The Health Benefits of Hot Tubbing with Melissa Young, MD

Podcast Transcript

John Horton:

Hey there, and welcome to another Health Essentials Podcast. I'm John Horton, your host.

Hot tubs hold a special place for us in pop culture, and let's be honest here, they've got a reputation as a fun place to splash around. But hot tubs are more than just a bubbly good time; they're also therapeutic on multiple levels, as we'll discuss today with one of our regular guests on the podcast, functional medicine specialist Melissa Young. Dr. Young is one of the many experts at Cleveland Clinic who visit us weekly to chat about wellness trends and ways to live healthier. So with that, let's soak in some knowledge about the benefits of hot tubs.

Welcome back to the podcast, Dr. Young. I got to tell you, I love your visits. We always find something fun to chat about.

Dr. Melissa Young:

We do. Thank you so much for having me back.

John Horton:

So our topic today is hot tubbing. And when it comes to plopping in a hot tub, my first thought isn't that I'm entering healing waters. Am I underselling the potential benefits because I watched the “Hot Tub Time Machine” and, full confession, the sequel?

Dr. Melissa Young:

I have to admit, I have not seen that.

John Horton:

You're not missing a cinematic masterpiece, I can promise you that.

Dr. Melissa Young:

But I think a lot of us think about, gosh, when we're traveling, we are going on vacation, we look forward to being able to sit in a hot tub and relax. So I think we can talk about the benefits and potential drawbacks of doing that, but it's definitely something that we think about that can be beneficial and fun.

John Horton:

Yeah, oh, definitely. And you are so right with vacations. I know last family trip I had, my grandkids were all over that hot tub, so it is just a favorite. But let's look … it is more than just fun here.

Dr. Melissa Young:

Yeah.

John Horton:

So what kind of health perks might you get out of a hot tub session?

Dr. Melissa Young:

Well, one, I think it's important to know that hot water, hydrotherapy, it's been used for over 4,000 years, and it's been part of the cultures of the Native Americans, the Japanese and Norwegians, the ancient Greeks. So this is not new. We're putting, in modern times, it's a hot tub rather than buildings erected on natural hot springs, which probably has additional benefit of all the minerals in the waters. But it actually was interesting in researching some of this… Of course, we have the basic benefits of relaxing muscles, increasing blood flow to help with the stiffness and any discomfort or pain we might have. But it was interesting to see that there were some studies that showed there might be benefits to our cardiovascular health, even minor benefits, say, to metabolic health. So improving insulin resistance, markers of inflammation. Though I think it's important to know, one, I think we need more studies that really show consistent benefit. And the other piece is, you need to be using the hot tub consistently. So most of us-

John Horton:

…not just a one-and-done sort of thing.

Dr. Melissa Young:

…exactly. It's not a one-time deal. The one-time deal is great for stress management, which we're always talking about, relaxing the muscles, just increasing blood flow. But you need that regular use if you're going to have a lot of those other potential benefits.

John Horton:

Yeah. When you talk about the heart-health and the sore muscles and things like that, is that just all related to what that warm water does to blood flow and just getting everything really flowing that much better?

Dr. Melissa Young:

Yeah, I definitely think we're improving circulation and blood flow that helps carry nutrients and oxygen to our tissues, which is helpful in those situations. Probably, when we think about not only that blood flow bringing nutrients to the muscles, it's getting rid of metabolic waste that may build up, especially, say, for athletes, who are using this to be helpful with muscle pain. So I think those are the main sort of mechanisms, at least that we're aware of at this time. It's an interesting subject. It'd be nice to have more data on this.

John Horton:

Yeah. Well, and I even saw where it can briefly lower your blood pressure. And that's like what you were saying, if you just jump in, I mean, it does, it kind of widens those arteries up and even will bring it down, at least temporarily, while you're sitting in there.

Dr. Melissa Young:

Yeah, correct. And it's going to sort of lower blood pressure and it's going to lower that diastolic number, so the bottom number of people are familiar with their blood pressure. But that also ... we can talk about what precautions we want to take. But yeah, I mean, I think that that's part of the relaxation, and over time, if you are doing it consistently, part of that benefit from a cardiovascular standpoint.

John Horton:

Now, as far as stress relief, I mean, you almost feel like these waters are magical sometimes when you feel so good when you get up. But what's really the … that's going on there to make you feel just so chilled out?

Dr. Melissa Young:

Well, I think if we're talking about a hot tub, which is going to be probably chlorinated water, most of the benefit is going to be from the heat and the jets. So that's just allowing us to relax, relaxing physically the muscles, because stress often leads to [inaudible 00:06:25] our shoulders coming up here and tight muscles.

John Horton:

Oh, yeah.

Dr. Melissa Young:

So it's that relaxation piece, physically, of the muscles, that I think then leads to probably — not that there's data here on this yet — but helping with the autonomic nervous system, leading to moving out of that sympathetic fight-or-flight response.

John Horton:

Now, what about it improving sleep? And I've read some stuff there where, just kind of that heating-cooling effect … so if you're in that warm water and then you hop out, you feel so drowsy all of a sudden.

Dr. Melissa Young:

So don't hop out because your blood pressure may decrease and we don't want lightheadedness. But yes, so we've known for a while that whether it's a hot bath or a hot tub, heating up our core temperature, maybe an hour or two before bed, that cooling process triggers the relaxation response. And it's a trigger in some ways as well for the body to think about time for sleep, and then you're more easily able to fall into the sleep as your body cools.

John Horton:

Yeah. And I know you've been on the podcast before, and we've kind of talked about the sort of meditative things you can do.

Dr. Melissa Young:

Yeah.

John Horton:

It seems like if you're going to make a habit out of this, as far as the therapeutic thing to do, setting it up kind of maybe in those hours before bedtime, it might be a good way to go.

Dr. Melissa Young:

I agree. I agree.

John Horton:

Well, you've given us some really good incentives to schedule some hot tub time.

Dr. Melissa Young:

Mm-hmm.

John Horton:

But yeah, let me ask you this. Can you even overdo it and maybe get too much of this good thing?

Dr. Melissa Young:

I think you can. So, one, we want to think about temperature, we want to think about time in the hot tub. Typical temperatures are about 104 degrees [Fahrenheit], though I found it interesting that some of the studies ... there was one out of Japan that showed the more consistent use of hot tub therapy with impact on cardiovascular markers, the temperature was 107 degrees.

John Horton:

That's a little hotter than what they recommend.

Dr. Melissa Young:

A little hotter, yeah. But for more, what we call “recreational use,” 104 degrees. Probably about 15 minutes, 15 to 20, using your body as a guide. You don't want to feel overheated or dizzy or nauseated. Then, it's time to get out. So those are some of the guidelines.

John Horton:

OK, well, that makes a lot of sense. Because sometimes, you're prone to just sitting in there.

Dr. Melissa Young:

Yes.

John Horton:

You end up with those pruney fingers and you don't want to get out. But it sounds like you really do need to kind of cut it off after a little bit.

Dr. Melissa Young:

I think those are, for the average person, a good guideline. I mean, if someone is younger, super healthy, they might be able to stay in longer without any adverse effects. But it's knowing kind of your health history and your tolerance to heat.

John Horton:

Well, it sounds like you don't want to boil yourself there. You don't want to be that lobster in the pot.

Dr. Melissa Young:

It's true.

John Horton:

So I mean, can you work this in daily? I mean, if you do these limited sessions, is that something that you could do? Or should you try to limit it to a few times a week?

Dr. Melissa Young:

I think for the average person, if they wanted to do it daily, and there's no contraindications, which of course, with medical conditions, wanting to talk to your health provider, but I think for the average person looking for that muscle relaxation, stress reduction, it's fine if you want to do it daily. But a couple times a week is probably ideal.

John Horton:

And you said the real key is to make sure that water temperature doesn't get too hot because if it gets a little over 104, you start running the risk of dehydration, dizziness, headaches all those-

Dr. Melissa Young:

…hyperthermia, overheating of the body, which actually can be life-threatening for sure.

John Horton:

And that would definitely kill the vibe that you're trying to set with the hot tub anyway.

Dr. Melissa Young:

Yes.

John Horton:

So what's some other potential bubble trouble that you can get into in a hot tub?

Dr. Melissa Young:

Well, I mean, we do have to be conscious of that. So those people, say, with low blood pressure, since it's going to potentially lower your blood pressure more, need to be very careful. I would avoid it in pregnancy. You don't want to go in with any open wounds or sores. If you've had a gastrointestinal or diarrhea illness recently, I would avoid going into the hot tub.

John Horton:

Nobody needs that shared in the water.

Dr. Melissa Young:

Exactly. And definitely no sedatives, no alcohol while using a hot tub. The other big thing is not all hot tubs are maintained properly, and you can get skin infections, lung infections — so that's not fun either. If possible, looking at the maintenance records, making sure it looks clean. You don't have the film or bubbles that seem to not look clean. You want to be prudent with what hot tub you're using.

John Horton:

Now, you had mentioned alcohol, which I know a lot of people, when you are kicking it and using one, a cocktail or beer may come out. What's the big risk that you run if you mix those two things together?

Dr. Melissa Young:

Well, one, when you're drinking alcohol, you're less aware of your tolerance for heat. And so that concerns me that you'd stay in longer and not be aware that you were overheating or not feeling well. And then, there's always a remote risk with alcohol of drowning. So I don't think those mix, I would wait until you're done with ... especially if you're on vacation, wait until after the hot tub and then have your beer or libation.

John Horton:

Yeah, yeah. That stuff can sneak up on you a little bit.

Dr. Melissa Young:

It can.

John Horton:

Especially when you're sitting in there and it's a little dehydrating, like you said, with the hot water.

Dr. Melissa Young:

That, too.

John Horton:

And add the alcohol in, and it just kind of doubles the effect.

Dr. Melissa Young:

It does, it does.

John Horton:

What about one thing you always hear is hot tubs and sperm health, that it's just not the best thing for it. If you're looking to conceive, is that something you should avoid if you're a guy?

Dr. Melissa Young:

Yes. If you're looking to conceive, you want to avoid hot tubs and hot baths because that impacts fertility. The changes are transient, so I mean, they're going to reverse and go back to normal, but if you're trying to conceive, I would avoid that altogether during that time.

John Horton:

And it's an interesting segue, but what about kids in hot tubs? That's something they're always drawn to it. It's like a fun little pool with all these jets. I mean, should you let kids go in there? What should you do to make sure that they're safe and everything's good?

Dr. Melissa Young:

Sure. So, no kids under 5, for sure.

John Horton:

Wow, how come?

Dr. Melissa Young:

I think that one, increased risk of drowning. They're going to be more sensitive to becoming overheated. And again, they're less aware at that age of discomfort or understanding that they're not doing so well in the heat. If, say, 5 or over, you want to bring your kids into the hot tub, it's going to be for a much shorter time, maybe five, at most 10 minutes, and ideally a lower temperature. Because little people just have a different physiology and more of a risk of drowning, so you have to keep a really close eye on them as well.

John Horton:

And I got to say, and if you're looking to relax in a hot tub, too, kids also kill that relaxing feeling you've got around it. So limiting their time might be the best thing on top of that.

Dr. Melissa Young:

For adults and the children, right.

John Horton:

So what else should we think about when you're looking at whether to maybe consider adopting a hot tub routine? I mean, what would be the reasons to go and do it?

Dr. Melissa Young:

So I would probably put aside, for the most part, the potential benefits that we talked about of cardiovascular disease and metabolic health, because that really requires warmer temperatures that may not be comfortable, a very consistent practice. I think about hot tub therapy as something that you're going to be doing for fun, relaxation, if you have more chronic muscle tension or you are more active or an athlete where that's going to be partially therapeutic but also enjoyable. That's how I think about it.

John Horton:

All right. Well, it sounds like we all could look at hot tubs a little bit differently here because there are some good things that you get out of it.

Dr. Melissa Young:

Yeah.

John Horton:

Any chance I can get a prescription for a hot tub that maybe my health insurance will cover?

Dr. Melissa Young:

So for some people who have medical conditions, a letter of medical necessity can be helpful. It's a good question in terms of whether insurance would cover that, versus you could think about, "Well could it be taken off, deducted from taxes as a medical deduction?" So I'll get back to you on the specifics of that, but I have heard of that.

John Horton:

Yeah, well it's worth a shot. We'll have to talk offline, maybe.

Dr. Melissa Young:

We'll talk offline, for sure.

John Horton:

Wouldn't mind having one in the back there, though. It could work.

Dr. Young, I appreciate you coming in. I always feel like in these conversations, I always feel so good, and my face hurts, we laugh so much.

Dr. Melissa Young:

We do. Good for that stress reduction as well.

John Horton:

Who needs that hot tub? I can just talk to you more.

Dr. Melissa Young:

I feel the same way.

John Horton:

All right. Thanks a lot, Dr. Young.

Dr. Melissa Young:

Thank you.

John Horton:

Hot tubs certainly offer some splashy fun, but there's more to them, too. Whether it's calming your mind, soothing sore muscles or improving blood flow, just remember to responsibly enjoy your hot tub escape.

If you liked what you heard today, please hit the subscribe button and leave a comment to share your thoughts. Until next time, be well.

Speaker 3:

Thank you for listening to Health Essentials, brought to you by Cleveland Clinic and Cleveland Clinic Children's. To make sure you never miss an episode, subscribe wherever you get your podcasts or visit clevelandclinic.org/hepodcast. This podcast is for informational purposes only and is not intended to replace the advice of your own physician.