Could the Wim Hof Method Help Treat Autoimmune Disease?
Wim Hof does things that defy logic, like climb Mount Kilimanjaro in shorts and tennies. He also appears to defy biology: He doesn’t get sick. He’s immune to cold. He can run a marathon in the desert without a sip of water. Which all makes it sound as if he’s a very, very special case. But Hof has always insisted he isn’t an anomaly—and that anyone can learn to do what he does.
For decades, Hof has been practicing self-developed techniques he calls the Wim Hof Method, which he says can make the human body more resilient in the face of physical and psychological stress. In teaching the method, he’s amassed a following and even converted potential debunkers to true-blue believers. Anecdotally, people have used the Wim Hof Method to optimize athletic performance, improve immunity, mitigate symptoms of chronic disease, and buffer themselves against mental health triggers.
The Wim Hof Method consists of three basic parts, all of which, he claims, contribute to the mastery of mind over body. (A note: These should not be performed without the okay from your doctor and proper training, so if you’re interested in learning, refer to the Wim Hof Method website or the Wim Hof Method app.)
1. Third eye meditation, which is an unguided visualization exercise aimed at total relaxation.
2. Cold exposure by a variety of techniques, from chilly showers to ice baths to long hikes in the snow.
3. Specialized breathing techniques. There are two types: The first alternates between short periods of hyperventilating followed by periods of breath retention, in which you hold your breath as long as you can following an exhale. The second consists of a cycle of one deep inhalation, one full exhalation, and ten seconds of breath retention in which you squeeze all your muscles.
One research group in the Netherlands is working to better understand why and how Wim Hof’s method may work. Matthijs Kox, PhD, is one of the researchers heading that team: He’s an assistant professor at the Radboud University Medical Center in the Department of Intensive Care Medicine, and his focus is on developing and implementing techniques to point the immune system the right way for patients in the ICU. Kox thinks that early research results on the Wim Hof Method and immunity are encouraging—for both healthy people and sensitive groups, like ICU patients or people suffering from autoimmune disease.
While the research is still developing, Kox is excited about where it’s headed. He shared with us where things stand according to his team’s early studies, as well as what’s coming up next.
A Q&A with Matthijs Kox, PhD
I specialize in modulation of the immune system, mostly for critically ill patients who are admitted to the ICU. We try to come up with new treatment methods to steer the immune response in the right direction. In the United States, in the early 2000s, a group showed that the autonomic nervous system has major impact on the immune system. So when I was starting my PhD in 2007, I chose to investigate this interplay.
Eventually, my team came across Wim Hof, who claimed he could voluntarily modulate his own autonomic nervous system and thereby also his immune response. These seemed like outlandish claims—the autonomic nervous system is not called autonomic for nothing. It’s not generally considered to be voluntarily influenceable. The body has voluntary functions: I want to lift my hand or my arm, and I can do that. But the autonomic nervous system controls things like heart rate and digestion. Normally, in textbooks, it is written that you can’t influence those mechanisms voluntarily. So when Wim Hof said he can do just that using self-taught techniques, we were interested.
In our case study of Wim, we first put him in this ice bath—something he does normally as well for his record attempts. (He holds the world record for length of time spent submerged in ice.) Before and after the ice bath, we took a sample of his blood and stimulated that blood in the laboratory with bacterial compounds to activate and observe the immune response in blood. What we saw was that his immune cells reacted much less to this bacterial compound in the sample taken after he was in the ice bath than in the one taken before, implying some suppression of the immune system involved with that exposure to cold. Testing his blood, we also found very high levels of hormones pointing towards activation of the autonomic nervous system in the post-ice-bath sample, which we thought could be a factor involved in this immune system suppression.
We followed up on this by subjecting Wim to what we call an endotoxemia experiment, in which we inject the bacterial compound I talked about before into healthy volunteers. This is safe to do because it’s just the part of the bacterium the immune system recognizes and responds to; it is not whole and cannot replicate, so it cannot infect you. Instead, when we inject this compound into healthy volunteers, they get flulike symptoms for just a couple of hours, and we can measure the increase of inflammatory markers in the blood.
“Normally, people have symptoms for one or two hours: fever, headaches, chills—sometimes even nausea and shivering. Wim had almost no symptoms.”
With Wim, we asked him to perform his concentration meditation technique and breathing exercise during this experiment. We injected him with this compound, he did his thing, and we measured the inflammatory mediators in his blood as well as his symptoms. Normally, people have symptoms for one or two hours: fever, headaches, chills—sometimes even nausea and shivering. Wim had almost no symptoms, and when we measured inflammatory markers in his blood, they were much, much lower than they were in the large groups of subjects we have studied with in endotoxemia experiments in the past fifteen years.
What Wim’s blood work did show was that his levels of the autonomic nervous system hormone epinephrine were very high. So we could hypothesize that very high levels of epinephrine could suppress the immune response. But because this was a case study of only one subject, the results cannot serve as scientific evidence to support that hypothesis. You need to have a controlled group study. That’s when Wim said: “Okay, you want to do this in group? That’s no problem. I’m not special. I can teach this to anybody.”
In that study, subjects were healthy volunteers who had no previous experience with the Wim Hof method. Over a ten-day period, they went through a training with Wim, partly in Poland and partly in the Netherlands, in which they learned the three parts of the Wim Hof Method, including meditation, breathing exercises, and cold exposure. We also had another group of comparable healthy volunteers who were not trained in these interventions. When those ten days were up, we subjected both groups to the previously mentioned endotoxemia experiment. We injected members of each group with those same bacterial compounds to induce an inflammatory response, and lo and behold, what we saw was that the group trained by Wim had much lower levels of inflammatory mediators in the blood, as well as fewer and less intense symptoms, including fever. We also found that when subjects practiced the breathing technique, epinephrine levels in the blood went very high.
The results of this study, which we published in the scientific journal Proceedings of the National Academy of Science of the USA (PNAS), demonstrated that the Wim Hof phenomenon is a real effect. It’s not that Wim is genetically different or anything like that. It’s that people who participate in the Wim Hof Method could voluntarily activate their sympathetic nervous systems (part of the autonomic nervous system) and thereby suppress their immune response.
In our second experiment, we measured the pH of our subjects’ blood during the hyperventilation phase of the breathing exercises, and we noticed it gets very alkaline. It’s quite spectacular: The blood normally has a pH of 7.4, which is tightly regulated by the body. (If this pH is significantly disrupted for a prolonged period of time, cells aren’t able to function normally. In the hospital, this would be alarming—and a sign that a patient isn’t doing well.) During these breathing exercises, the blood gets up to a pH of 7.8, which is very extreme—but it’s only during the few minutes of hyperventilation. During the breath-retention phase, when they released their breath and held their breath for up to a couple of minutes, the pH of the blood was quickly restored to normal levels.
Our hypothesis is that this short duration of blood alkalinity might be a sufficient trigger to induce a controlled stress response that tells the body to release epinephrine, which activates the sympathetic nervous system and suppresses the immune system. We are currently doing mechanistic studies to illustrate how exactly this works. We’ve already collected the data for a first round of research, which we’re writing up for journal publication now. And we’re planning some more experiments going forward. For example: If we artificially keep the blood at a normal pH during the breathing exercises, will we still observe the rest of the effect?
That’s the million-dollar question. We’re investigating it. We think that this method could be of benefit to patients with autoimmune diseases, because these patients suffer from an overactive immune system that harms their own body. These patients often take immunosuppressive medication. If the Wim Hof Method can suppress the immune system, practicing it could be a novel way for patients to manage their autoimmune disease with less medication or without medication at all. It could empower patients to do something about their disease.
“If the Wim Hof Method can suppress the immune system, practicing it could be a novel way for patients to manage their autoimmune disease with less medication or without medication at all. It could empower patients to do something about their disease.”
We have not done a large study yet to confirm this hypothesis, but a few weeks ago, we published a proof-of-concept trial focusing on patients with a certain form of rheumatoid arthritis. These patients were trained in the Wim Hof Method over an eight-week period, and after the training, they reported fewer symptoms and less disease. That’s really encouraging. It’s a preliminary study with a very small number of patients, but it does give us indication that it’s worth doing a larger study to see whether this method has significant effects over a longer period of practice.
Matthijs Kox, PhD, is an assistant professor in the Department of Intensive Care Medicine at the Radboud University Medical Center in Nijmegen, The Netherlands. Kox specializes in immune system modulation for critically ill patients with the goal of reducing mortality in the ICU. He is a founding member of the European Group on Immunology of Sepsis.
This article is for informational purposes only, even if and regardless of whether it features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The views expressed in this article are the views of the expert and do not necessarily represent the views of goop.
