Full Transcript: How to Prevent & Treat Colds & Flu

Andrew Huberman | January 8, 2024

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0:00 ANDREW HUBERMAN: Welcome to the Huberman Lab podcast

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0:04 for everyday life.

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0:09 I'm Andrew Huberman, and I'm a professor

0:11 of neurobiology and ophthalmology

0:13 at Stanford School of Medicine.

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1:42 Without further ado, let's get to answering your questions.

1:45 The first question asks, is it possible to get a cold

1:48 or to get sick from deliberate cold exposure?

1:51 And I suppose a related question is, should you even

1:53 do deliberate, cold exposure if you have

1:56 a sniffle, a cold, or a flu?

1:58 I get that question all the time as well.

2:00 So answer both of those questions.

2:01 And I will also touch on some of the immune enhancing effects

2:05 of deliberate cold exposure.

2:06 But just to make sure that we answer

2:08 the specific question asked here right off the bat,

2:11 is it possible to get a cold or to get sick from deliberate

2:15 cold exposure?

2:16 Well, assuming that you're not doing

2:17 the deliberate cold exposure for more than,

2:20 say five or six minutes at one stretch,

2:24 probably not directly from the deliberate cold exposure.

2:28 I mention that because most people

2:30 are doing anywhere from about a minute

2:32 to three minutes, sometimes five or six minutes.

2:34 And maybe for those of you that are really

2:36 pushing it, 10 minutes of deliberate cold exposure.

2:39 And most often after doing that deliberate cold exposure,

2:41 people are either getting clothed,

2:43 or they're getting into a sauna, or they're taking a hot shower,

2:46 and then getting clothed and heading off into their day

2:49 or off to sleep depending on what time of day or night

2:51 you happen to do your deliberate cold exposure.

2:54 We can safely say that if you warm up

2:56 after a relatively brief, meaning one minute to,

2:59 let's extend out to 10 minutes, 10-minute deliberate

3:01 cold exposure, although, I really

3:03 want to caution people to not do 10-minute deliberate

3:05 cold exposure right off the bat.

3:06 If you are somebody who is not accustomed to it,

3:09 don't jump right up to that long exposure to cold water.

3:13 Start with shorter exposures.

3:16 But if you're doing that one-to-10-minute deliberate,

3:18 cold exposure, and then you're getting warm afterwards

3:20 and heading about your day, I can't see how the deliberate

3:23 cold exposure itself would enhance your susceptibility

3:27 to getting sick.

3:29 That said, we know from an enormous number

3:32 of studies that have looked at cold virus transmission

3:35 and other forms of viral and bacterial transmission

3:38 that the environment that you happen to be in

3:41 does impact your susceptibility to colds

3:44 and other types of viruses and to bacterial infections

3:48 in the following way.

3:50 There have been controlled studies in which people

3:52 go into laboratories.

3:54 Those laboratories have rooms, which they can very tightly

3:57 control the humidity, so essentially,

3:59 the water content in the air, as well

4:02 as the temperature in the room.

4:04 And if you look at the total mass of those data,

4:07 we can say a couple of specific things

4:09 in kind of bullet point fashion.

4:11 First off, cold, dry air does seem

4:14 to increase our susceptibility to

4:17 viral and bacterial infections.

4:18 Because whether or not you're a mouth breather or a nose

4:21 breather, and by the way, I suggest everyone be a nose

4:24 breather unless you're exercising hard enough that you

4:26 have to breathe through your mouth,

4:28 or you're talking or something of that sort.

4:30 But if you're a nose breather or a mouth breather or both,

4:34 viruses and bacteria enter through your nose and mouth,

4:38 sometimes through your eyes, but your nose and mouth

4:40 are going to be the main sites of entry

4:42 and your main barriers to viral and bacterial infections.

4:45 In fact, one of the ways you are constantly fighting off

4:48 bacterial and viral infections that you're

4:49 exposed to all the time is by way

4:53 of those viruses and bacteria getting

4:55 trapped in the mucous lining of your nose

4:57 or your mouth, most notably in the back of your throat.

5:01 So if you spend time in cold, dry environments,

5:05 there is a tendency for that mucosal lining to be thinner.

5:08 There is a tendency for that mucosal lining

5:10 to not be as robust in general.

5:12 And when I say robust, what I mean

5:14 is that if your mouth breathing, for instance

5:16 in a cold, dry environment, I'm thinking from the time

5:19 I spent in Cambridge, Massachusetts in winter

5:21 at the T station.

5:23 If you're I'm just imagining myself

5:24 because it was so darn cold back there breathing

5:27 through your mouth or having gone for a run,

5:30 and your mouth isn't covered, or even if you're deliberately

5:33 nasal breathing, you are drying out your nasal passages

5:36 and making them more susceptible to infections.

5:39 Does that necessarily mean that every time you

5:41 go out in cold, dry air that you're

5:43 going to get an infection?

5:44 No, of course it doesn't.

5:45 But to relate this back to the question we have before,

5:49 there are a lot of data pointing to the fact that more humid,

5:52 warm environments are going to make your mucosal lining

5:56 and the general upper respiratory area more,

6:00 I don't want to say immune because I

6:01 don't want to conflate that word with the other meaning

6:03 of immune.

6:03 It's going to make it more robust against

6:07 bacterial and viral infections.

6:10 So if you get into a cold shower or a cold plunge

6:14 or a cold ocean or a cold lake, and then you get out,

6:17 and you're out there shivering and shaking, trying

6:20 to boost your metabolism or whatever

6:22 it is that you're doing it for, and it's

6:24 cold, dry air, and especially if your mouth

6:27 breathing in that cold, dry air, yes, I

6:29 could see how that might lead to a higher

6:32 probability of getting a cold or other type of infection.

6:35 But there's nothing specific about the deliberate, cold

6:38 exposure itself that can induce a cold or other type

6:43 of infection assuming that the water is clean, right?

6:45 We're not talking about bacterial infections

6:47 of cuts on the skin, et cetera.

6:48 We're talking about colds and other forms of being sick,

6:51 namely upper respiratory infections.

6:54 OK, now with that said, I often get asked whether or not

6:58 for people who already have a little sniffle,

7:01 they're feeling a little run down or perhaps a lot run down,

7:04 should they do deliberate cold exposure?

7:06 And what's a little tricky to give a one size fits all

7:09 answer, , but I think we can safely say that if you are

7:13 feeling malaise, if you're feeling like you have to rest

7:16 you're tired, you're not feeling good because of a cold

7:20 or because of a flu or because of a bacterial infection, now,

7:24 I'm not saying just feeling not good,

7:26 I'm saying feeling not good due to a cold or other form

7:30 of virus or bacterial infection, then I would say stay out

7:33 of deliberate, cold exposure.

7:35 Don't use it.

7:36 Now, why would I say that?

7:37 Given the data I'll talk about in a few minutes showing

7:39 that regular deliberate cold exposure if done correctly,

7:43 can in fact increase immune system markers

7:46 and perhaps even make you much more robust to combating

7:49 different types of infection through the release

7:51 of adrenaline.

7:52 We'll talk about what all that looks like

7:54 in a moment in terms of protocols

7:55 and some of the science.

7:56 But to just be very clear and very direct, if you're sick,

8:00 stay out of deliberate cold exposure.

8:03 There, I, would instead recommend

8:05 warmer hot baths warmer hot showers, the sauna, et cetera.

8:09 But I also would caution that if you are getting into saunas

8:13 that are too hot, saunas they're so

8:15 hot that it's stressful for you, and again, a lot of people

8:18 use deliberate heat exposure because of the stress

8:20 it induces, they're doing some heat induced,

8:22 for instance, heat shock proteins and different ways

8:25 of increasing heart rate.

8:26 That's a different sort of thing.

8:28 That's hard, stressful in order to generate an adaptation.

8:33 I don't recommend doing that.

8:34 In fact, I don't recommend doing deliberate cold exposure,

8:37 exercise, or deliberate heat exposure if you're

8:39 feeling really not well.

8:41 Now, if you're feeling just a little bit not well,

8:43 you're feeling a little bit rundown, a little bit

8:46 of sniffle, a little bit of malaise, well then,

8:49 it's kind of an edge case where we could

8:50 say, all right you know what?

8:52 Just take a hot shower and go to sleep.

8:53 That's probably the best advice, that good old-fashioned advice.

8:57 But if you are determined to do your deliberate cold exposure

9:00 anyway, then I would say definitely get warm

9:03 or take a hot shower afterwards, hot bath, or hot sauna,

9:07 but, not too hot that it's stressful, of course.

9:09 And keep in mind that one of the variables that's

9:11 been measured quite a lot in laboratory

9:13 studies of deliberate cold exposure

9:14 is the increase in immune system markers.

9:16 So I'll provide a few links to some of these studies.

9:20 Although, nowadays there are many, many of them.

9:23 But it's very clear that deliberate cold exposure

9:27 can increase the release and the production

9:31 of different immune molecules and immune cells.

9:34 One slightly older study, but nonetheless a good study

9:37 that has relevance here is entitled

9:39 "Immune system of cold exposed and cold adapted humans."

9:43 Keep in mind that this study is a little bit extreme.

9:46 And there are reasons for that.

9:48 I guess to make a long story short, oftentimes,

9:50 in order to quote unquote "see an effect in a study,"

9:54 scientists will use conditions that are pretty extreme

9:57 compared to control group.

9:58 Oftentimes, you'll see a dose response to,

10:00 but it's a little bit trickier to do with human studies

10:03 of deliberate, cold exposure.

10:04 It can be done, but not too common.

10:06 But here, they used a pretty what

10:07 I would call extreme stimulus.

10:09 It was exposing people to 14 degrees Celsius water,

10:12 so that's 57.2 degrees Fahrenheit,

10:16 which isn't that cold.

10:17 It's like cool, I would say very cool water,

10:19 but not what you might consider cold depending

10:22 on how well you tolerate cold.

10:23 And that will vary, of course.

10:24 But they had people exposed to that for an hour, which

10:27 is a pretty long time.

10:29 Most people, as I mentioned, are using colder temperatures

10:32 of deliberate cold exposure, so even high 30s,

10:35 low 40s, maybe upper 40s for anywhere

10:39 from one to 10 minutes, depending

10:40 on how conditioned they are.

10:42 And again, don't just jump into 10 minutes of deliberate, cold

10:45 exposure, please at 35 degrees or 40 degrees

10:49 or even 45 degrees if you aren't familiar with deliberate cold

10:52 exposure.

10:52 You have to ease into these sorts of things over time.

10:55 And if you're interested in protocols

10:56 for deliberate cold exposure, we have a zero-cost newsletter

10:59 at hubermanlab.com.

11:00 Go to the Menu, go to Newsletter,

11:01 and you can find that.

11:02 We've done several episodes on deliberate cold exposure.

11:06 In any event, this study, "Immune system of cold exposing

11:09 cold adapted humans," as I mentioned,

11:11 had people in 14 degrees Celsius water for one hour.

11:14 And basically what they found is that one exposure to cold

11:17 did not change immune system function

11:20 in any kind of significant way.

11:21 However, what they found was if people did deliver

11:25 cold exposure repeatedly over a period of about six weeks,

11:29 and by repeatedly, I mean three times per week, what they found

11:32 were trends.

11:33 And again, trends are not statistically significant,

11:37 but trends towards increases in plasma concentrations of things

11:41 like IL 6, interleukin 6 or total numbers of T lymphocytes

11:45 and T helper cells and T suppressor cells

11:48 and activated T and B lymphocytes,

11:49 these are all immune cells and immune molecules

11:52 that roughly correspond to an increase in immune system

11:56 function.

11:56 If you'd like to learn more about the immune system,

11:58 I did an episode on immune system function.

12:00 Again, you can find that at hubermanlab.com.

12:02 And it spells out the basic cell types

12:03 of what's called the innate and the adaptive immune system.

12:06 This study, which we will link to in the show note captions

12:08 is but one study of several other studies showing

12:11 that deliberate cold exposure can increase immune system

12:14 markers, especially when deliberate cold exposure is

12:16 done repeatedly over time, so in this case, three times

12:19 a week over a period of six weeks.

12:20 But again, I want to highlight these aren't

12:22 highly significant effects.

12:24 These are trends in the direction

12:25 of increased numbers of immune cells and immune markers.

12:28 Now, what's impossible to know is

12:30 how those trends translate to actual resistance

12:34 to specific concentrations of, say cold virus or flu virus

12:37 or any other virus or bacteria.

12:39 That would be great, but that's a very difficult study

12:42 to do, especially in the context of deliberate cold exposure

12:44 as well.

12:45 Now, we can all be scientists about this and say, what is it

12:50 about deliberate cold exposure that would increase

12:52 immune system function?

12:54 And there, we can confidently say the molecules

12:57 epinephrine and norepinephrine, which

12:58 are released in both brain and body in response to cold water

13:02 exposure, as well as things like deliberate hyperventilation,

13:06 the release of norepinephrine and epinephrine into the brain

13:09 and body is known to have a number of different effects

13:12 related to the immune system.

13:14 It can be pro-immune, at least in the short term.

13:17 And in the long term, meaning if noradrenaline and adrenaline,

13:21 again those are just different names for norepinephrine

13:24 and epinephrine.

13:24 I'm sorry, those are the same thing,

13:26 but that's why I use them interchangeably so

13:28 that you don't get confused.

13:29 If you see noradrenaline or norepinephrine,

13:31 that's the same thing you hear, epinephrine or adrenaline,

13:34 same thing.

13:36 Deliberate cold exposure or deliberate hyperventilation

13:38 will increase those molecules, norepinephrine and epinephrine.

13:43 And their increase is pro-immune.

13:46 It can trigger the activation of immune cells

13:50 and immune molecules that can make

13:51 you more resistant to certain forms of infection.

13:54 However, if norepinephrine and epinephrine

13:57 are elevated chronically, and especially

13:59 if they are elevated late in the day repeatedly

14:02 over many, many days, that can cause reductions

14:06 in the number and efficiency of immune cells

14:09 in combating infections.

14:10 So getting cold in this context of

14:12 whether or not you can get sick from it

14:14 should really be considered more as

14:15 what happens when you spike your adrenaline and norepinephrine?

14:19 And there's one other study that we can look to,

14:21 which is now really a famous study published in proceedings

14:24 of the National Academy of Sciences

14:26 looking at so-called Wim Hof breathing.

14:28 But really, that just translates to cyclic hyperventilation.

14:31 So this is inhaling through nose,

14:33 exhaling through the mouth repeatedly 25 times or so.

14:36 [BREATHING]

14:38 If you do that, you notice you feel quite warm,

14:41 lots to do with some things relate to vasodilation,

14:43 has some things to do with release of norepinephrine.

14:46 And epinephrine, we know that pattern

14:47 of deliberate hyperventilation, much like deliberate

14:49 cold exposure, deploys or releases

14:52 noradrenaline and adrenaline into your brain and body.

14:55 And we know from this study entitled

14:57 "Voluntary activation of the sympathetic nervous system

14:59 and attenuation of the innate immune response in humans"

15:02 showed really nicely, I think.

15:04 That if people are injected with E. coli, a bacteria

15:09 it's actually an end-- they did this

15:11 through endotoxin injections.

15:12 People got really sick.

15:13 They'd get feel like they had the flu,

15:16 they vomit, diarrhea, get a fever, et cetera.

15:19 However if they did the sorts of breathing

15:21 that I talked about just a moment ago, prior to that,

15:24 they were able to ward off a lot of the symptoms associated

15:29 with the endotoxin infection.

15:31 And you would say, OK wow, their immune system just fired up,

15:33 and they were able to fight it off.

15:34 But it's trickier than that, actually.

15:36 What happened was the release of epinephrine

15:39 and norepinephrine from cyclic hyperventilation, which

15:41 is really what [BREATHING] really

15:44 is, cyclic hyperventilation, also called Wim Hof breathing,

15:47 also called tummo breathing, et cetera, that actually had

15:50 a suppressive action on certain arms of the immune system

15:55 in a way that allowed people to avoid symptomology

15:59 such as fever, nausea, et cetera.

16:01 And we would imagine the same thing would

16:03 occur with deliberate cold exposure done

16:06 prior to bacterial infection or viral exposure.

16:10 So if you're sensing that I'm saying two things at once,

16:13 I am.

16:14 I'm saying deliberate cold exposure,

16:16 and cyclic hyperventilation can both cause deployment

16:19 of molecules such as epinephrine and norepinephrine

16:23 that lead to enhanced immune system

16:24 function if done repeatedly.

16:26 I'm also saying that increasing norepinephrine and epinephrine

16:29 too much can suppress your immune system.

16:33 In this study, the PNAS study that I mentioned a moment ago,

16:36 that suppression of the immune response

16:38 was actually one of the reasons people avoided symptomology.

16:40 But they were still injected with endotoxin,

16:42 so they just weren't fighting off the endotoxin with fever.

16:45 Remember, fever is an adaptation to fight infection.

16:48 It's designed essentially to heat up the infection

16:51 and kill it.

16:52 So what are we to take away from this?

16:54 Here are what I think are the key takeaways.

16:57 One, if you are feeling good to great,

17:00 do your deliberate cold exposure.

17:02 And perhaps don't worry so much about using your body's

17:05 natural metabolism and thermogenic abilities

17:08 to heat back up afterwards.

17:10 But I don't suggest anyone ever allow themselves

17:13 to stay really cold after deliberate

17:15 cold exposure for more than 10, 15 minutes or maybe

17:19 half an hour, right?

17:20 Get bundled back up, or put on clothes.

17:22 If it's a nice hot, sunny day, get out in the sun and warm up.

17:25 Again, temperatures and conditions

17:27 will vary for different people, different locations, et cetera.

17:32 If you are not feeling great, you're

17:33 feeling a little rundown, and you really

17:35 want to do your deliberate cold exposure,

17:37 do it, but then warm up really well afterwards.

17:39 Maybe even drink some hot tea or other fluid afterwards as well.

17:44 And if you are not feeling good, you're feeling malaise,

17:46 you're feeling run down.

17:48 Despite what you read about deliberate,

17:51 cold exposure or cyclic hyperventilation,

17:54 allowing for the deployment of immune molecules

17:57 or increasing the number of immune cells

17:59 that you're making, avoid anything

18:01 that's stressful or challenging whether or not

18:05 it's a cold challenge, a heat challenge, or an exercise

18:08 challenge when you're feeling run down.

18:10 Because under those conditions, what you really want to do

18:12 is slow your circulation down, probably

18:14 find and take a little walks or something

18:15 provided you're not doubled over in bed and vomiting,

18:18 and things like that.

18:18 A little bit of movement, probably

18:20 good to circulate your blood.

18:21 But in general, the advice that you

18:23 get to rest when you're sick and not push yourself,

18:27 that's really good advice because you

18:28 want all of your body's resources

18:30 to be devoted to getting over that infection.

18:33 And if you're interested in sickness and sickness

18:36 behavior and the sorts of behaviors

18:38 that can combat infection, check out the episode

18:40 I did on the immune system.

18:41 We'll link to it in the show note captions.

18:43 Because it talks about how when we

18:44 have a viral or bacterial infection,

18:46 a whole set of brain circuits get

18:48 activated that encourage us to be more in the fetal position,

18:52 to move less, to be eyes down, to kind of slump down.

18:56 That's not a coincidence.

18:57 That's because of the activation of these so-called sickness

18:59 circuits that are really designed

19:01 to help you heal yourself.

19:02 So I both apologize, and what do the kids say?

19:07 Sorry, not sorry.

19:08 Don't apologize for the somewhat nuanced answer here.

19:12 Because a lot of information out there says,

19:14 oh, cold boosts your immune system.

19:16 And yeah, that's true under certain conditions.

19:18 It can also deplete your immune system

19:20 and limit your ability to fight off infections

19:23 under other conditions.

19:24 And perhaps the last thing to say about this

19:27 is that I am a big believer in using nasal breathing whenever

19:31 you don't have to breathe through your mouth.

19:33 So if you're exercising hard, by all means breathe

19:35 through your mouth.

19:35 If you're doing martial arts, and it

19:37 requires that you breathe through your mouth,

19:38 go ahead and do that.

19:40 But if you're doing, say a zone two cardio, low level

19:42 cardio, or you're just walking along,

19:44 it's very clear based on a growing amount of data

19:46 that being a nasal breather is better

19:48 than being a mouth breather.

19:49 And there are a number of different reasons

19:50 for that we've talked about on the podcast and elsewhere.

19:53 But one of the additional reasons is a main site of entry

19:56 for infections is through the mouth.

19:58 So keep that mouth shut unless you need to talk.

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