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Cold baths/ice baths for ME to break pain/inflammation cycle?

Sasha

Fine, thank you
Messages
17,863
Location
UK
I realised I was hijacking a thread on Rituximab and another auto-immune drug, Enbrel, because Sherlock raised an interesting question about other ways to break the pain/inflammation cycle:

It is dramatic, and argues in favor of the MOA of breaking a self-perpetuating cycle of pain/inflammation. The same can be true in the fast responses to RTX in CFS. So, for anybody not getting RTX or Enbrel, is it possible to break that cycle using something else? Quercetin, trans-resveratrol, EGCG? Ice baths? Something?


Until you mentioned ice baths, I had forgotten that about 20 years ago in the UK, a doctor wrote in a major national newspaper, the Daily Mail, about a therapy he was trying for ME patients involving cold baths. I think he might have been a rheumatologist but I can't remember and I can't remember his name, either. I thought he was going to do a proper trial but he just seemed to vanish.

The treatment involved taking cold baths at 16 deg Celsius lasting for 20 mins (?). He advised starting at 23 deg on Day One and gradually dropping the bath's temperature by a degree per day (?) until reaching 16 deg. His full protocol was published, encouraging people to try it - I bet a lot of UK patients had a go.

[Edit: my memory on this was wrong, now that I've read the media coverage (link below) - the adapatation process actually took several weeks, with probably at least a week at each temperature before moving down a degree.]

At the time, I had been confined to bed for several years and only able to leave it for a total of maybe an hour a day, including trips to the bathroom. I had then (and have now) acute viral-onset ICC/CCC ME.

The short-term results were spectacular. I improved considerably and within (if memory serves) a few days of hitting 16 degrees, I was able to go for a long walk - a mile? A couple of miles? - outside the home. This held up for a week or so until I caught some new infection (or possibly the originating infection reactivated because I pushed it, who knows) and I was back where I started.

I kept up the cold baths for 18 more months because, unpleasant (I'm not kidding) as they were, I was desperate. They had absolutely no further effect.

What was your rationale for mentioning ice baths, Sherlock? At the time I thought the idea was that it was something to do with adrenaline but I could easily be misremembering this - it's so long ago.

By the way, I imagine there are risks to ice baths, if anyone is thinking of trying them! Like a massive heart attack! :eek:

I used to play a particular music tape to keep my mind off the pain. If I hear the first song from that tape on the radio these days, it takes me in my mind straight back to that bath. :aghhh: And not in a good way. Ow!
 

Valentijn

Senior Member
Messages
15,786
The theory is that as the body tries to warm itself during and after a cold shower, the metabolic rate speeds up and activates the immune system, which leads to the release of more white blood cells, important for fighting off bugs.
So we need a functioning metabolism AND a functioning immune system? I think we're screwed, and that's even before we get to a discussion about the effect shivering can have in triggering PEM :p
 

Lou

Senior Member
Messages
582
Location
southeast US
Hi Sasha,

Back in the mid-nineties I took ice baths and they certainly did wonders initially. Lifted brain fog and gave me energy and practically felt well for awhile. Sadly, like you, they soon had no effect whatsoever.
 

lansbergen

Senior Member
Messages
2,512
Icebath when the body can't even warm up to normal temperture.? An icecold body during tropical tempurature does not need icebaths..
 

Sherlock

Boswellia for lungs and MC stabllizing
Messages
1,287
Location
k8518704 USA
The short-term results were spectacular. I improved considerably and within (if memory serves) a few days of hitting 16 degrees, I was able to go for a long walk - a mile? A couple of miles? - outside the home.

Hi, Sasha. Thanks for posting that account, it's one of the most interesting things I've seen here. It was entertaining, too :) You're a good writer.

Well, my rationale for using cold is simply to dampen the inflammation. If I burn my fingers on a hot pot, I go very quickly to the freezer to get an ice pack That doesn't change the amount of damaging heat that entered the fingers, but it does change the response and in most cases it's as if I wasn't burned at all.

Or take the example of a sprained ankle, even in a normal person. The acute inflammatory response is often more harmful than the actual mechanical damage from the sprain. The body's response goes overboard, for reasons of its own; so it's prudent to use ice and NSAIDs to dampen that.

A third example is using a cold shower after hard exercise to promote recovery, again because the inflammation goes too far if left on its own..

This held up for a week or so until I caught some new infection (or possibly the originating infection reactivated because I pushed it, who knows) and I was back where I started.

For the last few years I'd wondered about every time that I got sick, whether it was from an infection or merely from an immune response. After all, symptoms from a cold or flu are never from actual damage done by viruses - all the bad feelings are from immune responses. So I've been using ginger a lot lately.

As to your experience, I'd guess that the cold dampened your inflammation, then the exercise and other extra activity resuted in some condition that resulted in even more inflammatory signalling which overcame the dampeneing effect. What condition resulted? Maybe leaky gut. maybe reduced immunity which let a pathogen run wild. Or maybe something more profound: what if the body wants to be inflamed (just like overly the swelling of a sprained ankle) - so it upregulates production of some signalling molecules or of some immune cells or their receptors.

You might on day try the ice again and find that it works once again. Maybe it'd even work for a day or two every month, or every week - provided that you take a prolonged period off from the ice regularly. If you do happen to try that again, please let me know Sherlock. I'd be all ears.

By the way, I imagine there are risks to ice baths, if anyone is thinking of trying them! Like a massive heart attack!
Especially from jumping in quickly, which spikes BP more so than easing in. Or from cold-induced bronchoconstriction, especially in those with overly active mast cells.

It might also be that you don't actually need such extreme exposure as was done previously, maybe less time spent in it. Just thinking out loud here.

Prof Kakkar... appears to be a lord

As soon as you'd said that I remembered him from a roundtable on anticoagulation at theheart.org, because everyone was going on about how he was newly minted... including Lord Kakkar himself.

I'm off to lie down now! And not in a cold bath.

LOL! We need one of those pounding-the-floor-laughing smilies here :)
 

Sherlock

Boswellia for lungs and MC stabllizing
Messages
1,287
Location
k8518704 USA
I don't get the impression that it's supposed to be activating the same mechanism. It's talking about lymph.
I'd also just last week heard a talk about using cold to induce more glutathione.

Still, I think the real mechanism is not about provoking more immune activity but producing less. My speculation is that Kakkar's explanation is probably just speculation. :)
 

Sushi

Moderation Resource Albuquerque
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19,935
Location
Albuquerque
I tried it for a short while, but just felt extremely cold! :oops:

It was really unpleasant so I gave it up but didn't really give it a fair trial.

Sushi
 

Sasha

Fine, thank you
Messages
17,863
Location
UK
Thanks, Sherlock - very interesting explanation (and/or speculation!). I may well have another go, possibly a more moderate or possibly pulsed one as you suggest.

So it's not the 'shock to the system' that's beneficial, it's simply the cold? So even gradual immersion at maybe less drastic temperatures might have some effect? Or maybe even just bits of yourself? I wonder what the minimum would be? Just feet? Just 20 deg?

I used to go in slowly, a bit at a time. Once I was in, and had been immersed for a bit, I'd found that I was lifting my feet out without noticing. It was as though parts of my body were trying to sneak out of the bath and dry themselves off with a towel when I wasn't looking.

I'm 20 years older now, so I'll consult my doctor before I do any of this again.

LOL! We need one of those pounding-the-floor-laughing smilies here :)

Somebody used this one on me the other day: :rofl: which kind of alarmed me because I thought I'd never seen it before but it's in the menu. It must have been there all the time.... :eek:
 

Sasha

Fine, thank you
Messages
17,863
Location
UK
I tried it for a short while, but just felt extremely cold! :oops:

It was really unpleasant so I gave it up but didn't really give it a fair trial.

Sushi


It's a pity Prof Kakkar didn't publish any kind of detail or follow-up (unless he did and I just haven't seen it). It would have been good to see data on time-to-response and the percentage of patients who relapsed and so on.

You're not kidding it was unpleasant! :confused:
 

Sasha

Fine, thank you
Messages
17,863
Location
UK
You might on day try the ice again and find that it works once again. Maybe it'd even work for a day or two every month, or every week - provided that you take a prolonged period off from the ice regularly.


Incidentally, I didn't need any ice (that's a British summer for you). I ran the cold tap, took the temperature of the water, and added enough hot to bring it up. I used a thermometer from a gardening shop (I think they're used to measure pond temperatures or swimming pool temperatures or something).
 

Sherlock

Boswellia for lungs and MC stabllizing
Messages
1,287
Location
k8518704 USA
So it's not the 'shock to the system' that's beneficial, it's simply the cold? So even gradual immersion at maybe less drastic temperatures might have some effect? Or maybe even just bits of yourself? I wonder what the minimum would be? Just feet? Just 20 deg?
Well, who knows really? It's also not quite right to refer to the immune system anyway, since it's so varied. Maybe some parts get upped and others get downed.
Somebody used this one one me the other day: :rofl:
When I see it in my FF browser, it just lays there on its side. There must be a good punch line for that :)
 

Sherlock

Boswellia for lungs and MC stabllizing
Messages
1,287
Location
k8518704 USA
Incidentally, I didn't need any ice (that's a British summer for you). I ran the cold tap, took the temperature of the water, and added enough hot to bring it up. I used a thermometer from a gardening shop (I think they're used to measure pond temperatures or swimming pool temperatures or something).
Okay, that's more doable. I didn't do the conversion from Celsius to F before, but tapwater here is probably around 50-55F.

This might be the video I remembered, it's a CME:
Best Practices in Preventing Stroke in Patients With Atrial Fibrillation: Solutions in Everyday Practice CME
Robert A. Harrington, MD; Professor The Lord Ajay K. Kakkar, MD, PhD, FRCS
http://theheart.medscape.org/viewarticle/774372

If I get an email on him, I'll write and ask.
 

Sasha

Fine, thank you
Messages
17,863
Location
UK
Okay, that's more doable. I didn't do the conversion from Celsius to F before, but tapwater here is probably around 50-55F.

This might be the video I remembered, it's a CME:
Best Practices in Preventing Stroke in Patients With Atrial Fibrillation: Solutions in Everyday Practice CME
Robert A. Harrington, MD; Professor The Lord Ajay K. Kakkar, MD, PhD, FRCS
http://theheart.medscape.org/viewarticle/774372

If I get an email on him, I'll write and ask.


Can't see the video, alas, you have to be a member - oh well!

Yes, it would be great to hear from him about what happened with that work. I almost literally froze my *** off.