Crates Health

The Temperature Therapy Revolution

Something fascinating is happening in the wellness world. The ancient practices of sweating in saunas and plunging into cold water have collided with modern science, and the results are so compelling that insurance companies and the IRS are taking notice. Temperature therapy isn’t just for Finnish grandmothers and Instagram biohackers anymore. It’s becoming legitimate medical treatment.

The numbers are mind-blowing. A 20-year study of 2,315 Finnish men found that using a sauna 4-7 times per week reduced all-cause mortality by 40%. That’s better than most medications. For sudden cardiac death, the reduction was 63%. These aren’t marginal improvements. These are game-changing health outcomes.

On the cold side, research is showing that cold exposure increases brown fat activation by 15-fold, doubles norepinephrine (improving focus and mood), and triggers anti-inflammatory responses that rival pharmaceutical interventions. We’re talking about water temperature as medicine.

The Finnish Secret We’re Finally Understanding

Finland has 3.3 million saunas for 5.5 million people. They’ve been doing this for 2,000 years, and they have one of the lowest rates of cardiovascular disease in the developed world despite a diet heavy in dairy and meat. Coincidence? The research says absolutely not.

Here’s what happens in a sauna at 175-195°F:

• Heart rate increases to 120-150 bpm (similar to moderate exercise)
• Cardiac output increases by 60-70%
• Blood flow to skin increases 10-fold
• Core temperature rises 1-2°C
• Growth hormone increases 16-fold
• Heat shock proteins activate

The cardiovascular benefits alone are staggering. Regular sauna use:

• Reduces high blood pressure by 47%
• Reduces cardiovascular disease by 50%
• Reduces Alzheimer’s risk by 65%
• Reduces all-cause mortality by 40%

But here’s what the Finns knew intuitively that we’re just proving: sauna isn’t just about physical health. It’s about mental resilience. Sitting in 190°F heat for 20 minutes is uncomfortable. Doing it regularly builds distress tolerance. Studies show sauna use reduces depression scores by 50% and anxiety by 60%.

Cold Plunging: From Wim Hof to Mainstream Medicine

Wim Hof seemed crazy when he started evangelizing cold exposure. Then scientists studied him and found he could voluntarily activate his sympathetic nervous system and suppress inflammatory markers. Now major medical journals are publishing research on cold therapy for depression, inflammation, and metabolic health.

Here’s what happens during cold exposure (50°F or below):

• Norepinephrine increases 200-300%
• Dopamine increases 250% (lasting hours)
• Brown fat activation increases 15-fold
• Metabolic rate increases 350%
• Inflammatory markers decrease 40%
• White blood cell count increases

The mental health benefits are particularly compelling. A study in the British Medical Journal found that cold water swimming allowed a patient to completely stop antidepressant medication after years of treatment-resistant depression. The cold shock response essentially reboots the nervous system.

But beyond the biochemistry, there’s something profound about voluntarily doing something difficult every day. Cold plunging is 2 minutes of choosing discomfort. It’s meditation for people who can’t sit still. It’s proof that you can do hard things.

The Science of Heat Shock and Cold Shock

Your body has ancient mechanisms for dealing with temperature stress that we’ve largely eliminated from modern life. These mechanisms, when activated, trigger cascades of beneficial adaptations that impact everything from cellular repair to mood regulation.

Heat Shock Proteins (HSPs)

When exposed to heat stress, your cells produce heat shock proteins. These molecular chaperones:

• Repair damaged proteins
• Prevent protein aggregation (linked to Alzheimer’s)
• Protect against oxidative stress
• Reduce inflammation
• Improve insulin sensitivity

Research shows HSP expression decreases with age, but sauna use can restore youthful levels. This might explain why regular sauna users have 65% lower Alzheimer’s risk.

Cold Shock Proteins

Cold exposure triggers different but equally powerful proteins:

• RNA-binding motif protein 3 (RBM3) – protects synapses
• Cold-inducible RNA-binding protein (CIRP) – reduces inflammation
• Increased PGC-1α – mitochondrial biogenesis

The combination of hot and cold (contrast therapy) appears to be synergistic. Studies show alternating hot and cold:

• Increases growth hormone 5-fold more than either alone
• Improves insulin sensitivity better than exercise
• Reduces delayed onset muscle soreness by 47%
• Increases parasympathetic tone (better recovery)

HSA/FSA Eligibility for Temperature Therapy

The IRS recognizes heat and cold therapy as medical treatments when prescribed for specific conditions. This includes saunas, steam rooms, cold plunges, and contrast therapy systems. The key is medical necessity, not general wellness.

Qualifying purchases include:

• Home sauna installation (infrared or traditional)
• Sauna membership or day passes
• Cold plunge tubs
• Cryotherapy sessions
• Contrast therapy systems
• Portable saunas
• Ice bath equipment

What matters is documentation. You need:

• A diagnosed condition that benefits from temperature therapy
• Letter of Medical Necessity from a healthcare provider
• Receipts for all expenses
• Clear connection between treatment and condition

How to Get Coverage

Step 1: Identify Your Qualifying Condition
Temperature therapy is indicated for numerous conditions. Even stress or poor sleep can qualify.

Step 2: Get Your Letter of Medical Necessity
Must specify:

• Your diagnosis
• Why temperature therapy is medically necessary
• Type and frequency of therapy recommended
• Duration (typically 12 months, renewable)

Step 3: Choose Your Setup
Options range from $100 inflatable cold plunges to $15,000 home saunas. All can be HSA/FSA eligible with proper documentation.

Step 4: Purchase and Document
Keep detailed records. For home installations, you may need to show the medical portion vs general home improvement.

Crates Health simplifies this process, particularly for equipment purchases and memberships, handling the LMN instantly instead of requiring multiple doctor visits.

Medical Conditions That Qualify

Temperature therapy has evidence for treating:

Cardiovascular Conditions

• Hypertension
• Congestive heart failure
• Peripheral artery disease
• Coronary artery disease
• High cholesterol

Mental Health

• Depression
• Anxiety
• PTSD
• Chronic stress
• Seasonal affective disorder

Pain and Inflammation

• Rheumatoid arthritis
• Fibromyalgia
• Chronic back pain
• Muscle recovery
• Joint pain

Metabolic Conditions

• Type 2 diabetes
• Insulin resistance
• Obesity
• Metabolic syndrome

Other Conditions

• Chronic fatigue syndrome
• Autoimmune conditions
• Sleep disorders
• Respiratory conditions
• Skin conditions (psoriasis, eczema)

Your Temperature Therapy Options

Home Saunas

Type	HSA Eligible	Price Range	Best For
Infrared Sauna	✓ Yes	$3,000-8,000	Lower temps, easy install
Traditional Sauna	✓ Yes	$5,000-15,000	Authentic experience
Portable Sauna	✓ Yes	$150-500	Renters, small spaces
Sauna Blanket	✓ Yes	$300-700	Apartment dwellers
Steam Shower	✓ Yes	$3,000-10,000	Bathroom integration

Cold Plunge Options

Type	HSA Eligible	Price Range	Best For
Cold Plunge Tub	✓ Yes	$4,000-8,000	Dedicated setup
Ice Barrel	✓ Yes	$1,200-2,000	Simple, effective
Inflatable Tub	✓ Yes	$100-300	Budget option
Chest Freezer Conversion	✓ Yes	$400-800	DIY approach
Cryotherapy Sessions	✓ Yes	$40-100/session	No home setup

Facility Memberships

Facility Type	HSA Eligible	Monthly Cost	What’s Included
Traditional Spa	✓ Yes	$150-400	Sauna, steam, pools
Recovery Centers	✓ Yes	$200-500	Full contrast therapy
Athletic Clubs	✓ Yes	$100-300	Basic sauna/steam
Bathhouse/Thermal Spa	✓ Yes	$50-150/visit	Multiple temperatures
Float Centers	✓ Yes	$60-100/session	Often have saunas

Building Your Hot/Cold Protocol

Based on research, here are evidence-based protocols:

For Cardiovascular Health:

• Sauna: 4-7x per week, 20 minutes at 175°F
• Cold: 2-3x per week, 2-5 minutes at 50°F

For Mental Health:

• Morning cold exposure: 2-3 minutes daily
• Evening sauna: 15-20 minutes, 3-4x per week

For Recovery (Athletes):

• Post-workout: 10 min sauna, 2 min cold, repeat 2x
• Off days: 20 min sauna for parasympathetic recovery

For Metabolic Health:

• Cold before breakfast: 2-5 minutes
• Sauna before dinner: 20 minutes
• Focus on brown fat activation

Progressive Protocol for Beginners:

• Week 1-2: 5 min sauna at 150°F, 30 sec cold shower
• Week 3-4: 10 min sauna at 165°F, 1 min cold shower
• Week 5-6: 15 min sauna at 175°F, 2 min cold plunge
• Week 7+: 20 min sauna at 185°F, 3-5 min cold plunge

The Bottom Line

Temperature therapy represents one of the highest ROI health interventions available. The research is overwhelming: regular sauna use and cold exposure deliver benefits that pharmaceutical companies would kill for. We’re talking about 40% reductions in all-cause mortality, 50% improvements in depression scores, and cardiovascular protection that rivals any drug.

The fact that saunas and cold plunges are now HSA/FSA eligible reflects a broader shift in medicine. We’re finally recognizing that ancient practices backed by modern science deserve the same insurance coverage as prescription medications. A home sauna that reduces your heart disease risk by 50% is absolutely medical equipment.

The barriers are falling. You don’t need to move to Finland or join the Polar Bear Club. Whether it’s a $200 inflatable cold plunge or a $10,000 infrared sauna, temperature therapy is accessible and covered by your HSA/FSA when medically necessary.

Your ancestors used temperature stress to stay healthy. Modern science proved they were right. Now your pre-tax health dollars can pay for it.

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