Heat Therapy and Adrenal Fatigue Syndrome
By: Michael Lam, MD, MPH
Various types of heat therapy in the form saunas (a small wooden room or facility that is designed to relax its occupants through sweating with heat) have been used by many cultures going back thousands of years as a therapeutic measure in everyday health.
The Northern European, in particular, has popularized this in recent years. Saunas are now readily available in most spas, health clubs, gyms, and even homes.
Using a sauna is safe and a powerful eliminator of toxic metals from the body; that can include minerals such as: lead, cadmium, mercury, aluminum, fluoride, and arsenic. In addition, it promotes relaxation, provides a forum for social interaction, as well as spiritual development. Many people meditate within the quiet solitude of the sauna room. Saunas can effect a rebalancing of the bodies neuroendocrine system; heat is a powerful healing force. Reported health conditions that have been relieved include: chronic fatigue, fibromyalgia, cancer, adrenal fatigue, and chronic infection, amongst others.
The key to a proper therapeutic sauna starts with the right apparatus and temperature. There are three general types of dry sauna: traditional Finnish sauna using rocks, Far-Infrared sauna using heating elements such as ceramics, and Near-Infrared sauna using infrared lamps in clusters. The sauna temperature will vary according to the type of sauna you desire; as a result, the therapeutic result will vary.
From the chart below you can see the differences in maximum heat and pre-heat times among conventional Finnish sauna and Far- Infrared sauna.
|Type of Sauna||Finnish Conventional Sauna||Far Infrared Sauna|
|Heat Source||Electric/Gas/Wood Heater||Infrared Heating Elements|
|Temperature Range||160°-194°F (70°-90°C)*||80°-125°F (26°-52°C)|
|Time to Pre-Heat||Up to 1 Hour||10 – 30 min.|
*In the United States and Canada, the maximum temperature allowed is 194°F (90°C).
Conventional Sauna vs. Far-Infrared Sauna
Traditional saunas (also called Finnish saunas) heat the bather by moving hot air. Rocks are placed on top of electric coil heaters; they are the most popular and clean. Bathers can sprinkle water on top of the rocks to produce steam. The traditional saunas are the saunas you commonly see in health clubs.
In recent years, a new form of sauna emerges that uses Far-Infrared heat. Far- Infrared sauna (FIR) is heated by radiant method. Ceramic or metallic elements are used to emit mainly a narrow band of energy, usually between about four and forty microns. It is highly efficient, requires less electricity and little, if any preheating. It penetrates the skin and heats from the inside as well as on the skin. This helps the heat reach deeper tissues in the body. The air within the chamber is not heated as much and the ambient temperature remains lower; and more comfortable for the bather. The heating elements are usually built into several walls and floor of the sauna. To maximize the advantage of Far-Infrared sauna proper seating is key; always sit directly in the path of the radiant energy so the rays strike all parts of the body for direct radiant heating; most home units use FIR. One drawback is that they can produce a significant amount of disruptive electromagnetic field (EMF). Those who are sensitive to EMF may not tolerate this type of sauna.
Another type of infrared sauna uses infrared heat lamps to heat the occupant. They emit mostly Near-Infrared energy, although some middle infrared and a small amount of Far-Infrared is also emitted. This type of energy penetrates the body the deepest and it is good for localized use to give intense heat. Also, these produce no detectable electromagnetic fields (EMF).
A typical traditional sauna bath will last about fifteen to thirty minutes with a cool down interval, followed by a second and possibly third sauna session. The relative humidity and high temperature will vary for a dry sauna when the rocks are splashed with water to create steam. Depending on the amount of water splashed on the rocks, the spike in temperature is very brief. A Far-Infrared sauna session generally lasts much longer, about thirty to forty-five minutes, because the temperature is much lower and therefore more tolerable.
Not everyone can tolerate heat therapy well; death has been reported. The cardiovascular system does collapse at extreme high temperatures so if one is not careful, with prolong intense use in any single session it could cause problems. Those who are elderly, have pre-existing cardiovascular conditions, neuroendocrine dysfunction (such as AFS), and those with impaired or sub-optimal body temperature regulation; must proceed with care and preferably with close supervision.
Because the therapeutic effect of sauna is directly related to the session length; professional guidance should be considered for those who are weak. Session length can range anywhere from a few minutes upwards of an hour.
Sauna therapy works through two separate but overlapping mechanisms within a single sauna therapy session. As a result, the effects of saunas actually occur in two phases physiologically. This distinction is important as one can maximize the beneficial part of each of these phases separately.
Phase 1 Sauna Therapy
In the first phase of the heat therapy, the body temperature remains approximately at base level (before sauna has began) and the sweating is light; relatively speaking. This usually happens during the first ten to fifteen minutes of each sauna session. Although tissue heating occurs and heat is gradually increasing, the body is able to dissipate the extra heat by increasing circulation; moving more blood to the skin from internal organs as the skin pore size increase; sweating is increased but only slightly. As a result, the body temperature remains steady and does not rise significantly. One remains quite comfortable during this phase inside the sauna with a sense of embracing warmth; this is also called the relaxation phase.
Phase 1 Sauna and AFS
AFS consist of four stages. Those in early AFS (stages 1 and 2) can generally tolerate sauna therapy well in its entirety. Those with advanced AFS, however, usually are quite fragile. The use of sauna therapy may not be appropriate, and in fact, may make matters worse. Many people, especially those in advanced AFS, have over stimulated and decompensated sympathetic nervous systems. Common symptoms of AFS include fatigue, hypoglycemia, anxiety, poor circulation, impaired immune system, poor digestion, constipation, temperature intolerance, insomnia, depression, and low libido. Many of these symptoms are associated with and the result of a high sympathetic nervous system tone (SNS). To balance the SNS, focus should be placed on enhancing the opposing parasympathetic nervous system (PNS) function. Strengthening of the parasympathetic nervous system also relieves blood stagnation, chronic sympathetic stimulation due to stress, forces more blood into the internal organs as part of the fight or flight response. When blood stagnates in these systems, internal metabolites build up, impaired circulation is the norm as well as the new tissue of the organs become compromised. Phase 1 sauna is therefore particularly suitable for those with advanced AFS.
As one begins a sauna program, congestion and inactivity of the skin can impair sweating. After weeks, or perhaps, up to a few months of repeated sauna use the skin becomes more active and sweating increases exponentially. This causes decreased concentration of sodium chloride in the sweat, which allows progressively better conservation of minerals. Most of this effect is caused by increased secretion of aldosterone. When one begins a sauna program, sweating may only occur in some areas of the body. As the program progresses, more of the skin sweats, relative to other parts of the body. The sauna therapy also includes oxygenation by the body’s attempt to reduce this temperature; therefore allowing more blood flow to the lungs and skin, where the blood picks up more oxygen. (as the pulse increases with the strong volume the cardiac output rises and tissue oxygenation increases)
Those in advance stages of AFS may find this phase most revitalizing. Because most sufferers of advanced AFS (stage 3 and beyond) are in a state of sympathetic dominance, the body tends to be flooded in a sea of epinephrine and norepinephrine. The autonomic nervous system (ANS) is invariably imbalanced as AFS progresses. The more advance the state of AFS, the higher sympathetic tone is at baseline, generally speaking. The resting heart rate is usually above 80 beats per minute (normal is 72-76). In addition, many people are presented with unpleasant symptoms such as postural hypotension, dizziness, heart palpitation with slight exposure to stress that can be physical or emotional; a sense of anxiety is also common. Phase 1 of sauna therapy often leads to a sense of calm and tranquility, provided that the duration is acceptable to the body.
Along with adrenal breathing to increase the opposing parasympathetic tone, the body’s neuroendocrine system can achieve homeostasis quickly, leading to a sustained recovery from AFS. It is important to remember that not everyone with advance AFS benefit from this phase of sauna therapy. If the body’s nutritional reserve is low or weak, even gentle phase 1 sauna therapy can trigger adrenal crashes. Proper timing is key. Those who are weak and constantly fatigue should avoid using the sauna as a way to increase energy for such therapy. When done at the wrong time this can backfire triggering adrenal crashes.
In phase two, which usually happens about 10-30 minutes after one goes into the sauna, the body can no longer dissipate the heat of the sauna without calling for extra help. The body temperature will rise gradually. The rise in body temperature can go up from one to four degrees Fahrenheit. Blood is more forcefully sent to the surface of the skin. The heart rate increases as the sympathetic nervous system (SNS) is called into action. It is at this time that someone may feel sluggish and uncomfortable. The longer one stays in the sauna, the more the sympathetic nervous system may be stimulated at this point. In phase two, some effects include increased body temperature and hastening of the death of the weaker cells. The increase in heart rate and circulation can also lead to disabling of pathogenic micro-organisms. Phase 2 may begin as little as ten minutes of initially starting the sauna therapy. The harder the SNS has to work, the more sweating will occur and the more uncomfortable one will be.
Phase 2 sauna therapy is generally more beneficial for those who are healthy and strong. If you have AFS, be very careful with prolonged Phase 2 sauna activity. While it can improve circulation and enhances immune system activity, it is not for everyone. Those who are weak or have AFS should be careful not to be engaged in this phase of sauna therapy for a prolonged period of time as it can trigger adrenal crashes.
After the sauna
After a sauna session ends, the body temperature may remain elevated for up to fifteen minutes or so; then it may suddenly drop to the base level. At this point, one may often feel fatigued or light-headed. Rest to make sure that the body is hydrated fully for ten to fifteen minutes after the sauna session is important because it will give the body a better ability to restore normal functioning.
Many like to have a cold shower or bath immediately after using the sauna. This is not recommended for those with advanced AFS. The sudden drop in temperature may be hard for those who are already weak and unable to tolerate fluctuation of temperatures. When the body is out of its comfort range of temperature, a range of undesirable neuroendocrine response including dizziness, fainting, nausea, vomiting, joint pain, and fatigue can ensue. Simply rinsing off with warm temperature water is best.
Germanium as a Source of Far Infrared
Another way of getting a low dose therapeutic effects of heat therapy without far infrared sauna is the use of apparel, wraps, or braces that are made out of germanium, an elemental found in nature. Human body emits infrared rays at a wavelength of about nine microns. Germanium emits far infrared rays measuring around 4 to 14 microns in very small amount. When both emit the same nine-micron wavelength rays, the overlap may help water molecules in the body to warp up and as a result improves blood circulation. Bear in mind that the potency of this approach is very small, but can be detectable, especially by those who are sensitive. This increasing circulation approach can be effective in reducing inflammation. Those who have joint or muscle pain of unknown origin may find this effective.
Heat therapy using conventional or Far-Infrared sauna has its place within the AFS recovery protocol. The effect of sauna occurs in two phases. Phase 1 sauna therapy, in particular, is most suitable because of its parasympathetic nervous system enhancement effect. Unfortunately, improper and indiscriminate use of sauna therapy can trigger adrenal crashes and worsen existing conditions; especially if one engages in excessive Phase 2 sauna therapy where the sympathetic nervous system is stimulated.
Sufferers of AFS should only embark on sauna therapy when closely supervised.
About The Author
Michael Lam, M.D., M.P.H., A.B.A.A.M., is a western trained physician specializing in nutritional and anti-aging medicine. Dr. Lam received his Bachelor of Science degree from Oregon State University, and his Doctor of Medicine degree from the Loma Linda University School of Medicine in California. He also holds a Master’s degree in Public Health. He is board certified by the American Board of Anti-Aging Medicine where he has also served as a board examiner. Dr. Lam is a pioneer in using nontoxic, natural compounds to promote the healing of many age-related degenerative conditions. He utilizes optimum blends of nutritional supplementation that manipulate food, vitamins, natural hormones, herbs, enzymes, and minerals into specific protocols to rejuvenate cellular function.
Dr. Lam was first to coin the term, ovarian-adrenal-thyroid (OAT) hormone axis, and to describe its imbalances. He was first to scientifically tie in Adrenal Fatigue Syndrome (AFS) as part of the overall neuroendocrine stress response continuum of the body. He systematized the clinical significance and coined the various phases of Adrenal Exhaustion. He has written five books: Adrenal Fatigue Syndrome - Reclaim Your Energy and Vitality with Clinically Proven Natural Programs, The Five Proven Secrets to Longevity, Beating Cancer with Natural Medicine (Free PDF version), How to Stay Young and Live Longer, and Estrogen Dominance. In 2001, Dr. Lam established www.DrLam.com as a free, educational website on evidence-based alternative medicine for the public and for health professionals. It featured the world’s most comprehensive library on AFS. Provided free as a public service, he has answered countless questions through the website on alternative health and AFS. His personal, telephone-based nutritional coaching services have enabled many around the world to regain control of their health using natural therapies.