Sauna for dyslipidemia / hypercholesterolemia
Evidence review
Overview
Studies in healthy young adults report short-term reductions in total and LDL cholesterol after repeated Finnish sauna sessions that return toward baseline within 1-2 weeks after stopping. A 2025 systematic review of seven RCTs of hot spring and sauna use found reductions in total and LDL cholesterol in younger adults but no significant change in adults aged 60 or older. A 2025 meta-analysis of passive-heating RCTs found no significant effect on total, HDL or LDL cholesterol or triglycerides. In an 8-week RCT, adding sauna to exercise lowered total cholesterol compared with exercise alone in sedentary adults with cardiovascular risk factors. An earlier review of far-infrared sauna studies found consistent evidence against a cholesterol-lowering effect.
Key findings
- Systematic review (7 RCTs, 2025): lower total and LDL cholesterol in 4 RCTs of younger adults; no significant lipid changes in 3 RCTs of adults >=60 years.
- RCT meta-analysis (20 trials, 2025): no significant pooled effect on total, HDL or LDL cholesterol or triglycerides.
- Healthy young men (n=16, 10 sessions at 194 F): total and LDL cholesterol fell during the 3 weeks and returned toward baseline within 1-2 weeks after stopping.
- Review of 9 far-infrared sauna studies (2009): consistent fair evidence refuting a cholesterol-lowering effect.
Every study we reviewed
2 found no effect · 1 mixed results · 3 found benefit
Each study was checked on PubMed. The colored edge shows the direction of the result. The research library lists 15 studies on cardiovascular disease (general), across all heat and cold therapies, including case reports and older work not graded here.
Non-acute effects of passive heating interventions on cardiometabolic risk and vascular health: systematic review and meta-analysis of randomized controlled trials.
Hamaya R et al. Am J Prev Cardiol. 2025. PubMed 41049507 · DOI · Free full text
- Who
- 20 RCTs of passive heating >=1 week in adults
- What
- Passive heating interventions, 2-15 weeks
- Protocol
- 2-15
- Measured
- Total, HDL and LDL cholesterol, triglycerides
- Result
- No significant pooled effects on total, HDL or LDL cholesterol or triglycerides (estimates not given in abstract).
- Limitations
- Mixed modalities and populations.
Hot spring and sauna use for improving blood lipid profiles: A systematic review and expert consensus on efficacy and recommendations.
Yamasaki S et al. Complement Ther Med. 2025. PubMed 40914321 · DOI · Free full text
- Who
- 7 RCTs of hot spring or sauna use in adults
- What
- Hot spring or sauna use, alone or combined with exercise
- Measured
- Serum lipid profile
- Result
- 4 RCTs in younger adults (mean age <60) showed reductions in total and LDL cholesterol (weak expert recommendation); 3 RCTs in older adults (mean age >=60) showed no significant lipid changes.
- Limitations
- Hot springs and sauna combined; populations not selected for dyslipidemia; effect sizes not given in abstract.
Far-infrared saunas for treatment of cardiovascular risk factors: summary of published evidence.
Beever R et al. Can Fam Physician. 2009. PubMed 19602651 · Free full text
- Who
- 9 human studies of far-infrared sauna (4 in congestive heart failure, 5 in people with coronary risk factors)
- What
- Far-infrared sauna
- Measured
- Serum cholesterol and other cardiovascular risk factors
- Result
- Consistent fair evidence refuting a cholesterol-lowering effect of far-infrared sauna; limited moderate evidence for blood pressure and heart failure.
- Limitations
- Small evidence base; qualitative synthesis; populations not selected for dyslipidemia.
Effects of regular sauna bathing in conjunction with exercise on cardiovascular function: a multi-arm, randomized controlled trial.
Lee E et al. Am J Physiol Regul Integr Comp Physiol. 2022. PubMed 35785965 · DOI · Free full text
- Who
- Sedentary adults with >=1 CVD risk factor; 22% had total cholesterol >239 mg/dL
- What
- Exercise + 15-min post-exercise Finnish sauna vs exercise alone vs control, 8 weeks
- Protocol
- 149 rising to about 176 °F · 15 min · 3/wk · 8 wk
- Measured
- Total cholesterol (secondary outcome)
- Result
- Total cholesterol lower with exercise + sauna than with exercise alone (secondary outcome; magnitude not stated in abstract).
- Limitations
- Small; secondary outcome; sauna combined with exercise; minority had hypercholesterolemia.
The effect of sauna bathing on lipid profile in young, physically active, male subjects.
Gryka D et al. Int J Occup Med Environ Health. 2014. PubMed 25001587 · DOI · Free full text
- Who
- Healthy, physically active men aged 20-23
- What
- 10 Finnish sauna sessions every 1-2 days
- Protocol
- 194 °F · 45 (3 x 15) min · 3-7/wk · 3 wk
- Measured
- Total, LDL, HDL cholesterol, triglycerides
- Result
- Statistically significant decrease in total and LDL cholesterol during the 3 weeks and the following week, returning toward baseline in weeks 1-2 after stopping; HDL non-significantly higher.
- Limitations
- Healthy volunteers; uncontrolled; plasma volume shifts may affect concentrations; numeric values not in abstract.
Changes in the lipid profile of blood serum in women taking sauna baths of various duration.
Pilch W et al. Int J Occup Med Environ Health. 2010. PubMed 20682487 · DOI
- Who
- Healthy young women aged 19-21
- What
- 7 Finnish sauna sessions every second day (30 or 40 min)
- Protocol
- 30-40 min · 3-4/wk · 2 wk
- Measured
- Lipid profile
- Result
- Reduced total and LDL cholesterol and increased HDL after repeated sessions (numeric values not given in abstract).
- Limitations
- Healthy volunteers; uncontrolled; very short.
Protocols used in the studies
Healthy-volunteer studies used Finnish sauna at about 194 F (90 C), 30-45 min per visit, 7-10 visits over 2-3 weeks. The RCT used 15 min of Finnish sauna after exercise 3 times/week for 8 weeks, starting at 149 F (65 C).
What is still unknown
No trial in patients with diagnosed dyslipidemia; durability of lipid changes; effect in older adults; whether any change affects cardiovascular outcomes.
Safety
Cautions for sauna in this condition
- Avoid alcohol around sauna use; alcohol is present in about half of Finnish sauna deaths (PMID 18471223).
- Lipid changes after sauna may partly reflect plasma volume shifts from sweating (PMID 25001587).
For clinicians
Suggested rationale
Repeated sauna sessions produced short-term reductions in total and LDL cholesterol in healthy young adults (Gryka 2014), but an RCT meta-analysis found no lipid effect (Hamaya 2025); sauna is not an evidence-based treatment for dyslipidemia and would be at most an adjunct to lifestyle and lipid-lowering therapy.
Suggested wording only. The treating clinician decides whether it reflects their clinical judgment for this patient.
Typical ICD-10 codes: E78.5, E78.00, E78.2. Examples only; the clinician assigns the code.
What a letter of medical necessity should containWho can write it: physicians, NPs, PAs and others