Many people swear by weekly (or even close to daily) sauna use to support overall health. There are different types of saunas to choose from, including traditional dry saunas, infrared saunas and steam saunas. In this article, we will explore the use of traditional, dry saunas and infrared saunas for people with ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome). Steam saunas, while they do work up a terrific sweat, can expose you to vaporized chemicals such as chlorine, unless the steam is from purified water. Since using purified water is uncommon in gyms and spas, we will stick to the other two types of sauna.
One 2018 review  discusses the use of saunas for overall health, particularly with regard to traditional dry saunas, showing that consistent use is widely beneficial for the general population. Traditional, dry sauna use has been shown to lower the risk of high blood pressure, vascular diseases, pulmonary diseases, and neurocognitive diseases. It may even help with weight loss. But is it good for people living with ME/CFS?
Different Types of Saunas for ME/CFS Patients
For some people with ME/CFS, sitting in a traditional, dry sauna — which are typically heated to between 170 and 210 degrees Fahrenheit — is just too much. It can be as exhausting as strenuous exercise, and cause post-exertional malaise (PEM) . But using an infrared sauna is a great alternative to traditional, dry saunas. Infrared saunas are gentler, and may help people with ME/CFS build their tolerance to heat exposure.
In contrast, infrared saunas are cooler than traditional, dry saunas. They are typically heated to around 120 degrees Fahrenheit (with some variation). The infrared light penetrates several centimeters into the body (deeper than the hot air in a traditional sauna), and stimulates sweating at lower temperatures. People can usually tolerate more time in an infrared sauna than a traditional one, and sometimes can work up a better sweat. Because infrared saunas may be better tolerated than dry saunas, they might be better suited to aid in the body’s detoxification efforts. In general, the benefits of sauna use are powerful enough to make gradual exploration worth a try.
Benefits of Sauna Therapy for ME/CFS Patients
1. Sauna Therapy for Detoxification:
One of the primary ways saunas confer benefits is through sweating. Sweating is nature’s simplest detoxification pathway, as it utilizes our skin, avoiding taxing our liver or kidneys. When we sweat, our body dumps toxic metals, pesticides, pharmaceutical residues, and other harmful molecules out through our sweat glands. Basically, the more you’re able to sweat, the better you detox.
Functional medicine doctors and naturopaths seem to agree that the myriad of chemicals, metals and pesticides we are exposed to in modern life are great contributors to the rise of chronic illness. There is almost no way to avoid some contact with poison chemicals in this day and age, unless you live on a self-sustaining organic farm (and even then it’s still questionable). People with ME/CFS often have a hard time exercising enough to work up a good sweat. And everyone’s liver and kidneys could use a break due to the chemicals most of us are regularly exposed to as part of living in an industrialized society. The sauna offers a gentler alternative to exercise that may be tolerable, especially in small doses initially.
2. Sauna Therapy to Support Mitochondrial Health:
Besides sweating, saunas offer another important health benefit. This one is especially of interest to those healing ME/CFS. One 2017 study  shows heat stress stimulates mitochondrial biogenesis in skeletal muscle. In other words, heat exposure caused mitochondria in skeletal muscle to multiply. Mitochondria  are little cell organelles responsible for creating the molecule ATP— our body’s most important energy source. More healthy mitochondria means more energy.
Mitochondria actually respond quite well to some levels of stress, and in the case of saunas, it’s heat. This kind of low-level, beneficial stress is called hormesis.
Hormesis stimulates mitochondria to grow bigger and stronger, and to multiply. Essentially, mitochondria adapt to the stress load, and the adaptations are beneficial to our health. Hormesis increases the amount of energy available in the body. Heat-related hormesis may be a reason why ME/CFS patients have shown a subjective improvement in fatigue after repeated sauna use — both using far infrared saunas and traditional dry saunas.
3. Sauna to combat depression and anxiety
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Sauna use has been shown to stimulate the release of endorphins in the brain, and make receptors more sensitive to those endorphins. This may help with symptoms of depression and anxiety, which can affect some people with ME/CFS. A 2015 study  showed that people with ME/CFS symptoms showed a subjective decline in negative mood after a period of traditional, dry sauna treatment.
Contraindications for Sauna Use
If you’re interested in incorporating sauna therapy as part of an ME/CFS treatment protocol, note that there are some contraindications for use:
- Use cautiously if you have orthostatic intolerance issues , including POTS (postural orthostatic tachycardia syndrome), or are intolerant to heat. Ask your doctor for advice before undertaking any kind of thermal therapy.
- If you’re pregnant, have a high-risk pregnancy, or aren’t accustomed to sauna use, you should check with your doctor before trying it.
- If you have a heart condition or are at risk for heart attack, please consult with your doctor.
- Talk to your healthcare professional if you have a bleeding disorder, such as hemophilia. Sauna therapy may not be right for you.
- If you have other chronic, medical conditions, please talk to your doctor before attempting to use a sauna.
People with ME/CFS may tolerate infrared saunas more easily because they can begin with a lower temperature setting to avoid overtaxing your system. However, because of the difference in temperature, traditional saunas most likely stimulate greater heat-related hormesis, so you may be unable to tolerate them without experiencing a setback  or crash.
It’s worth experimenting with both kinds of saunas, and seeing what your body likes best. There is never a one-size-fits-all-approach in healing. Maybe you will choose a mix of infrared and traditional sauna use. Or, maybe one will work for you much better than the other. Trust your body, and go with what feels good.
Shona Curley lives and works in San Francisco. She is co-owner of the studio Hasti Pilates, and creator of the website www.redkitemeditations.com. Shona teaches meditation, bodywork and movement practices for healing Lyme disease, chronic illness and pain.
Laukkanen JA, Laukkanen T, Kunutsor SK. Cardiovascular and Other Health Benefits of Sauna Bathing: A Review of the Evidence. Mayo Clin Proc. 2018; 93(8): 1111–1121. doi:10.1016/j.mayocp.2018.04.008 
Masuda A, Kihara T, Fukudome T, Shinsato T, Minagoe S, Tei C. The effects of repeated thermal therapy for two patients with chronic fatigue syndrome. J Psychosom Res. 2005;58(4):383–387. doi:10.1016/j.jpsychores.2004.11.005 
Tamura Y, Hatta H. Heat stress induces mitochondrial adaptations in skeletal muscle. J Phys Fitness Sports Med. 2017 Feb 21; 6(3): 151-158. doi: 10.7600/jpfsm.6.151 
Soejima Y, Munemoto T, Masuda A, Uwatoko Y, Miyata M, Tei C. Effects of Waon therapy on chronic fatigue syndrome: a pilot study. Intern Med. 2015; 54(3): 333–338. doi:10.2169/internalmedicine.54.3042