength counts independent studies that agree, so one trial is limited at any size.
Limited

Sleep and quality of life

Limited evidence: a systematic review described better sleep quality and quality of life in a few trials, without pooled estimates.

The numbers and sources
Effect
Narrative synthesis of randomized trials reported improvements in sleep quality and quality of life after cold water immersion [14]. In 5 patients with depression who swam regularly, Pittsburgh Sleep Quality Index scores went from 10.4 to 8.0 [21].
Population
Healthy adults in 11 randomized trials [14]. 5 patients [21].
Sources
[14], [21]
Caveats
The review abstract gives no effect sizes for sleep or quality of life. The patient study had no control group.
Limited

Alertness, noradrenaline and dopamine

Small studies found plasma noradrenaline rose 530% and dopamine 250% during an hour in 14°C water, and people reported feeling more alert after a 5-minute immersion.

The numbers and sources
Effect
During 1-hour head-out immersion at 14°C, plasma noradrenaline rose by 530% and dopamine by 250%, with adrenaline unchanged. Immersion at 20°C or 32°C did not produce these rises [16]. After a 5-minute cold bath, 33 adults reported feeling more active, alert and attentive [19].
Population
A group of young men, number not given in the abstract [16]. 33 adults [19].
Sources
[16], [19]
Caveats
Hormones were measured in blood during a 1-hour immersion, far longer than a typical plunge, and blood levels are not brain levels. Neither study had a control group for the self-reported feelings. No trial measured attention or cognitive performance.
Limited

Insulin sensitivity

Limited evidence: insulin sensitivity rose over a season of cold water swimming in women and lean swimmers, in one uncontrolled study of 30 people.

The numbers and sources
Effect
Among 30 people swimming in cold water at least twice a week for 6 months, insulin sensitivity increased and insulin secretion and resistance decreased from the start to the middle of the season in women and in lean participants [26]. A review of 104 studies concluded that cold water immersion seems to reduce insulin resistance and improve insulin sensitivity [25].
Population
30 healthy adults with a mean age of 50 [26]. 104 studies of voluntary cold water exposure [25].
Sources
[26], [25]
Caveats
The change appeared in subgroups, and swimming is also exercise. The review notes most studies were small and often in one sex [25].

Mixed results5

Moderate

Recovery of power and performance

Mixed results: pooled trials found small gains in next-day muscular power and no effect on strength recovery, and umbrella reviews call performance findings inconsistent.

The numbers and sources
Effect
Cold water immersion improved recovery of muscular power 24 hours after eccentric exercise (SMD 0.34, 95% CI 0.06 to 0.62) and high-intensity exercise (SMD 0.22, 95% CI 0.004 to 0.43), and lowered creatine kinase 24 hours after high-intensity exercise (SMD -0.85, 95% CI -1.61 to -0.08). Recovery of strength did not differ from passive recovery after either type of exercise [4]. An umbrella review of 15 meta-analyses reported better muscular power and jump performance at 24 to 48 hours despite impaired jumping in the first hours after immersion, and no improvement in strength performance [6]. A second umbrella review judged findings for objective performance inconsistent, time-dependent or comparator-dependent [5].
Population
Physically active people in 52 studies [4]. 161 unique studies across 15 meta-analyses [6]. 14 reviews [5].
Sources
[4], [6], [5]
Caveats
Certainty of evidence was rated low to very low, mainly for inconsistency and imprecision [6]. The lower confidence limit for power after high-intensity exercise sits at zero [4].
Moderate

Stress

Mixed results: pooled trials found lower stress 12 hours after immersion and no difference immediately, at 1 hour, at 24 hours or at 48 hours.

The numbers and sources
Effect
A meta-analysis of randomized trials in healthy adults found stress lower 12 hours after immersion (SMD -1.00, 95% CI -1.40 to -0.61), with no significant effect immediately (SMD -0.09), at 1 hour (SMD -0.29), at 24 hours (SMD -0.06) or at 48 hours (SMD 0.09) [14]. In 16 adults, cortisol was lower 180 minutes after a 15-minute immersion at 10°C than before it (p = 0.014) [15]. During 1-hour immersions at 14°C, cortisol tended to decrease [16].
Population
3,177 participants in 11 randomized trials, at 7°C to 15°C for 30 seconds to 2 hours [14]. 16 healthy adults [15]. Young men [16].
Sources
[14], [15], [16]
Caveats
One time point of five showed an effect. The reviewers describe the evidence as limited by few trials, small samples and narrow populations [14]. The single-session studies had no control condition [15].
Limited

Mood

Mixed results: a systematic review of randomized trials found no improvement in mood, while small single-session studies without control groups reported less negative feeling afterward.

The numbers and sources
Effect
A systematic review of 11 randomized trials reported improvements in sleep quality and quality of life, but not mood [14]. In 16 adults, positive affect did not change after 15 minutes at 10°C, and negative affect was lower at 180 minutes (p < 0.001) [15]. In 33 adults, a 5-minute immersion was followed by feeling more active, alert, attentive, proud and inspired, and less distressed and nervous [19]. Among 722 outdoor swimmers surveyed, a positive impact on mental health conditions was 44.32 times more probable than no impact [20].
Population
Healthy adults in 11 trials [14]. 16 healthy adults [15]. 33 adults aged 20 to 45 [19]. 722 self-selected outdoor swimmers [20].
Sources
[14], [15], [19], [20]
Caveats
The positive studies had no control condition, and participants chose to take part in a cold water study. The survey authors state it cannot show cause [20].
Limited

Depression

Limited evidence: a case report and a feasibility study in which 5 of 13 patients attended regularly describe improved well-being with cold water swimming. No controlled trial was located.

The numbers and sources
Effect
In an open-label feasibility study of twice-weekly group cold water swimming added to usual depression treatment, 13 patients were recruited and 5 took part regularly. Their well-being score rose from 39.2 to 54.0 [21]. A case report describes a 24-year-old woman with major depressive disorder whose symptoms eased with weekly open water swimming and who was medication-free a year later [22].
Population
13 outpatients with depression aged 20 to 69 [21]. One patient [22].
Sources
[21], [22]
Caveats
No control group, six people in total with outcome data, and swimming outdoors in a group adds exercise, nature and company to the cold.
Limited

Fat loss and metabolism

Mixed results: metabolic rate rose during cold immersion, and adults ate about 50% more at a meal afterward in one crossover trial. No trial measuring fat loss was located.

The numbers and sources
Effect
Metabolic rate rose by 350% during 1 hour at 14°C and by 93% at 20°C [16]. In 15 adults, energy intake at a meal after 30 minutes in 16°C water was 2,783 kJ, against 1,817 kJ after 35°C water and 1,894 kJ after sitting in air [23]. Experienced winter swimmers showed greater cold-induced thermogenesis than controls, and no brown fat activity at a comfortable temperature [24]. A review of 104 studies concluded cold water immersion seems to reduce or transform body fat, and that small, single-sex studies prevented clear conclusions [25].
Population
Young men [16]. 10 men and 5 women in a randomized crossover [23]. Young men who swim in winter 2 to 3 times a week, combined with sauna, and controls [24]. 104 studies [25].
Sources
[16], [23], [24], [25]
Caveats
Energy burned during immersion was not weighed against the extra food eaten afterward in the same people. Winter swimmers may differ from controls for reasons other than swimming, a point the review also raises [25].

Not shown to help5

Strong

Strength gains from resistance training

Shown to reduce strength gains when used after resistance training sessions, in two meta-analyses. Whole-body immersion on its own showed no significant difference.

The numbers and sources
Effect
Across 8 controlled studies, regular cold water immersion with resistance training reduced gains in one-repetition maximum, isometric strength and strength endurance (SMD -0.60, 95% CI -0.87 to -0.33) and in ballistic efforts (SMD -0.61, 95% CI -1.11 to -0.11) [7]. Across 10 studies (170 participants, 92% men), it attenuated strength gains (effect size -0.23, 95% CI -0.45 to -0.01). The effect was -0.31 (95% CI -0.61 to -0.01) when only the trained limbs were immersed and -0.08 (95% CI -0.53 to 0.38) with whole-body immersion [8]. In 21 men training for 12 weeks, strength rose more with active recovery than with 10 minutes of cold immersion after each session (P < 0.05) [9]. In 16 men training for 7 weeks, leg press gains were similar with and without 15 minutes at 10°C [10].
Population
Participants in 8 controlled studies of immersion at 15°C or colder [7]. 170 participants in 10 studies [8]. 21 physically active men [9]. 16 men [10].
Sources
[7], [8], [9], [10], [6]
Caveats
The two meta-analyses draw on an overlapping set of small trials, almost all in young men. The whole-body subgroup did not reach significance [8], and one trial found strength unaffected while muscle fiber growth was blunted [10]. An umbrella review reached the same conclusion on strength at low to very low certainty [6].
Moderate

Muscle growth from resistance training

Not shown to help muscle growth. Used after resistance training, it was associated with smaller gains in pooled trials, a difference whose interval narrowly included zero.

The numbers and sources
Effect
A meta-analysis of 8 randomized studies found smaller hypertrophy with cold water immersion plus resistance training than with training alone (comparative SMD -0.22, 95% credible interval -0.47 to 0.04), with a 95.7% probability that the difference was below zero [11]. In 21 men over 12 weeks, muscle mass increased more with active recovery, and type II fiber cross-sectional area rose 17% with active recovery and did not rise with cold immersion [9]. In 16 men over 7 weeks, the increase in type II fiber area was smaller with cold immersion (effect size -1.37) [10].
Population
Healthy adults in 8 randomized studies of at least 4 weeks [11]. 21 physically active men [9]. 16 men training 3 days a week [10].
Sources
[11], [9], [10], [6]
Caveats
The authors of the meta-analysis rated the evidence fair to poor in quality [11]. Trials were short and mostly in young men. An umbrella review also concluded that hypertrophic gains were impaired [6].
Moderate

Endurance training adaptations

Not shown to change gains from endurance training, for better or worse, in one meta-analysis and a later 5-week trial.

The numbers and sources
Effect
Regular cold water immersion with endurance training had no effect on time-trial mean power or maximal aerobic power (SMD -0.07, 95% CI -0.54 to 0.53) or on time-trial duration (SMD 0.00, 95% CI -0.58 to 0.58) [7]. In 16 men doing interval training 3 times a week for 5 weeks, 15 minutes at 11.2°C after each session did not change VO2 max, running time to failure, or muscle markers of adaptation and inflammation relative to training alone [12].
Population
Participants in controlled endurance training studies [7]. 16 healthy men, 9 using cold immersion and 7 controls [12].
Sources
[7], [12], [6]
Caveats
Few small trials with wide intervals. An umbrella review found endurance performance improved immediately after immersion with no later benefit and no effect on adaptations [6].
Moderate

Inflammation

Not shown to lower inflammation. Inflammatory markers rose in the hour after immersion, and post-exercise reviews found no change in C-reactive protein or interleukin-6.

The numbers and sources
Effect
In healthy adults, inflammation markers were higher immediately after immersion (SMD 1.03, 95% CI 0.37 to 1.68) and 1 hour after (SMD 1.26, 95% CI 0.59 to 1.94) [14]. Across meta-analyses of post-exercise immersion, there were no significant effects on C-reactive protein or interleukin-6 up to 72 hours [6]. Five weeks of immersion after interval training did not change inflammatory markers in muscle [12].
Population
Healthy adults in 11 randomized trials [14]. Healthy people in 15 meta-analyses of post-exercise immersion [6]. 16 men [12].
Sources
[14], [6], [12]
Caveats
The acute rise was measured within an hour and the reviewers call it an acute inflammatory response. Long-term markers in everyday users were not pooled [14].
LimitedStudied in men

Testosterone

One small study found testosterone fell after a single immersion in water below 4°C in 13 young men.

The numbers and sources
Effect
Blood testosterone was significantly lower after the immersion than before it (p = 0.000037). Thyroid-stimulating hormone and cortisol did not change significantly [27].
Population
13 healthy young men, one immersion at an air temperature of -15°C [27].
Sources
[27]
Caveats
One immersion, no control group, and no measurement beyond the day. The abstract gives no size for the fall.

Protocols studied

Recovery trials immersed people after exercise in water below 15°C [1]. One meta-analysis found the largest soreness effects at 11°C to 15°C for 11 to 15 minutes [2], and an umbrella review described 10 to 15 minutes at 5°C to 15°C as the most studied range [6]. Training studies used 10 minutes after each of 2 weekly sessions for 12 weeks [9], 15 minutes at 10°C after each of 3 weekly sessions for 7 weeks [10], and 15 minutes at 11.2°C after interval training for 5 weeks [12].

The health trials pooled in one review used baths or showers at 7°C to 15°C for 30 seconds to 2 hours [14]. The cold shower trial ended a warm shower with 30, 60 or 90 seconds of cold water daily for 30 days [17]. Single-session studies used 15 minutes at 10°C [15], 5 minutes [19], 30 minutes at 16°C [23] and 1 hour at 14°C [16].

Risks

Reported risks7

Moderate

Smaller strength and muscle gains when used after lifting

Shown to reduce strength and muscle gains when used regularly after resistance training sessions, mostly in studies of young men.

The numbers and sources
Effect
Pooled trials found smaller strength gains (SMD -0.60, 95% CI -0.87 to -0.33) [7] and smaller hypertrophy (comparative SMD -0.22, 95% credible interval -0.47 to 0.04) [11] with cold water immersion after resistance training than with training alone. An umbrella review of 15 meta-analyses concluded that immersion impaired strength and hypertrophic gains [6].
Population
Participants in 8 controlled studies [7] and 8 randomized studies [11].
Sources
[7], [11], [6]
Caveats
The effect was studied with immersion straight after training. No trial tested immersion at other times of day. Endurance training gains were not reduced [7].
Limited

Cold shock and irregular heartbeats

One small study recorded ectopic heartbeats in 11 of 12 healthy volunteers during breath-hold submersion in water at 5°C to 10°C.

The numbers and sources
Effect
In 12 volunteers submerged in water at 5°C and 10°C while holding their breath, ectopic arrhythmias occurred in 11 subjects and 29 of 36 submersions, mostly in the 10 seconds after breath holding ended. They included supraventricular tachycardia and premature ventricular beats [28]. A review proposes that simultaneous cold shock and diving responses, which it calls autonomic conflict, may account for these arrhythmias and for some deaths ascribed to drowning or hypothermia [29]. An earlier review concluded the cold shock response can incapacitate or kill long before hypothermia develops [30]. A meta-analysis found the response habituates with repeated immersions, with heart rate 14 beats a minute lower and minute ventilation 21.3 L a minute lower [31].
Population
12 volunteers wearing wet or dry suits [28]. Up to 145 participants in 17 groups in habituation studies [31].
Sources
[28], [29], [30], [31]
Caveats
The arrhythmia study involved face-under submersion with breath holding, not a head-out plunge. The link from these arrhythmias to deaths is a hypothesis in the review, not a measured rate [29].
Moderate

Higher blood pressure during and after immersion

Shown to raise blood pressure slightly after cold exposure in healthy adults. Systolic pressure rose 7% during an hour in 14°C water.

The numbers and sources
Effect
Across 24 studies in healthy people, mean blood pressure was slightly higher after cold exposure (SMD 0.28, p < 0.001) [13]. During 1-hour immersion at 14°C, heart rate rose by 5%, systolic pressure by 7% and diastolic pressure by 8% [16].
Population
Healthy participants in 24 studies of cold water immersion and cryostimulation [13]. Young men [16].
Sources
[13], [16]
Caveats
All participants were healthy. No study here measured the response in people with high blood pressure or heart disease.
Limited

Hypothermia, afterdrop and swim failure

Small studies found core temperature kept falling after leaving cold water in 10 of 11 swimmers, and only 5 of 10 swimmers lasted 90 minutes at 10°C.

The numbers and sources
Effect
After a swim in 11.7°C open water without wetsuits, 5 of 11 swimmers had a rectal temperature below 36.0°C and 1 below 35.0°C. Continued cooling after leaving the water occurred in 10 of 11 [32]. In a swimming flume, all 10 volunteers completed 90 minutes at 25°C and 5 did at 10°C. One reached swim failure at 61 minutes and 4 were withdrawn at a rectal temperature of 35°C [33]. At a 19.2 km open water race, hypothermia was found in 26 of 35 swimmers screened, of whom 5 needed short-stay hospital care and 2 critical care transfer [34]. Core temperature dropped for 15 minutes after a 30-minute sit in 16°C water [23].
Population
11 swimmers [32]. 10 volunteers [33]. 109 race competitors [34]. 15 adults [23].
Sources
[32], [33], [34], [23]
Caveats
These are swims of tens of minutes to hours. No study located measured core temperature after plunges of a few minutes.
Limited

Fluid in the lungs during cold water swimming

Case series: 292 published cases of immersion pulmonary edema in swimmers and divers. Of 58 triathlon deaths reviewed, 42 happened during the swim.

The numbers and sources
Effect
A case series of 36 people who had immersion pulmonary edema found 72.2% had a medical condition such as hypertension, heart rhythm or structural problems, asthma or diabetes. Its literature review counted 292 cases, 24.0% with identifiable cardiopulmonary risk factors [35]. Of 58 deaths in triathlon training or events in the US and Canada from 2008 to 2015, 42 (72.4%) occurred during the swim. Heart mass exceeded the 95th percentile in 9 of 20 autopsies reporting it, a marker the authors tie to susceptibility [36].
Population
36 swimmers and divers, mean age 50 [35]. 58 deaths, 23 with postmortem reports [36].
Sources
[35], [36]
Caveats
Case series give no rate per swimmer. These cases involve exertion while swimming or diving, not sitting in a tub. The triathlon paper proposes pulmonary edema as a possible cause of death and does not prove it [36].
Limited

Temporary memory loss after cold water swimming

Case series: 9 women aged 55 to 82 had transient global amnesia during or just after sea swimming, all recovering fully within 24 hours.

The numbers and sources
Effect
At one Irish coastal hospital from 2019 to 2024, 9 patients had transient global amnesia directly related to sea swimming in water of 9.2°C to 18°C. Symptoms lasted 1 to 7 hours, brain imaging showed no acute change, and all recovered fully within 24 hours [37]. Interviews with 11 UK open water swimmers described similar episodes of confusion, disorientation and repetitive questioning [38].
Population
9 women [37]. 11 swimmers, 7 of them women [38].
Sources
[37], [38]
Caveats
Case series with no denominator. Most of the interviewed swimmers had no formal diagnosis [38].
LimitedStudied in men

Blood test changes after one ice-cold immersion

One small study found liver and muscle enzymes rose after a single immersion below 4°C in 13 young men, all staying within non-pathological limits.

The numbers and sources
Effect
After the immersion, aspartate transaminase, alanine transaminase, lactate dehydrogenase, creatine kinase, its CK-MB form and total bilirubin were higher, and urea, creatinine and uric acid were lower. The authors report all changes stayed within non-pathological limits [27].
Population
13 healthy young men [27].
Sources
[27]
Caveats
One immersion, no control group, healthy young men only.

Checked, no increase found1

Limited

Serious adverse events in a cold shower trial

No related serious adverse events were reported among 3,018 adults taking daily cold shower finishes for 30 days.

The numbers and sources
Effect
The trial of 30 to 90 second cold shower finishes reported no related serious adverse events [17]. In the Cochrane review of post-exercise immersion, most trials did not actively monitor predefined adverse events [1].
Population
3,018 adults aged 18 to 65 without severe comorbidity [17]. 17 trials [1].
Sources
[17], [1]
Caveats
People with severe comorbidity were excluded, and a shower finish is a smaller exposure than immersion. Trials that do not look for adverse events cannot rule them out [1].

Claims tested and not found

  1. That an ice bath after lifting helps build muscle. Pooled trials found smaller muscle gains with immersion after resistance training than with training alone [11], and two training studies found blunted fiber growth [9][10].
  2. That cold water immersion improves endurance training gains. Pooled trials found no effect on aerobic power or time-trial performance [7], and a 5-week trial found no change in VO2 max [12].
  3. That cold water immersion lowers inflammation. Markers rose in the hour after immersion in healthy adults [14], and C-reactive protein and interleukin-6 did not change after exercise [6].
  4. That cold showers mean fewer days of illness. Illness days did not differ from control in 3,018 adults, though sickness absence from work was lower [17].
  5. That cold water immersion speeds recovery of strength. Strength recovery did not differ from passive recovery in pooled trials [4].
  6. That a cold plunge raises testosterone. Testosterone fell after a single immersion in 13 young men [27].

Sources

  1. Bleakley C, McDonough S, Gardner E, et al. Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise. Cochrane Database of Systematic Reviews. 2012. https://doi.org/10.1002/14651858.cd008262.pub2
  2. Machado AF, Ferreira PH, Micheletti JK, et al. Can Water Temperature and Immersion Time Influence the Effect of Cold Water Immersion on Muscle Soreness? A Systematic Review and Meta-Analysis. Sports Medicine. 2016. https://doi.org/10.1007/s40279-015-0431-7
  3. Batista NP, de Carvalho FA, Machado AF, et al. What Parameters Influence the Effect of Cold-Water Immersion on Muscle Soreness? An Updated Systematic Review and Meta-Analysis. Clinical Journal of Sport Medicine. 2023. https://doi.org/10.1097/jsm.0000000000001081
  4. Moore E, Fuller JT, Buckley JD, et al. Impact of Cold-Water Immersion Compared with Passive Recovery Following a Single Bout of Strenuous Exercise on Athletic Performance in Physically Active Participants: A Systematic Review with Meta-analysis and Meta-regression. Sports Medicine. 2022. https://doi.org/10.1007/s40279-022-01644-9
  5. Liang W, Ma X, Sun G, et al. Cold-Water Immersion for Post-exercise Recovery: An Overlap-Aware Umbrella Review. Sports Medicine - Open. 2026. https://doi.org/10.1186/s40798-026-01132-8
  6. Berjisian E, Miraftabi H, Ihsan M, et al. Strategic Application of Post-exercise Cold-Water Immersion to Enhance Performance Recovery and Adaptation: An Umbrella Review of 15 Published Systematic Reviews with Meta-analysis. Sports Medicine - Open. 2026. https://doi.org/10.1186/s40798-026-01116-8
  7. Malta ES, Dutra YM, Broatch JR, et al. The Effects of Regular Cold-Water Immersion Use on Training-Induced Changes in Strength and Endurance Performance: A Systematic Review with Meta-Analysis. Sports Medicine. 2021. https://doi.org/10.1007/s40279-020-01362-0
  8. Grgic J. Effects of post-exercise cold-water immersion on resistance training-induced gains in muscular strength: a meta-analysis. European Journal of Sport Science. 2023. https://doi.org/10.1080/17461391.2022.2033851
  9. Roberts LA, Raastad T, Markworth JF, et al. Post-exercise cold water immersion attenuates acute anabolic signalling and long-term adaptations in muscle to strength training. The Journal of Physiology. 2015. https://doi.org/10.1113/jp270570
  10. Fyfe JJ, Broatch JR, Trewin AJ, et al. Cold water immersion attenuates anabolic signaling and skeletal muscle fiber hypertrophy, but not strength gain, following whole-body resistance training. Journal of Applied Physiology. 2019. https://doi.org/10.1152/japplphysiol.00127.2019
  11. Piñero A, Burke R, Augustin F, et al. Throwing cold water on muscle growth: A systematic review with meta-analysis of the effects of postexercise cold water immersion on resistance training-induced hypertrophy. European Journal of Sport Science. 2024. https://doi.org/10.1002/ejsc.12074
  12. Malta ES, Neto JCR, Beck WR, et al. Regular Cold-Water Immersion Following HIIT Does Not Affect Intramuscular Adaptation Markers, Inflammatory Profile or Endurance Performance. Scandinavian Journal of Medicine and Science in Sports. 2026. https://doi.org/10.1111/sms.70241
  13. Jdidi H, Dugué B, de Bisschop C, et al. The effects of cold exposure (cold water immersion, whole- and partial- body cryostimulation) on cardiovascular and cardiac autonomic control responses in healthy individuals: A systematic review, meta-analysis and meta-regression. Journal of Thermal Biology. 2024. https://doi.org/10.1016/j.jtherbio.2024.103857
  14. Cain T, Brinsley J, Bennett H, et al. Effects of cold-water immersion on health and wellbeing: A systematic review and meta-analysis. PLOS ONE. 2025. https://doi.org/10.1371/journal.pone.0317615
  15. Reed EL, Chapman CL, Whittman EK, et al. Cardiovascular and mood responses to an acute bout of cold water immersion. Journal of Thermal Biology. 2023. https://doi.org/10.1016/j.jtherbio.2023.103727
  16. Šrámek P, Šimečková M, Janský L, et al. Human physiological responses to immersion into water of different temperatures. European Journal of Applied Physiology. 2000. https://doi.org/10.1007/s004210050065
  17. Buijze GA, Sierevelt IN, van der Heijden BCJM, et al. The Effect of Cold Showering on Health and Work: A Randomized Controlled Trial. PLOS ONE. 2016. https://doi.org/10.1371/journal.pone.0161749
  18. El-Ansary MRM, El-Ansary AR, Said SM, Abdel-Hakeem MA. Regular cold shower exposure modulates humoral and cell-mediated immunity in healthy individuals. Journal of Thermal Biology. 2024. https://doi.org/10.1016/j.jtherbio.2024.103971
  19. Yankouskaya A, Williamson R, Stacey C, et al. Short-Term Head-Out Whole-Body Cold-Water Immersion Facilitates Positive Affect and Increases Interaction between Large-Scale Brain Networks. Biology. 2023. https://doi.org/10.3390/biology12020211
  20. Massey H, Gorczynski P, Harper CM, et al. Perceived Impact of Outdoor Swimming on Health: Web-Based Survey. Interactive Journal of Medical Research. 2022. https://doi.org/10.2196/25589
  21. Hjorth P, Sikjær MG, Løkke A, et al. Cold water swimming as an add-on treatment for depression: a feasibility study. Nordic Journal of Psychiatry. 2023. https://doi.org/10.1080/08039488.2023.2228290
  22. van Tulleken C, Tipton M, Massey H, Harper CM. Open water swimming as a treatment for major depressive disorder. BMJ Case Reports. 2018. https://doi.org/10.1136/bcr-2018-225007
  23. Grigg MJ, Thake CD, Allgrove JE, Broom DR. Effects of cold-water immersion on energy expenditure, ad-libitum energy intake and appetite in healthy adults. Physiology and Behavior. 2025. https://doi.org/10.1016/j.physbeh.2025.114914
  24. Søberg S, Löfgren J, Philipsen FE, et al. Altered brown fat thermoregulation and enhanced cold-induced thermogenesis in young, healthy, winter-swimming men. Cell Reports Medicine. 2021. https://doi.org/10.1016/j.xcrm.2021.100408
  25. Espeland D, de Weerd L, Mercer JB. Health effects of voluntary exposure to cold water, a continuing subject of debate. International Journal of Circumpolar Health. 2022. https://doi.org/10.1080/22423982.2022.2111789
  26. Gibas-Dorna M, Chęcińska Z, Korek E, et al. Cold Water Swimming Beneficially Modulates Insulin Sensitivity in Middle-Aged Individuals. Journal of Aging and Physical Activity. 2016. https://doi.org/10.1123/japa.2015-0222
  27. Teległów A, Cicha I. Single immersion in cold water below 4 °C: A health hazard in young healthy men? PLOS One. 2025. https://doi.org/10.1371/journal.pone.0324502
  28. Tipton MJ, Kelleher PC, Golden FS. Supraventricular arrhythmias following breath-hold submersions in cold water. Undersea and Hyperbaric Medicine. 1994. https://pubmed.ncbi.nlm.nih.gov/7950804/
  29. Shattock MJ, Tipton MJ. 'Autonomic conflict': a different way to die during cold water immersion? The Journal of Physiology. 2012. https://doi.org/10.1113/jphysiol.2012.229864
  30. Tipton MJ. The Initial Responses to Cold-Water Immersion in Man. Clinical Science. 1989. https://doi.org/10.1042/cs0770581
  31. Barwood MJ, Eglin C, Hills SP, et al. Habituation of the cold shock response: A systematic review and meta-analysis. Journal of Thermal Biology. 2024. https://doi.org/10.1016/j.jtherbio.2023.103775
  32. Nuckton TJ, Claman DM, Goldreich D, et al. Hypothermia and afterdrop following open water swimming: The Alcatraz/San Francisco swim study. The American Journal of Emergency Medicine. 2000. https://doi.org/10.1053/ajem.2000.16313
  33. Tipton M, Eglin C, Gennser M, Golden F. Immersion deaths and deterioration in swimming performance in cold water. The Lancet. 1999. https://doi.org/10.1016/s0140-6736(99)07273-6
  34. Brannigan D, Rogers IR, Jacobs I, et al. Hypothermia Is a Significant Medical Risk of Mass Participation Long-Distance Open Water Swimming. Wilderness and Environmental Medicine. 2009. https://doi.org/10.1580/08-weme-or-214.1
  35. Peacher DF, Martina SD, Otteni CE, et al. Immersion Pulmonary Edema and Comorbidities: Case Series and Updated Review. Medicine and Science in Sports and Exercise. 2015. https://doi.org/10.1249/mss.0000000000000524
  36. Moon RE, Martina SD, Peacher DF, Kraus WE. Deaths in triathletes: immersion pulmonary oedema as a possible cause. BMJ Open Sport and Exercise Medicine. 2016. https://doi.org/10.1136/bmjsem-2016-000146
  37. Tuohy C, Polania Zuleta GA. Transient global amnesia triggered by cold water swimming: A series of 9 cases presenting to a hospital on the coast of Ireland within 5 years. European Journal of Case Reports in Internal Medicine. 2025. https://doi.org/10.12890/2025_005200
  38. Elliott D, Christie M, Smith M. A Descriptive Analysis of Transient Global Amnesia-Like Cases in Open Water Swimmers. Sports Medicine. 2026. https://doi.org/10.1007/s40279-026-02527-z

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