Sauna: Discover how to get the most out of your home sauna

Good day and welcome to Medicine Health with Dr. Paul Anderson. That's me, I'm Dr. Paul, and today we're going to be talking about heat as medicine, heat therapies. So I want to go through this in 2 chunks, so we're going to have 2 little sections here. The first one is generally how does heat work in the body, how do we augment it, how does the body naturally create heat, What does it do for us other than keep us alive, obviously, etc.? And then we want to talk about safety and how to augment heat therapies if we're going to do them and what to look for, etc. But before we get into that, 2 quick things for housekeeping. One would be, none of this is medical advice for you. Nothing is specific. This is educational information. about different medicine and health topics. If you are going to do something, anything with taking something, doing something with your body, etc., please clear it with your healthcare provider. 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Thanks a lot. All right, so heat therapy. So Like most things in medicine, there's a spectrum. But the first thing I want to talk about is how does the human body manage heat? So where does our temperature— we all know we have a temperature that is normal-ish, and then if we get a fever, we have a higher temperature. So let's start with normal-ish. We have this idea, you know, that 37 degrees centigrade or You know, 98.6 Fahrenheit is normal temperature. Some people run a little lower, some people run a little higher, but those are the averages. So where does our baseline body temperature come from? Well, your baseline body temperature is the sum total of the metabolism of all of the cells in your body. And so When all of the cells in your body are working, or most of them hopefully are, they do this thing called metabolism. So they have nutrients and oxygen go in. It goes and it feeds different processes, and it goes to the mitochondria, which produce the energy for the cell. Mitochondria are working, and that creates our metabolic rate. Now, when the mitochondria are working and we have cellular respiration, we're going to excrete or throw out Cellular waste, carbon dioxide, etc. So in the good stuff goes, out the bad stuff goes. And that you think of it like that cell is running at a particular speed. So if you had a motor and it was just barely running, the temperature of that motor is going to be fairly low for a motor. And if you put your foot on the gas and run it real hard, it's going to get really hot. If you ever had a motor overheat, you understand. How hot a motor can get. So same with these little engines inside your cell called the mitochondria. If you take the trillions of cells that are you and you consider they're all doing this cell energy production, the metabolism of the cell, put that together, and that pretty much is what creates your body temperature. So what's the modulation part of it? How does the body, you know, raise and lower the temperature? Well, Well, your brain has this really cool thing, and it's a conceptual idea that it has a set point, a thermostat, basically a temperature set point. And so under normal circumstances, your brain says, okay, 37 degrees centigrade or 98.6 Fahrenheit, this is about where we need to be. And so your metabolism keeps you there, et cetera. Now, if you get too warm, you start to sweat, and that helps you release temperature. There's a number of other ways your body can lower your temperature, but what if you need a fever because you're getting sick? How's your body work that out? Well, same part of the brain that is regulating how warm your body stays, and it won't let it get too far above or too far below, that set point, That part of your brain is very sensitive to the chemistry of infection, inflammation, and immune activity. So what happens is these chemicals—they call them thermogens or other you know temperature stimulating chemicals—when they start to be released, that could be released from a piece of a bacteria; it could be released secondary to response to a viral illness or some other. infection, could be released secondary to a medication, number of things can do that. You get a thermogen going up and it gets up there to the center part. So if you think of your head, you know, kind of ball-shaped, and if you were to go in the very center of your head, you know, just right at the top of your ears here, and then right down the center, pick the middle, there's a little part of your brain right in the center, it's called the diencephalon. And inside of it, it has things like your hypothalamus and your thalamus and your epithalamus and stuff, and your pineal gland sits in there. Well, in there is the communication for this set point for your temperature. So as the thermogens go up and they float around, these chemicals that might create a fever, they go into that part of your brain. Now, this part of your brain, the diencephalon, has a little bit of a difference from the rest of your brain. We talk a lot in our brain trauma talks and things about the blood-brain barrier and how the blood-brain barrier is there to kind of protect your brain. It keeps the good stuff in, bad stuff out, and has some regulatory gates. So the blood's just not flowing in and out without some regulation. Well, the diencephalon has very low regulation, so it's mostly, you know, blood going in. And the reason for that is you have all of these little sensory areas, very complex complex sensory cell groups. Blood flows through there and they check your blood sugar, they check your temperature, they can check and see how your thyroid's doing, all sorts of other stuff going on. Reason that's important is this place in the middle of your brain, the diencephalon, then if it sees something not right or you need more of this or less of that, sends a message downstream To your pituitary gland, which then will be triggered usually to release a hormone from the pituitary gland to tell other organs what to do. If you need a fever because you have these, you know, thermogenic substances around you, you got an infection or whatever, you're having a reaction to a drug, whatever you need the fever for, these chemicals go in, they go into your diencephalon, they're perceived as, oh no, we've got one of these things going on. And so things are released such as interleukin number 1 and some other chemicals that go around in the brain. And then that causes this place with all these control centers in the diencephalon to send signals downstream. One of the places they send signals to is to your thyroid gland to increase your metabolic So your thyroid, which sits here in your throat, makes thyroid hormone, and if you have appropriate amounts, your metabolism runs at a particular rate. It's part of how you keep your, you know, temperature and your energy going. Well, if suddenly I send down messages and I'm kicking out more thyroid, I'm going to increase the metabolism. Remember, your temperature is the sum total of all of metabolism in your body, and so we're going to increase that metabolism by trillions. I'm going to raise my temperature, okay? When I don't need the fever anymore, those pyrogens, thermogens, pyrogens, whatever you like to call them, are going to decrease. The signals from the diencephalon are going to calm down, and then the signaling to tell me to increase my temperature in the body is going to go away, and I'm going to go back to my normal Normal body temperature, hopefully that's somewhere in the normal range. So that's important. So your body does this all the time. Why would we apply extra heat to the body, medically speaking? Now, there's a range. So you can get heat from moving your body. You can get heat from external application like sauna. You can get heat from immersion like a hot tub or a hot bath or something like that. And then you can get heat from something called medical hyperthermia, which we use and is experimented with a lot currently in cancer, certain infectious diseases. It's used all over the world. There's different types of hyperthermia. Now, technically, anything that raises your, your body temperature above its normal range is a hyperthermia event. Higher temperature. But medical hyperthermia is a controlled application of heat to raise your core temperature temporarily to do something, usually with your immune system. And like I say, there are 2 major types of medical hyperthermia. There is locoregional, where you will have a normally like a head that That generates the extra energy to create the heat. And they might put that, say, over your liver, and there'll be a receiver on the back end, and it will just heat that organ up, local, regional. And there's whole body hyperthermia, where you will be in a— it's like a hospital bed device, and then there's a unit over you, and it literally heats your body up to quite a high temperature. Now, Would these be good things to do without medical supervision? You don't wanna do either one of those without medical supervision. You have to monitor the person. In many cases, they will have anesthesia specialty monitoring the patient. In many cases with very high heat, whole body hyperthermia, the patient will be sedated. Sometimes not, some, but usually they'll be sedated to one degree or another. They're going to have an IV running, all sorts of stuff. That's whole body hyperthermia when you get up to those high levels. Now, from research in Europe, what we know now is we used to think it's, well, it's you're hot or you're not, right? Turns out that there's actually 4 levels of medical hyperthermia, and the one I'm talking about with the these devices that really crank up the heat in your body, we're looking at level 3 and 4, very, very high heat, which has to be monitored quite assiduously. But let's say you're not in one of those devices or you're not in getting local regional hyperthermia. Can you still get some immune response by heating your body up generally? The answer is yes. And you can get into level 1 or level 2 hyperthermia With non-medicalized types of devices and heating. So the next question, we know now, we know that the body does its own thing to raise temperature when we need a fever. Number 2, we know that there's a medicalized intervention called hyperthermia that you have to be monitored very closely and all of this stuff. But then we also realize there's 4 levels of hyperthermia, and the first 2 you can often pull off with non-inpatient, non-medicalized sort of treatment. Now, we'll talk about those treatments, and what we're gonna do is separate a section on the treatments proper, meaning what's the difference between different types of, say, saunaing or immersion or working out or, you know, all these things. So we'll do that separately. Okay. On part 2 of this. But we might go back then and say, okay, well, I, I get it that my body makes fevers. I've had a fever, had a lot of fevers. Usually I'm sick. Okay, makes sense. Well, what's the purpose of all this heat? Well, there's a few things. One is that heat speeds up certain enzyme systems in your body. Not all, but enzymes are sensitive to temperature, so you can often slow them down by being cold, speed them up by heating them up. Many of these enzyme systems are used in and around your immune system and your immune cells, etc., but also others of these enzyme systems are used for things such as detoxification pathways, turning on particular neurotransmitters for production, All kinds of things happen, and the heat now that we understand more in you know modern times here in the 21st century about hyperthermia, the heat engenders a lot of immune chemistry shift. So just like when our body makes a fever, it creates immune chemistry shift. When we use a device to heat our body up, it also shifts the immune chemistry as well. Now you do different shifts at, you know, grade 1 hyperthermia and 2 than you might do at 3 and 4, but there's some crossover. So we get this increase in, uh, the immune stimulating, you know, enzymes and the chemistry of the immune system, et cetera. And it makes it easier for the immune system to fight. Largely, the immune cells that we're relying on for fighting are also heat sensitive, and when we raise the body temperature, they tend to get more active and more busy. Now, that's a grand simplification, but you kind of get the idea. So the next thing I wanted to talk about real quickly would be safety. So safety around the use of hyperthermia heat therapies. So I'm not going to talk specifically about the hospital-based units where it's either local, regional, which is a little easier, you know, on your whole body because you're just heating one group of organs or one organ up, but whole body hyperthermia, which can be incredibly useful for particular I'm not going to talk about their safety because those should only be done in a facility that is purpose-built for that. And like I said, you're going to have particular medical specialties monitoring you and nursing staff and all that. So we're not going to talk about high-level, you know, hyperthermia. But what about the others? Well, the first thing you have to think about with heat therapies is dehydration. When we are doing hyperthermia with people, I had mentioned that, you know, medical hyperthermia, like in a facility or hospital, we have particular types of intravenous therapies that are going in to help hydrate them and give them electrolytes and stuff of that nature. If you're doing this on your own, or you're at the sauna at the gym, or you've got a sauna at your house, or whatever, Same rules apply. Heat will dehydrate you. And one of the things that's not great about heating your body up is if you get dehydrated, a lot of the immune benefits get muted. And that's because when we're looking at— let's take one cell and think about it. So I got this cell heated up, it's working harder. Remember that the good stuff goes in the cell— oxygen, nutrients, substrates, and they go in and they hit the cell organelles and then the mitochondria. Mitochondria runs faster, and then it ejects waste from the cell and other organelles that eject waste and carbon dioxide. If we get dehydrated, that fluid area around the cell will slow down its ability to remove the waste. And so dehydration is actually very At cross purposes to having good cell metabolism and also from having a good immune response, which is very important to keep in mind. So the first thing is you want to be hydrated. Hydrate as much as you can before you do a heat therapy, hydrate afterwards, and especially if it's like a lot of times when I'll do a sauna, it's at the end of working out at the gym, so I'm already probably a little dehydrated. I'm going to dehydrate a bit more when I get in there. I got to be really careful. careful to do that. Next thing that goes along with dehydration is electrolyte status. So I told you in the hospital we'll put in a particular IV and it may have other things in it, but one thing it's going to be giving is electrolytes, and that's so that as we heat the body up and we're metabolizing things and water's going out and all of that, we don't throw the electrolytes off and make somebody, you know, dizzy or have a cardiac irregularity in their electrical rhythm or Some other problem like that. So hydration and electrolytes are 2 huge things, even if you're doing low-level heating up of your body. The next thing to consider with regard to safety is even if you're going to do low-level heat like sauna or hot tubs, et cetera, you really should talk to your healthcare provider and make sure there's no compelling reason you shouldn't be doing that. So, for example, people on certain types of blood pressure medications really should not heat their body up to a great deal. Now, there are parameters around which this can work, but the problem is that let's say you immerse yourself in a hot tub and you're on blood pressure medicine that's got you really well controlled, you might get hypotensive, have a low blood pressure event. You might get woozy. And especially if like you're in a hot tub, you don't want to be passing out in water, but also you just don't want to be passing out in general. So you always want to check with your healthcare provider and say, would it be safe for me to, you know, do sauna at the gym or do hot tub, etc.? Most people it is, but like I say, there are certain people with particular types of medical histories, etc., who shouldn't, and again, that's a question for your healthcare provider. So please do check that before you go and start to heat yourself up in an incredibly large way. The next thing about sauna and heating your body up with immersion or whatever is different people have different tolerance. So I have had patients who it was totally safe for them to do it. They were doing level 1 or 2 hyperthermia, but they could only tolerate 3 to 5 minutes the first couple of times, and if they went beyond that, they felt very sick. And part of that's dehydration, part is electrolytes, but a big part of it is another benefit of heat is it, it starts— like I said, it increases enzymatic activity. Well, that also increases your detoxification. So imagine if your body's been holding on to a whole bunch of toxic material and now you're heating Heating it up and saying, let's detox, woo! And all of a sudden you start moving these toxins out. Well, they can't all get out at the same time, especially if you've mobilized a lot. So in people who have histories of toxicity or poor liver function or certain genetic problems, we're always mitigating how much heat we do with them, and we may have to work up slowly. So a person may start with 3 to 5 minutes and then You know, with supportive things in between, and maybe after 1, 2, 3, 4 weeks, they're up to 7 minutes and then more. Then there's other people who are just like human heat sinks, and they do better— the hotter the better. They go in and they don't, they don't get any of these bad side effects. Now, they tend to hydrate well enough, they tend to keep their electrolytes up, but beyond that, the heat is not as much of a problem. They feel So that's the next thing. There's no one-size plug-and-play with these things. Now, if we're doing a medically supervised hyperthermia, there's a particular time structure and all of that, but you're also being monitored and supported through that process. If you're freestyling to do it on your own and you find that you don't feel well after a certain time, first 2 things to check are hydration, electrolytes, and then you need to look at the temperature. But then you also want to consider, you know, maybe— I mean, we're all toxic, but some people don't eliminate as well as other people. Maybe I'm mobilizing too many toxins. I need to do some different stuff around that. Now, the biggest way to kind of help out is to watch your signs and symptoms after the heat event. So you do a hot tub, or you go exercise, or you do the sauna, or steam How do I feel afterwards? Am I really woozy? Am I getting muscle cramps? Am I getting headaches? A lot of those things can be pure dehydration and electrolyte disturbance. Maybe you have a little bit of, you know, premature ventricular or atrial contractions that occur periodically and they get worse with your heat therapy. You really want to check in with your doctor. with your doctor about that if that's going on. So just be aware of what's happening in your body. What other things can be helpful in our final minute or so here? Well, in addition to hydrating and electrolytes, the infamous redox triplet I always talk about with vitamin C, vitamin E, and glutathione Very important because the heating up event does create more free radicals as you detoxify things. So, in addition to hydrating and all of the electrolytes, etc., those can be very useful. Alright, well, that's this section on heat therapies in general. We'll do another section specifically on the different types of devices or interventions for heat therapy. But again, thank you all the new subscribers. Like, share, and subscribe, whatever platform you're on. Please hit the notification bell or thing because we sometimes don't show up in your feed. And if you can't find any of the outlets, because we're on pretty much everything, go to dranow.com. Check us out there. We got links to all of the various media. But thank you very much for listening, and we will be back.