Cold therapy for metabolic syndrome
Evidence review
Overview
Three reports from one Polish research group studied 10-20 whole-body cryotherapy sessions (-184 to -202 F, 3 min) in postmenopausal women with metabolic syndrome, each compared with healthy women who received the same sessions. After 20 sessions, body mass, waist circumference and fat mass decreased in both groups, with additional reductions in trunk and android fat in the metabolic syndrome group. Fasting glucose and the glucose-regulating hormone asprosin decreased, mainly in women with hyperglycemia. No randomized or untreated control group, no long-term follow-up and no cold-water immersion study were found.
Key findings
- 20 sessions (-202 F, 3 min daily) in 19 women with metabolic syndrome and 18 healthy women: body mass, BMI, waist circumference and total fat mass fell significantly in both groups; total, trunk and android fat percentage fell in the metabolic syndrome group (Wiecek 2020).
- 37 menopausal women, 20 sessions: asprosin fell in metabolic syndrome, hyperglycemic and control groups (p<0.05) and glucose fell in the hyperglycemic group (Wiecek 2019).
- 10 and 20 sessions (-184 F, 3 min): fasting glucose fell after 10 sessions in all groups, with a further fall in the metabolic syndrome group after 20 (Wiecek 2023).
Every study we reviewed
3 found benefit
Each study was checked on PubMed. The colored edge shows the direction of the result. The research library lists 8 studies on metabolic syndrome, across all heat and cold therapies, including case reports and older work not graded here.
Whole-Body Cryotherapy Is an Effective Method of Reducing Abdominal Obesity in Menopausal Women with Metabolic Syndrome.
Wiecek M et al. J Clin Med. 2020. PubMed 32872598 · DOI · Free full text
- Who
- Menopausal women with metabolic syndrome (n=19, BMI 30.1) and healthy menopausal women (n=18)
- What
- Whole-body cryotherapy chamber, -202 F (-130 C), 3 min daily, 20 sessions
- Protocol
- -202 (chamber air) °F · 3 min · daily/wk
- Measured
- Body composition, waist circumference, irisin, IL-6, CRP
- Result
- Body mass, BMI, abdominal circumference, triceps skinfold, total fat mass and leg fat percentage fell significantly in both groups; total, trunk and android fat percentage fell in the metabolic syndrome group; CRP was higher in the metabolic syndrome group before but not after 20 sessions.
- Limitations
- Non-randomized; no untreated metabolic syndrome control; women only; magnitudes not given in abstract.
Decreased Blood Asprosin in Hyperglycemic Menopausal Women as a Result of Whole-Body Cryotherapy Regardless of Metabolic Syndrome.
Wiecek M et al. J Clin Med. 2019. PubMed 31510055 · DOI · Free full text
- Who
- Menopausal women with and without metabolic syndrome, grouped also by hyperglycemia
- What
- Whole-body cryotherapy chamber, -202 F (-130 C), 3 min, 20 sessions
- Protocol
- -202 (chamber air) °F · 3 min
- Measured
- Asprosin, glucose, insulin, HOMA-IR, adipokines, atherogenic index
- Result
- Asprosin fell significantly (p<0.05) in the metabolic syndrome, hyperglycemic and control groups; fasting glucose fell in the hyperglycemic group; change in asprosin correlated with change in glucose.
- Limitations
- Non-randomized; no untreated control; likely the same cohort as Wiecek 2020; biomarker outcomes.
Whole-Body Cryotherapy Alters Circulating MicroRNA Profile in Postmenopausal Women.
Wiecek M et al. J Clin Med. 2023. PubMed 37629307 · DOI · Free full text
- Who
- Postmenopausal women with metabolic syndrome (BMI 30.6), healthy postmenopausal women and healthy young women
- What
- Whole-body cryotherapy chamber, -184 F (-120 C), 3 min, 10 and 20 sessions
- Protocol
- -184 (chamber air) °F · 3 min
- Measured
- Circulating microRNAs, fasting glucose, lipid profile
- Result
- Fasting glucose fell after 10 sessions in all groups and fell further in the metabolic syndrome group after 20; miR-15a-5p was up-regulated in all groups after 20 sessions.
- Limitations
- Non-randomized; sample size not stated in abstract; no untreated control; surrogate outcomes.
Protocols used in the studies
Whole-body cryotherapy chambers at -184 F (-120 C) or -202 F (-130 C) for 3 min per session, 10-20 sessions on consecutive weekdays, in postmenopausal women with and without metabolic syndrome.
What is still unknown
Whether whole-body cryotherapy improves metabolic syndrome components compared with an untreated control in randomized trials; durability after sessions stop; effects in men and younger adults; whether cold-water immersion has any effect.
Safety
Cautions for cold therapy in this condition
- The studies did not report adverse events in their abstracts. Cold exposure raises blood pressure acutely, and hypertension and coronary disease are common in metabolic syndrome; see the cold general safety entry for whole-body cryotherapy contraindications.
- IL-6 rose after 10 and 20 sessions in the metabolic syndrome group (PMID 32872598); the clinical meaning is unclear.
For clinicians
Suggested rationale
Small non-randomized studies in postmenopausal women reported reductions in waist circumference, fat mass and fasting glucose after 20 whole-body cryotherapy sessions (Wiecek 2020); the evidence is preliminary, from a single group, and lacks an untreated control.
Suggested wording only. The treating clinician decides whether it reflects their clinical judgment for this patient.
Typical ICD-10 codes: E88.810. Examples only; the clinician assigns the code.
What a letter of medical necessity should containWho can write it: physicians, NPs, PAs and others