Understanding Sauna Therapy: Benefits, Risks, and Best Practices
Sauna adds real physiological load — and whether that load serves you depends entirely on what surrounds the practice. A clear-eyed look at the biometrics, the protocol, and when heat earns its place.
Video·Paul Saladino MD·11 min read·June 2026
Heat is a tool, not a ritual to layer mindlessly on top of an already full plate. A frank look at when sauna earns its place — and when it quietly works against you.
Sauna as Stress
The body keeps a running total. Every demand placed on it — a hard training session, a night of disrupted sleep, a difficult afternoon, a long commute — adds to what physiologists call allostatic load: the cumulative stress burden your system must absorb and eventually recover from. It doesn't reset automatically between commitments, and sauna adds to it. That is not an argument against heat; it is an argument for knowing precisely what you are adding, and when.
you try and throw sauna on top of that, you're just not going to get a net benefit
Think of sauna as a low-intensity cardiovascular event that the body doesn't know isn't movement. Heart rate climbs, core temperature rises, and circulation accelerates toward the skin's surface. For someone largely sedentary, this response is genuinely useful — the equivalent of several brisk walks delivered while sitting still on a cedar bench. Much of the Finnish longevity data on sauna almost certainly reflects this reality: a population where regular heat bathing was one of the few consistent physical challenges in an otherwise quiet daily life.
The Finnish longevity studies are compelling in aggregate, but context surrounds every finding. When you ask what was happening in those participants' lives beyond the sauna — how much they were moving, what their work demanded, how naturally they built recovery into their weeks — isolating heat as the single active variable becomes harder to defend. Technically correct conclusions drawn from the wrong context produce practically misleading prescriptions.
Going from zero to one delivers dramatic returns, in sauna as in any meaningful intervention. The question shifts when you already train. If your week includes lifting, running, intense sport, or any demanding physical practice, your allostatic bucket is already accumulating. Layering sauna onto that without accounting for recovery is not optimization — it is adding stress to a system that has not yet cleared its current load.
This doesn't place sauna off limits for active people. It places responsibility on the prescription. The threshold varies person to person and week to week, depending on sleep quality, training load, and total life demand. Unqualified instructions to use sauna daily for longevity can't account for that variation — and they don't try to.
Blanket longevity claims for sauna, drawn from Finnish population studies, don't transfer cleanly to athletes or anyone operating under significant physical demand. Those studies most likely captured the benefit of heat as a surrogate for exercise — meaningful at a sedentary baseline, considerably less so when a consistent training habit already exists. The honest read of the evidence is that sauna benefits are conditional: they depend on what surrounds the practice, not just what happens inside the room.
The goal is not to avoid heat. The goal is to treat it as what it is: a real physiological stimulus with a real cost-benefit ratio that shifts depending on everything else in your life. Used with intention — when recovery is adequate and training demand is relatively lower — sauna earns its place. Used indiscriminately, stacked onto an already full plate, it becomes another item on a tab the body is working hard to settle. Precision is the discipline here, not volume.
00:00What's up, man? So, I have like a little bit of a three-part question. Um, I do a lot of content and I like to introduce introduce a lot of people to cold plunge, sauna, contrast therapy. I'd love to know what your take is on all three, but a little more specifically on saunas, traditional versus infrared. I think that all of us have some sort of allstatic load, which is this idea that like we all carry a stress load, and saunas are stressful. Um, you know, you can use that to your advantage or you can use it to your detriment if you overuse it. So, my friend Gary Brea talked about putting his aged parents, I think his parents are in their 80s, and they're actually not ambulatory. So, he can put them in the sauna and get them a workout quote unquote without actually having them move. And it's true. I think this is the benefit of sauna for people that are um kind of sedentary or not super active is that you're getting a low-level workout. When I was in my residency in Seattle, I used to go to a gym there called SP Seattle Bouldering Project and we called it the VIP workout or the executive workout. You just go in the sauna. You don't actually go work
01:00out or do anything. You just go in the sauna. And I mean, living in Seattle, I know there's a few of you guys from Seattle here living in Seattle. It was nice to have warmth sometimes. Um, so I I would I would do the executive workout occasionally, but I think that it's easy to overuse sauna because if your allosatic load is already high and you're already doing jiu-jitsu and hitting the punching bag and doing hit workouts and throwing kettle bells around and swimming and maybe not sleeping a ton because your kids are young or something and you try and throw sauna on top of that, you're just not going to get a net benefit. I don't think for humans. Um, I think that there are unique benefits to sauna perhaps in terms of detoxification, but I don't think there's anything magical about it, right? I think the Finnish studies that we see for sauna are like, you know, it's interesting for me to think how much exercise are these other are these guys getting in Finland and are these humans that are just basically the only exercise they're getting is the sauna. Well, yes. If you're going from zero to one and you're getting the equivalent of a few walks per week, you're going to see a massive longevity benefit to sauna. Does that mean sauna benefits you right in terms of longevity? If you are
02:00already lifting weights, if you're already doing, you know, if you're already running six or 60 miles a week, it's a hard call. And I think we have to be honest about that. And I feel like this this sort of unqualified prescription for people to do sauna for longevity doesn't make sense to me. Um, but I think that you have to do it in your own life. And I think you will see if you look at sauna that it will elevate your stress hormones, um, like cortisol. It will elevate your fasting blood sugar. And I'm even experimenting with an aura ring. I have no association with them, but I definitely see my HRV go down, right? So, HRV is heart rate variability. Generally, it's a it's a high level indication of readiness or uh recovery, and you want that to be higher. Uh when when you guys are here in Costa Rica, I think your HRV is probably going up because you're in an environment where you're not stressed, you're sleeping, hopefully, you're exposing yourself to infrared, you around infrared light. You know, this is a a good thing to see the HRV go up. I think as a society we are overstressed and and overtrained and so when you see the HRV go down you think oh that's not
03:00maybe not a good thing and so you know I went to a gym in Miami and I did a couple of days of sauna with cold and my HRV went down noticeably down now I didn't continue that maybe it would have recovered and you know I'm curious what other people have experienced but just keep those factors in mind now when you add cold plunge it gets interesting for me um I I like to do sauna and cold together I like to do contrast therapy just because of the way it feels on my brain I don't like to do cold plunge by itself. And if you do cold plunge by itself, you should do it before your workout and not after your workout. And so I I don't mind doing sauna and cold plunging every once in a while. It can be a social thing. It's fun. Um and especially so I might do something like I don't know 180 degrees in the sauna for 15 minutes. Then you get in a cold plunge for a couple minutes and you go back in the sauna. And I think a lot of people do too much of the cold plunge with the the contrast. When I was hanging out with Gary Brea, he likes his s his cold plunge at like 52, 53, which I like that temperature. I had a very cold cold plunge at my house here and I actually sold it. I'm going to get another one, but I used to keep it at 34
04:00cuz I love the ice and you're like, "Look at how badass I am. I got this really icy sauna. You have to break the ice and I just don't think that's necessary." I like a 52 degree um um cold punch. So, if you're going to do that, that's great. It it certainly will change the neurotransmitters in your brain. You'll get more dopamine. you'll get more catakolamines, but what is it doing longterm to your recovery? Is it overstressing you long term? Keep those things in in in in sort of um in terms of consideration because ultimately we're all just trying to be as healthy as possible. And I think that no matter what you're doing, you always have to qualify it in the context of your own life and sometimes you could overfill the bucket or put yourself over the edge. And was there a third part to your question? >> Yeah. On the sauna, if you had to choose, if you were going to be doing it, would it be traditional? We pour some water on the rocks. >> I like that. >> Over infrared? >> Yeah, I like that. major reasons why >> just feels better. It's hotter, you know. >> Um, yeah, but I think that infrared light is valuable for humans and but you are getting a lot of infrared light even in a hot rock sauna because it's heat and so that there's a huge amount of infrared in there. So, one of the cool
05:00things about being in Costa Rica is we're getting a ton of infrared light because we're outside. I did a podcast with my buddy Tristan Scott and he really opened my eyes to this idea of infrared light deprivation and infrared light deficiency in humans. I did not know until I talked to him that the mitochondria in our whole body, not just in our eyes or our brain, use infrared light to make melatonin and use that as sort of a systemic store of an antioxidant in our body. And so you can think one of the probably the most damaging things that we could do for ourselves is sit indoors in an office behind glass all day. You're getting no infrared light. So it would be interesting to compare the amount of infrared in an infrared sauna versus an actual finished sauna. But just personally, I prefer the finished sauna. >> Totally. And would you say that time and temperature would absolutely make the difference? >> Absolutely. Yeah. And I think you could experiment with it and see what works best for you and see how you feel. Yeah, I think that sweating is valuable for humans. We use our sweat glands to do a lot a lot of detoxification and we want to sweat. I just think be careful. Don't overuse either of them. >> And then last last part of the conscious therapy part, do you think that by going
06:00from sauna to cold plunge the time and temperature? talked about that, but do you think there's any potential risks to to somebody just jumping into contrast therapy? >> Well, certainly if you have pre-existing cardiovascular disease, yeah, absolutely. It's definitely going to put a stress on your heart. [Music]
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What the Biometrics Are Saying
Sauna elevates cortisol — the body's primary stress hormone, which mobilizes energy and sharpens awareness in the short term — and measurably raises fasting blood glucose. These are not theoretical outcomes; they are measurable, acute effects that modern wearables can detect with reasonable consistency. If your metrics shift predictably after heat exposure, that data is worth attending to. It is the body's honest accounting, translated into numbers.
Cortisol in appropriate doses is not the enemy — it drives performance, sharpens focus, and initiates recovery signaling in muscle tissue. The concern is cumulative elevation, the kind that comes from stacking stress without adequate clearance between sessions. When chronically elevated, cortisol disrupts sleep architecture, reduces immune competency, and quietly blunts the recovery you are trying to build. Sauna, used thoughtfully, keeps cortisol within its useful range; used excessively, it extends that arc past the point of return.
Heart rate variability, or HRV, is one of the clearest readiness signals available outside a clinical setting. A higher HRV reflects a recovered, prepared nervous system; a lower reading indicates the body is still processing stress and not yet ready to absorb further demand. What HRV actually measures is parasympathetic tone — the degree to which your nervous system has returned to calm equilibrium after the work of recovery. When HRV trends downward across consecutive days, that trajectory is a signal, not a coincidence.
I did a couple of days of sauna with cold and my HRV went noticeably down
In practice, even a short run of sauna combined with cold exposure can produce a noticeable, unexpected HRV dip — the kind that interrupts a trend of steady improvement and prompts genuine recalibration. The cause isn't the heat or the cold in isolation. It is the cumulative demand of doing both together, repeatedly, without sufficient margin for the body to absorb what it has taken on. Thermal stress is logged the same way a hard training block is logged: as a debt the system must eventually repay.
The practical lesson is personal data over blanket prescription. Your recovery baseline, your training volume, your sleep quality, your total life load — these variables determine whether any given sauna session is restorative or depleting in a specific week. Aggregate population studies set a general direction; your own biometrics tell you whether to lean in or pull back.
Track consistently and notice patterns without sentiment. The tools exist — HRV monitors, continuous glucose trackers, sleep staging devices — and the information they provide is specific enough to inform real decisions. The discipline is in being willing to hear what they say when the answer isn't what you hoped for.
Adjusting a protocol based on data is not retreat; it is refinement. Many people track their biometrics but override the numbers when results don't align with their plan. The body doesn't negotiate its signals based on your schedule or your expectations. When the HRV says rest, the most effective protocol is the one that honors that.
Building a Contrast Protocol
When sauna and cold plunge are combined deliberately, the effect on brain chemistry is pronounced. Dopamine rises, sharpening focus and elevating mood for hours afterward; catecholamines more broadly increase alertness and mental clarity, producing the kind of composed energy that carries through a full afternoon of work. Contrast therapy earns its place not just as a recovery ritual but as a protocol that changes how you think and feel for the rest of the day.
Sequencing matters, and the specifics are meaningful. If cold exposure is your standalone practice — no sauna — do it before your training session, not after. Cold immersion post-exercise blunts some of the inflammatory signaling muscles rely on to adapt and grow stronger; the adaptation you are building depends on that signal remaining intact. Timing the cold before training preserves the process while still delivering the neurological benefits of the plunge.
For full contrast therapy, a sound structure begins with approximately 180°F in a traditional sauna for fifteen minutes, followed by two minutes in a cold plunge, then a return to heat. The movement through thermal contrast is the stimulus — not merely the extremes in isolation, but the deliberate shift between them. Sit in each phase with presence rather than urgency; the body integrates the contrast across the full arc of the session.
The specific numbers — fifteen minutes, two minutes, 180 degrees — are starting points rather than edicts. Track your response across several sessions and notice where you feel most recovered the following day. Some people find that shorter sauna exposures with longer cold intervals serve them better; others need the extended heat phase to feel the full neurological shift. The protocol is a framework; your data refines it.
On temperature: around 52°F for the cold plunge delivers the full physiological response without the session becoming a test of willpower over recovery. Colder is not automatically more effective. The goal is the neurochemical shift, the circulatory response, the moment of stillness your nervous system learns to find even inside discomfort. Reserve the performance of extremity for training; reserve the plunge for what it actually does.
One contraindication carries genuine weight: pre-existing cardiovascular disease. The thermal shifts in contrast therapy impose real stress on the heart and vascular system, and that stress is not a minor caveat to be read past — it is a meaningful clinical consideration that should precede any decision to add this practice. And even for those without cardiovascular concerns, a well-designed protocol has a ceiling. Overfilling the bucket doesn't produce more benefit; it produces a different category of burden.
Traditional vs Infrared
The distinction between traditional and infrared saunas is narrower than the marketing implies. Both emit substantial infrared radiation — heat is infrared, and a Finnish sauna at operating temperature saturates the room with it. The marketed gap between formats closes considerably when you account for basic physics, and the choice between them becomes less a question of mechanism than one of preference and access.
What makes infrared worth understanding is the cellular story beneath it. Mitochondria throughout the body — not just in the eyes or brain, but in every tissue — use infrared light to produce melatonin as a systemic antioxidant, supporting cellular repair and reducing oxidative stress. This finding points to something broader than sauna format: prolonged time indoors, behind glass, in climate-controlled environments, creates a measurable infrared deficit. Modern life delivers almost none of the infrared exposure the body is built to expect. Both formats address that deficit, and that is a more useful frame than traditional versus infrared.
Finnish-style wet sauna runs hotter and produces a more complete sensation of thermal saturation — it feels like more because, by the measure of heat, it is. Personal preference is a legitimate tiebreaker here. The most effective protocol is the one you return to consistently, built from sessions that feel right rather than ones you merely endure. If the dry, still warmth of infrared is what you will actually show up for, that is the superior choice in practice.
Both formats deliver sweating, and sweating earns its own place in the accounting. The sweat glands are a genuine detox pathway — a mechanism for clearing compounds the body is ready to release — supporting both skin health and broader systemic function. Format is secondary to the habit of using heat deliberately at all. Show up, sit in it, and let the body do what millennia of heat exposure have always asked of it.
Heat is, ultimately, a shared language both formats speak. Whether the source is wet rocks or resistive panels, the body responds to the thermal demand with the same cascade: vessels dilate and circulation improves, delivering oxygen and clearing metabolic waste more efficiently; heat shock proteins activate, building cellular resilience that accumulates session by session. The format matters less than the consistency of use.
one of the probably the most damaging things that we could do for ourselves is sit indoors in an office behind glass all day. You're getting no infrared light.